Iatrogenesis - "retained surgical items"

New York Times - Sept. 24, 2012 - When Surgeons Leave Objects Behind:

On an overnight shift in 2005, Sophia Savage, a nurse in Kentucky, felt a crushing pain in her abdomen and started vomiting.

The next day she underwent a CT scan, which led to a startling diagnosis: A surgical sponge was lodged in her abdomen, left behind, it turned out, by a surgeon who had performed her hysterectomy four years earlier.

Ms. Savage’s doctor ordered immediate surgery to remove the sponge.

“What they found was horrific,” Ms. Savage said. “It had adhered to the bladder and the stomach area, and to the walls of my abdominal cavity.”

The festering sponge had spread an infection, requiring the removal of a large segment of Ms. Savage’s intestine. She sued the hospital where the hysterectomy had taken place, and in 2009 she won $2.5 million in damages. But the award has been appealed, and her life has been in tatters. Suffering from severe bowel issues and unable to work, Ms. Savage, 59, has been racked by anxiety and depression. Most days, she said, she cannot bring herself to leave home.

“I never dreamed something like this would happen to me,” she said.

Every year, an estimated 4,000 cases of “retained surgical items,” as they are known in the medical world, are reported in the United States. These are items left in the patient’s body after surgery, and the vast majority are gauzelike sponges used to soak up blood. During a long operation, doctors may stuff dozens of them inside a patient to control bleeding.

Though no two cases are the same, the core of the problem, experts say, is that surgical teams rely on an old-fashioned method to avoid leaving sponges in patients. In most operating rooms, a nurse keeps a manual count of the sponges a surgeon uses in a procedure. But in that busy and sometimes chaotic environment, miscounts occur, and every so often a sponge ends up on the wrong side of the stitches. ….

After Atheism, a 5-part radio series by David Cayley

Friend and interviewer of Ivan Illich, David Cayley has produced a series of quite interesting radio programs about religion for the CBC. They don't specifically mention Illich, but anyone who has listened to Cayley's The Corruption of Christianity radio program or read the accompanying book, The Rivers North of the Future, will likely appreciate this new program a good deal. We have, anyway.

The program is called After Atheism, and it consists of five interviews with thinkers, some believers, some not, who have been delving into religion and faith from a modern point of view. For instance, John Caputo is an expert in the philosophy of deconstruction, as put forth by Jacques Derrida, and he finds that method of analyzing texts very helpful in understanding Christianity. Indeed, he came to the surprising conclusion that Derrida himself had been thinking along religious lines right from the beginning, a thought that the radical and presumably atheistic philosopher eventually confirmed quite explicitly.

William Cavanaugh, meanwhile, has looked carefully at how religion and state relate to each other. Put simplistically, he finds that in certain ways, the state itself has created religion as a foil, as something whose clutches it can claim to have saved society from and thereby justify itself.

James Carse wonders what religion is and finds that belief actually has little to do with it. Instead, the great religions look to him like never-ending conversations, endlessly fascinating to those involved -- and to those on the outside, too -- because they attempt to answer questions -- could a guy nailed to a cross, for instance, really be god? -- that seem impossible to answer. The intent is not actually to answer these questions conclusively -- that would end the conversation -- but to make sure that the questions remain in play, so to speak. This leads Carse to some interesting thoughts on death, too -- and much more.

We're unable to do Cayley or his interview subjects justice. Anyone interested, however, can download and listen to his program as a set of five podcasts, available (at no charge) through the iTunes store or here on the CBC Ideas podcast page.

We highly recommend these shows, and especially to anyone who, like us, has sought to grapple with the religious aspects of Illich's thought. Like many people, we suspect, we came to Illich through his early books, about tools and schools, about hospitals and cars. There, Christian thought was quite implicit, lurking very far in the background. Only the occasional hint shined through - an intriguing citation of Thomas Aquinas in the introduction to Tools for Conviviality, for instance. It was clear enough to his readers that Illich was a Christian believer, but he made a point of never relying on biblical references, for instance, to buttress his critiques of major institutions. He knew better, he would later admit, than to lose his audience that way. Towards the end of his life, though, and largely in the interviews he gave to a well-informed and deeply appreciative David Cayley, he made his religious beliefs more explicit. And looking back, it's quite clear that those beliefs were always there, informing his thought, shaping his understanding much as we, for one, suspected all along but never were quite able to pin down.