This post is a tribute to the families of our patients. To all families of all patients we care for. My thoughts especially go to the families whose relatives had a bad outcome, experienced a severe complication or who sadly did not survive surgery.
Being confronted with the need to undergo cardiac surgery is a burden not only for the patient himself but for his whole family, too (in this context I consider “family” all people in a close and trusted relationship with the patient).
Families go through many feelings before, during and after surgery. Family members can support and encourage the patient in the decision to undergo surgery but can also express their fears, can feel terrified by negative thoughts, some ultimately may express themselves against surgery, too.
One thing is for sure: the impact of cardiac surgery on the family is significant.
I know from my own experience the feeling of having contributed to a decision towards surgery of one loved person and … then of the waiting for the news from the surgeon. These mixed feelings are engraved in my brain and soul.
The good outcome, by far the most frequent scenario, resolves most tensions. Family and patient are relieved. This doesn’t automatically result in a smooth recovery process as the burden of the family caring for a freshly operated patient remains significant. It decreases, however, with time and progressing patient recovery. Good will, positive attitude and bilateral understanding of the specific individual issues are the ingredients for a smooth end of the postoperative period.
Despite all efforts and progress in medicine bad outcomes still occur. This situation is tough. Extremely tough for the family I dare say. Severe impairment of the quality of life or death during or shortly after surgery are devastating news. A whole world collapses within minutes. All possible reactions can occur, from aggressive behaviour to loss of emotional control or acute depression. Conflicts can arise, either directed towards the surgeon or towards other members of the family or even self accusations for having influenced the patient in one or another way regarding the decision to undergo surgery (which now can be questioned).
We, as surgeons have to stand by the families and try to do our best to help them deal with this situation. It is tough for us too, it is a personal defeat. However for those families the situation is by far tougher and more painful. Many questions arise and we must answer them honestly, with calmness, sensitivity and empathy.
I pay my full respect to all those families who go through the emotional stress of deciding, waiting and dealing with difficult situations. Those families who most unfortunately have to mourn the loss of a loved one deserve and get my deepest respect and understanding.
PS1 For the reader of this post might be important to know, that the surgical team is debriefed after each fatal outcome. These cases are analyzed in many instances. Decisions and technical choices are challenged. We offer psychological support to all families who accept it or express themselves in this direction. Psychological & debriefing support is also offered to the medical & paramedical team involved.
PS2 A heartfelt thanks to Arianna, Francesca and Verusca. My respect to the families of our patients has been accompanying me from the very beginning of my career, my encounter with you, however, and your graceful attitude despite the pain and suffering inspired me to write this post. Thank you.