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NOT AN EASY
DECISION TO MAKE
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When you're headed into the operating room for a complex
procedure, it's probably not a good idea to have your surgeon mad at you.
But that's the quandary I faced a few weeks ago when I had both of my knees
replaced.
It all began at my pre-op appointment, two weeks prior to my
surgery. After going through all the details with the Physician Assistant
(PA), I was fully informed and ready for the big event.
"One more thing," the PA said. "The doctor would
like to talk to you about something."
I was honored. I'd only met the man who was going to invade my
body once before. He'd been highly recommended but didn't have time to deal
with details. His assistants could do that. But now he wanted to see me.
After waiting another 20 minutes, he wandered in, all smiles.
"I wanted to see if you'd be willing to participate in a study,"
he said.
He went on to explain that he was doing a study on bilateral
knee replacement patients where he installs the tried and true implant,
called a posterior stabilized (PS), into one knee, and installs a newer
version, called a medial congruent (MC), into the other knee. They don't
tell you which knee got which implant, and then in a year you tell them
which knee feels better.
"I'm fairly certain you won't notice a difference,"
he said in his best snake-oil salesman voice. "But we need to do the
study to affirm our opinion."
To be a viable study, he needed 100 victims---I mean
candidates. He already had 68 and hoped I would be number 69. I asked him
what percentage of patients agreed to do so, and he replied about 60%.
He showed me models of the implants. The functions were
identical, but they looked very different. Both have been approved by the
FDA. The newer version, which has been around for about five years, was
supposed to make your new knee feel a little more "normal."
"I think it's negligible," he said with a shrug.
"I seriously doubt you'll feel a difference."
I wasn't happy. I didn't need this complication. I knew he
would be grateful if I elected to participate, and I assumed he'd take a
greater interest in my case. And if I refused? Out with the old, in with the
new.
"You don't have to decide today," he said, handing me
the agreement I would need to sign. "I'll see you right before the
surgery and you can make your decision then."
What would you do? I understood the value of research and felt
an obligation to participate for the benefit of all the future knee
replacement patients. Here was a chance to do my little part in advancing
medical technology, just like those 68 other guinea pigs.
I was torn. It was also a chance to bond with my surgeon, who
might actually take the time to notice me if I participated in his study.
And if I refused---who needs a jilted lover cutting into you?
I had two weeks to make up my mind. I talked to a bunch of
people about it and got lots of opinions. When I arrived at the hospital for
my surgery, I was comfortable with my decision.
"FIND ANOTHER GUINEA PIG, BUDDY!" I cried when the
surgeon walked in and asked again if I wanted to participate in the study.
"I'M NO LAB EXPERIMENT!"
Well, I didn't say it quite like that. I patiently explained
that while I fully appreciated the importance of medical research and would
very much like to provide valuable information for future patients, I also
know how my mind works. Knowing I had two different implants in my knees
would create a lot of very much unwanted anxiety.
"Are you mad at me?" I sheepishly asked after I
explained my reasons.
I don't remember him answering, but I think he smiled. And then
off he went.
I only saw him once more, the morning after the surgery. He
came into my room and spent a grand total of 30 seconds with me. I did
manage to ask him which implant he put in my knees, the PS (older one) or
the MC (newer one).
"The MC," he replied as he walked out the door.
"I'm sure it will be fine."
I guess I get to be an experiment after all. I just hope he
didn't choose the MC out of spite.
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