Welcome back to Dr Paul McCoubrie’s a 'view from the dark side' — a series looking at the world of surgery through the lens of a radiologist.

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Every few years a campaign is launched to improve the diagnosis of a particular disease. There is often a catchphrase such as, “Think x” or “Could it be y?”, with social media-ready hashtags and bright logos. Campaigns that spring to mind include aortic dissection, sepsis and, oddly, porphyria.

Correspondence to: Martin Storr (email: m.storr@internistenzentrum.de)

Center for Endoscopy

Starnberg

PROTECT is a national platform trial designed to deliver multiple multi-centre randomised and non-randomised comparisons in adult surgical patients. Individual trial components will span phase II to phase IV, depending on the specific research question.

The study will be conducted across NHS surgical services and will include patients aged 18 years and over undergoing care within an NHS surgical pathway.

As a pelvic health physiotherapist, I’ve spent my career standing at the intersection of two worlds—where conservative rehabilitation meets surgical expertise. Working alongside surgeons has taught me not only about anatomy and surgical outcomes, but about perspective: how each of us sees only part of the patient’s journey until we start talking to one another.

In pelvic health, the human story is rarely linear. Patients may arrive years after a traumatic delivery, a hysterectomy, an endometriosis excision, or a prostate surgery—often having navigated layers of medical interventions before anyone asked, “How do you feel in your body” and “Can you use it how you’d like to?”

While a surgeon’s focus is often the success of a procedure—optimal resection, reduced pain, restored structure—mine is on function, integration, and lived experience. Where the surgeon works with a scalpels, cautery and sutures, I work with breath, skilled touch, and purposeful movement—restoring awareness, slowly unwinding guarded tissue and fear. Our work is complementary.

What if—before my life changed forever—someone had told me the real questions to ask that could shape my recovery? What will my days really look like after surgery? What supports should I have in place—physically and emotionally—both before surgery and during recovery?

"Lying on my bathroom floor in the middle of the day, in tears from physical pain and emotional exhaustion, I feared my kids would come home and see me. In that moment, I realized what had never been made clear: even with excellent surgical care, I was unprepared for the lived experience of having a Lower Anterior Resection. As both a survivor and a counselor who now supports others navigating cancer survivorship, I see it over and over. This isn’t a gap in skill; it’s a gap in communication."

At 38, I was diagnosed with thyroid cancer, which resulted in a thyroidectomy. While this was considered a relatively "easy" surgery, the road afterward was far from simple. Trying to find the right balance of hormones created years of emotional instability—a possibility I was never told about.

Correspondence to: Janhavi Venkataraman (email: Janhavi.Venkataraman@hcahealthcare.co.uk; janhavivraman@gmail.com)

The London Breast Institute

Princess Grace Hospital