Abstract
The surgeon is like the captain of a complex ship that often travels and navigates through some rough waters. Just like with any other leadership position, such as those associated with a business organization, flying an aircraft, a military unit or squadron, or even a sports team, a lot depends on this one person. The direction in which how he or she will steer the ship, which in this case represents the operating theater, through the dangerous and sometimes uncharted seas between life and death, will have substantial effects on everyone involved with the voyage. The difference between the realities of an operating theater and this wrecked ship metaphor is if things go wrong, the only one who is lost and never returns home is the patient. The aim of this chapter is attempt to understand the role of physiology and surgeon’s state of mind on surgical decision-making.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
HCUPnet. Healthcare cost and utilization project (HCUP). 2013 [cited 2015 October 16]. http://hcupnet.ahrq.gov/.
Wiegmann DA, et al. Disruptions in surgical flow and their relationship to surgical errors: an exploratory investigation. Surgery. 2007;142(5):658–65.
Mehtsun WT, et al. Surgical never events in the United States. Surgery. 2013;153(4):465–72.
Kohn LT, Corrigan JM, Donaldson MS. To err is human: building a Safer Health System, vol. 6. Washington, DC: National Academies Press; 2000.
Gawande A, Lloyd JB. The checklist manifesto: how to get things right, vol. 200. New York: Metropolitan Books; 2010.
Lupien SJ, et al. The effects of stress and stress hormones on human cognition: implications for the field of brain and cognition. Brain Cogn. 2007;65(3):209–37.
Driskell JE, Salas E, Johnston JH. Decision making and performance under stress. In: Britt TW, Adler A, Castro CA, series editors; Britt TW, Castro CA, Adler A, editors. Military life: the psychology of serving in peace and combat, vol 1. 2006. p. 128–54.
Cannon WB. The emergency function of the adrenal medulla in pain and the major emotions. Am J Physiol–Legacy Content. 1914;33(2):356–72.
Cannon WB. The influence of emotional states on the functions of the alimentary canal. Am J Med Sci. 1909;137(4):480–6.
Cannon WB, Shohl AT, Wright W. Emotional glycosuria. Am J Physiol–Legacy Content. 1911;29(2):280–7.
Cannon WB. Studies on the conditions of activity in endocrine glands: the isolated heart as an indicator of adrenal secretion induced by pain, asphyxia and excitement. V. 1919. Publisher not identified.
Cannon WB. Studies on the conditions of activity in endocrine glands: the influence of motion and emotion on medulloadrenal secretion. XX. 1927. Publisher not identified.
Mendl M. Performing under pressure: stress and cognitive function. Appl Anim Behav Sci. 1999;65(3):221–44.
Arora S, et al. The impact of stress on surgical performance: a systematic review of the literature. Surgery. 2010;147(3):318–30. e6.
Ahmed A, et al. Effect of distractions on operative performance and ability to multitask—a case for deliberate practice. Laryngoscope. 2015;125(4):837–41.
Mentis H, et al. A systematic review of the effect of distraction on surgeon performance: directions for operating room policy and surgical training. Surg Endosc. 2015:1–12. [Epub ahead of print].
Arora S, et al. The imperial stress assessment tool (ISAT): a feasible, reliable and valid approach to measuring stress in the operating room. World J Surg. 2010;34(8):1756–63.
Joels M, et al. Learning under stress: how does it work? Trends Cogn Sci. 2006;10(4):152–8.
Spencer R, McEwen B. Adaptation of the hypothalamic-pituitary-adrenal axis to chronic ethanol stress. Neuroendocrinology. 1990;52(5):481–9.
Durmer JS, Dinges DF. Neurocognitive consequences of sleep deprivation. Semin Neurol. 2005;25(1):117–29.
Abel T, Lattal KM. Molecular mechanisms of memory acquisition, consolidation and retrieval. Curr Opin Neurobiol. 2001;11(2):180–7.
