Surgeries are scary. Many surgeries are long, complex procedures where the patient’s quality of life dramatically depends on the outcome. It is immensely impressive to hear the stories of people close to me who have gone through them. What captures my imagination most is the moment when the anaesthesia starts, and you lose control over a pivotal event in your life. The next thing you know, it will all be over, for better or worse.
Of course, the thought of having surgery without anaesthesia is even more thought-provoking, and anyone having surgery today should count themselves lucky that anaesthesia is even possible. Surgery without it was the norm until the popularization of ether for surgical use by an American dentist in 1846, in a public demonstration referred to as ‘Ether Dome’. It’s worth reading a brief history. Some major procedures are still done without general anaesthesia, like heart catheterizations and brain surgeries. Imagine being awakened after having part of your skull removed so the surgeon can talk to you, while stimulating your brain, to identify the really important bits that they shouldn’t cut out.
In stark contrast, surgeries like mine are routine, have high success rates, and objectively minor consequences for failure. When these surgeries do fail, it’s usually because the patient pulls too hard on something during rehab, long after the surgery itself.
In spite of this, I still felt anxious thinking about my surgery, and couldn’t help but wonder what happens if something goes wrong. Climbers are familiar with this mismatch between perceived fear and genuine risk. Climbing often feels much more dangerous than it actually is. Being afraid and overcoming it is a great feeling, and it’s a big part of what draws me to climbing. It’s only possible to have that feeling over and over again if the the fear itself is misplaced. Climbing taps into that mismatch and gives us the feeling of surviving the scary situation, with only a small chance of actually getting hurt.
But the opposite mismatch also happens. Sometimes climbing is more dangerous than it seems. Sadly, climbers don’t get hurt from the things that are scary as often as they do from complacency with things that don’t feel scary. Not every story is like this, but there are common threads among the tragedies: Being tired on easy terrain but not using protection. Trusting fixed gear without testing. Inattention while rapping or lowering. Random, cruel, bad luck.
The things that I worried about before the first surgery- What are the chances of dying from anaesthesia? (~1/100,000 cases); that they’ll cut a nerve, paralyzing my arm? (1/10,000); that my humerus or scapula will crack? (1/400) ; that I’ll get a joint infection? (1/400)– those are bad, but extremely unlikely scenarios. The risks are more than balanced by what I lose if I don’t take them. I lose the opportunity to keep doing something that I love.
The biggest risks associated with this surgery are things under my control, in the long post-op period. Despite being less attention-grabbing, they are far more real. 1 in 30 patients stretch or rip out their biceps anchor just by using it before it’s fully healed. If I put my arm in an extreme position, I could peel my newly-anchored cartilage off of my shoulder blade and get fluid between the cartilage and the bone. If that happens just once, my cartilage won’t heal. So even though my arm feels pretty good right now, I’ll try to take it slow, and not do anything stupid.