דיאלוג מעולם אחר – מאמר חמישי בסדרת "ניתוחים על שולחן הניתוחים"
כך זה נראה בחדר הניתוח

דיאלוג מעולם אחר – מאמר חמישי בסדרת "ניתוחים על שולחן הניתוחים"

"תגיד, זה נכון שמיניסקוס לא יכול להתרפא"?  שאלה שנשאלתי אלפי פעמים.

המשך הדיון..

אני: "נכון מאוד. גם שערות שיבה לא 'מתרפאות' סתם כך. תמיד אפשר לצבוע את השיער אבל כולם יודעים שזה לא באמת"

המטופל: "טוב, מה הקשר, המיניסקוס הקרוע עושה לי כאבי תופת, וביטלתי את שביל ישראל בגלל זה. מה זה שייך לשערות שיבה. תהיה רציני"

אני : "ואיך אתה יודע שהמיניסקוס הקרוע גורם לך כאבים? כשכואב לך הראש אתה מאשים את שערות השיבה?"

המטופל (מתעצבן):  "אתה בא להגיד לי שמשהו קרוע בברך, וזה לא עושה כאבים?!"

אני: "אני לא בא להגיד כלום. כל עולם המדע אומר את זה. כל החוקרים בלי יוצא מהכלל"

המטופל (מיואש): "אז בכלל אין פתרון לבעיה שלי? חשבתי שיוציאו את החלק הקרוע והכל יהיה בסדר…

אני:  "בדיוק להיפך! אתה יודע שהחוקרים לקחו 146 אנשים עם קרע ענק במיניסקוס. ל 70 מתוכם כרתו את המיניסקוס, ול 76 אחרים נכנסו לברך אבל לא עשו כלום. עד לרגע הניתוח המנתח עצמו לא ידע אם המנותח יעבור ניתוח אמתי או פלסבו (ניתוח דמה). רק אחרי שהמנותח (שכמובן לא יודע עד היום אם הוא נותח באמת או לא) הורדם, שלפה החוקרת פתק רנדומלי מהכיס, ושם היה כתוב אם לבצע ניתוח אמתי או לא"

המטופל: "אתה רוצה להגיד לי שהרדימו אנשים ונכנסו להם לברך, בלי לעשות שם שום דבר, רק בשביל המחקר?"

אני: "בהחלט. זה קיבל אישור 'הלסינקי', כי מחקרים קודמים הראו שניתוחי דמה יעילים בדיוק כמו כריתת המיניסקוס"

המטופל (קצת בהלם): "נו , ומה היה במחקר הזה?"

אני: "אתה כבר יכול לנחש. אותם אחוזי הצלחה וכשלון בשתי הקבוצות. אין שום השפעה לכריתת המיניסקוס, פשוט כי הקרע שם אינו גורם לכאבים. אז למה לכרות?"

המטופל (עם זיק של תקוה):  "אבל מה יש להפסיד? הרי המחקר הוא רק סטטיסטי. אולי במקרה שלי הכאבים כן קשורים לקרע. המנתח אמר לי שאני יכול לחזור הביתה באותו יום ואחרי יומיים לחזור לעבודה. מקסימום הניתוח לא יעזור, מה הפסדתי?"

אני: "יש לך להפסיד את הברך שלך. אתה יודע שכריתת המיניסקוס מעלה באופן משמעותי את הסיכוי שתעבור בהמשך החיים החלפת ברך? זה נשמע לך סיכון משתלם?"

המטופל: "אז מה עושים?"

אני: "קודם כל מבינים. תפנים את כל מה שאמרתי לך, תעשה קצת תרגילים פשוטים, ובעז"ה עד מהרה תחזור לשביל ישראל"

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