Backhaus J, et al. Impaired declarative memory consolidation during sleep in patients with primary insomnia: influence of sleep architecture and nocturnal cortisol release. Biol Psychiatry. 2006;60(12):1324–30.
Scoville WB, Milner B. Loss of recent memory after bilateral hippocampal lesions. J Neurol Neurosurg Psychiatry. 1957;20(1):11–21.
Prince T-M, et al. Sleep deprivation during a specific 3-hour time window post-training impairs hippocampal synaptic plasticity and memory. Neurobiol Learn Mem. 2014;109:122–30.
Abel T, et al. Sleep, plasticity and memory from molecules to whole-brain networks. Curr Biol. 2013;23(17):R774–88.
Deary IJ, Tait R. Effects of sleep disruption on cognitive performance and mood in medical house officers. Br Med J (Clin Res Ed). 1987;295(6612):1513–6.
Goldman LI, McDonough MT, Rosemond GP. Stresses affecting surgical performance and learning: I. Correlation of heart rate, electrocardiogram, and operation simultaneously recorded on videotapes. J Surg Res. 1972;12(2):83–6.
Nelson CS, et al. Residents’ performance before and after night call as evaluated by an indicator of creative thought. J Am Osteopath Assoc. 1995;95(10):600–3.
Harrison Y, Horne JA. The impact of sleep deprivation on decision making: a review. J Exp Psychol Appl. 2000;6(3):236–49.
Saletin JM, van der Helm E, Walker MP. Structural brain correlates of human sleep oscillations. NeuroImage. 2013;83:658–68.
Rocklage M, et al. White matter differences predict cognitive vulnerability to sleep deprivation. Sleep. 2009;32(8):1100–3.
Drummond S, Gillin JC, Brown GG. Increased cerebral response during a divided attention task following sleep deprivation. J Sleep Res. 2001;10(2):85–92.
Blum AB, et al. Implementing the 2009 Institute of Medicine recommendations on resident physician work hours, supervision, and safety. Nat Sci Sleep. 2011;3:47.
Oreskovich MR, et al. Prevalence of alcohol use disorders among American surgeons. Arch Surg. 2012;147(2):168–74.
Rosta J, Aasland OG. Female surgeons’ alcohol use: a study of a national sample of Norwegian doctors. [Erratum appears in Alcohol Alcohol. 2005 Nov-Dec;40(6):590]. Alcohol Alcohol. 2005;40(5):436–40.
Schermer CR, et al. National survey of trauma surgeons’ use of alcohol screening and brief intervention. J Trauma Inj Infect Crit Care. 2003;55(5):849–56.
Groote Veldman R, Meinders AE. On the mechanism of alcohol-induced pseudo-Cushing's syndrome. Endocr Rev. 1996;17(3):262–8.
Mendelson JH. Biochemical mechanisms of alcohol addiction. In: The biology of alcoholism, vol. 1. New York: Springer; 1971. p. 513–44.
Gallagher AG, et al. Persistent next-day effects of excessive alcohol consumption on laparoscopic surgical performance. Arch Surg. 2011;146(4):419–26.
Dorafshar AH, O’Boyle D, McCloy R. Effects of a moderate dose of alcohol on simulated laparoscopic surgical performance. Surg Endosc. 2002;16(12):1753–8.
Kocher H, et al. Surgical dexterity after a ‘night out on the town’. ANZ J Surg. 2006;76(3):110–2.
Acknowledgements
There are no identifiable conflicts of interests to report.
The authors have no financial or proprietary interest in the subject matter or materials discussed in the manuscript.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
Copyright information
© 2016 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Latifi, R. (2016). The Role of Physiology and the Surgeon’s State of Mind in the Surgical Decision-Making Process. In: Surgical Decision Making. Springer, Cham. https://doi.org/10.1007/978-3-319-29824-5_3
Download citation
DOI: https://doi.org/10.1007/978-3-319-29824-5_3
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-29822-1
Online ISBN: 978-3-319-29824-5
eBook Packages: MedicineMedicine (R0)