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I have been thinking about the two threads about complication rates and how to use that information and the universe of information that is not readily in hand and etc. etc..
I am coming to think there is very little in common between a consult about an adult AIS case and that for a kid. If you made it to adulthood then there is likely always going to be some level of electiveness about your case. Some folks, though, due to pain or extreme progression, will have less apparent choice at least. But for the bulk of adult AIS cases, I think surgeons mince around a bit correctly because they have to balance the complications with the fact that the person is actually still alive and came to their office.
This mincing is appropriate because it is a true balancing act for many adult patients it seems.
At the other end of the spectrum, I have dealt with two surgeons with my kids. There was ZERO mincing around on the part of either one. The cases were such that I was not presented with anything I recognized as a choice though that could be my perception. Frankly, you don't have to be a surgeon to see where this was going definitely in the one case and almost certainly in the other. I am forever grateful to both surgeons for not mincing around. Now of course their knowledge base is always going to be imperfect but they balanced the risks and uncertainties with the likely outcome for two teenagers near the end of their growth.
Quality of life matters critically to a teenager (and to everyone except monks I guess). You only go around once. This operation not only probably saved their lives and health but allowed them to have a childhood. We traded a certain bad present and certain bad future for a quasi-normal present and uncertain but hopeful future. That's a no-brainer for me. Life is a crapshoot and we make the best decisions we can at any moment. And life is fundamentally and intrinsically unfair. Accepting that and making the best of it is all we can do.
I am coming to think there is very little in common between a consult about an adult AIS case and that for a kid. If you made it to adulthood then there is likely always going to be some level of electiveness about your case. Some folks, though, due to pain or extreme progression, will have less apparent choice at least. But for the bulk of adult AIS cases, I think surgeons mince around a bit correctly because they have to balance the complications with the fact that the person is actually still alive and came to their office.
This mincing is appropriate because it is a true balancing act for many adult patients it seems.
At the other end of the spectrum, I have dealt with two surgeons with my kids. There was ZERO mincing around on the part of either one. The cases were such that I was not presented with anything I recognized as a choice though that could be my perception. Frankly, you don't have to be a surgeon to see where this was going definitely in the one case and almost certainly in the other. I am forever grateful to both surgeons for not mincing around. Now of course their knowledge base is always going to be imperfect but they balanced the risks and uncertainties with the likely outcome for two teenagers near the end of their growth.
Quality of life matters critically to a teenager (and to everyone except monks I guess). You only go around once. This operation not only probably saved their lives and health but allowed them to have a childhood. We traded a certain bad present and certain bad future for a quasi-normal present and uncertain but hopeful future. That's a no-brainer for me. Life is a crapshoot and we make the best decisions we can at any moment. And life is fundamentally and intrinsically unfair. Accepting that and making the best of it is all we can do.
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