I’m exhausted

I maintain a shortlist of stupid or dare I say idiotic statements given by hospitals top administration to the newspapers. A decade ago, we were in a similar situation as today: a lack of nurses. The solution to this shortage was to bring in nurses from other countries. So far this sounds great, but there is more to this. In the newspapers I learned that the nurses were to be placed in the OR. Again fine, we need to do operations and operate more. The next sentence blew my mind: these nurses were placed in the OR since they did not have to learn Finnish, because no one talks in the OR.

So, basically everyone in the OR, surgeons, anesthetists, nurses and orderlies, work in total silence; maybe listen to radio, but no talking. We don't say a word. Maybe we communicate with hand gestures or perform pantomime. To me, this shows that the hospital administration does not understand what kind of work is done in the OR and especially how the work is actually done. Communication is of the utmost importance in the OR. One of the first things I learned in OR about communication, was that anyone can and should speak out if they notice shortcomings in sterility. This is really, really important.

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.

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.