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Second opinions--strongly suggestive, however, of the oldtime doctor-knows-best approach (women, especially, should beware). One good point is made at the start: the two viewpoints presented here on various surgical procedures are those of the internist and of the surgeon--because surgeons tend to agree with one another. The differences arise, in short, between medical and surgical treatment. The authors, both from Yale Medical School, take up 18 medical problems usually treated by surgery, in order to: 1) teach us about the condition; 2) tell us what some options might be; or at least 3) how to go about finding some alternatives. But in many cases the authors' own attitudes are just what patients are trying to escape in looking for another opinion: they utilize some time-worn surgical sayings (gall bladder disease sufferers are generally ""fat, forty, flatulent, and female""), some adjectives that are disappearing, fortunately, from careful medical speech (""a high-strung fifty-eight-year-old woman""), and some outdated or disproven medical myths (""the uterus is not a sexual organ, per se, and has little to do with enjoyment of sex""). More disturbing, they seem to be unable to see where their attitudes may have affected their own observations. On the treatment of breast lumps, they write: ""although many surgeons claim that [the two-step procedure] is a better psychological preparation, it has been the authors' experience that many patients prefer to be managed in the more traditional fashion."" They also tend at times to forget their purpose: a chapter on hemorrhoids ends by saying that ""before surgery is suggested, the patient should be aware that there are many other alternatives""--but those alternatives have not been mentioned. For more careful attention and guidance, try the Prevention Guide to Surgery and Its Alternatives.

Pub Date: April 21st, 1981
Publisher: Macmillan