A surgeon's gift of life


TVScope: Your Life in Their Hands, Wednesday, July 27th, 9pm, BBC One

Surgery makes for good television. Images of doctors rooting around in the gooey bits of people's brains and bodies have a way of getting the attention.

It's arguable, though, that the glamorisation of surgery is overdone. Public health doctors, for instance, save many, many more lives than surgeons do.

But their work doesn't involve dashing around in funny hats and gowns, wielding scalpels or making life and death decisions about individual patients.

Perhaps that's why the programme-makers think they don't make good drama or good documentaries, though that may change when the next big epidemic hits and we are depending on public health doctors to help us get through it alive.

That said, it would be absurd to deny that surgeons perform what to the eyes of the lay person are miracles. This three-part series focuses on the extraordinary work of three of Britain's top surgeons.

Last week's programme dealt with two cases of exceptionally severe epilepsy, one in 19-year-old Sarah and one in seven-year-old Harry. Sarah suffered more than 20 fits a day and so at all times had to be with family or friends who could help her.

The programme took us through her three operations at the hands of Chris Chandler, neurosurgeon at King's College Hospital in London. The operations left her with a speech deficit, though not a terribly serious one. She also lost her peripheral vision.

However, the epileptic fits have gone. As far as she is concerned, the cost in impaired speech and vision is worth it. She can, she says, do anything now.

Harry had no quality of life and poor prospects because of the severity of his epilepsy. Many of his fits were life-threatening: they stopped him from breathing and he did not come out of them until more drugs were administered by his parents or teachers. He also had many minor fits a day and the fits were gradually removing his memory. The outlook for Harry was extremely bleak.

Chandler agreed to operate, warning the parents that there was only a 50 per cent chance of success and a risk of brain damage. The outcome was a wonderful, 100 per cent success with no side effects at all.

As Chandler explains, neurosurgeons play for high stakes. If things go wrong, the patient can lose physical and personality attributes. If things go really right, the patient gains an immeasurably better life.

There's plenty of pressure for the surgeons. When emergencies are brought in at night you can't, he says, put them in bed and see how they are in the morning. You've got to do the surgery then and there.

He's up at 6am, even if he doesn't get home from the hospital until 2am. But he's not complaining - he is a man in love with his job.

In this programme the surgical parts were the least interesting, to this viewer at any rate. What really held the attention were the stories of the patients, their families, their hopes and fears and the parents' heroic devotion to their children.

Tomorrow night's programme focuses on the work of John Hutchinson, a spinal surgeon whose patients include a man whose spine has stiffened up so badly it has broken in the middle.

Padraig O'Morain is a journalist and counsellor accredited by the Irish Association for Counselling and Psychotherapy.