Hi! This is Dr. Michael Aaronson, kidney doctor/ simple country nephrologist. Today I'm speaking with Dr. Alan Parks, general surgeon at Alegent Health. Thank you doctor for taking time out of your busy schedule so that we can get to know you better.

Parks: Thank you.

Aaronson: Tell me a little about yourself: where did you grow up, where did you train, and what you do for fun?

Parks: I grew up all throughout the United States.

Aaronson: Why was that?

Parks: My father worked for the Air Force, civil service. We would move approximately every six years. So I've lived in Virginia, Hawaii, Nebraska and Florida. But Nebraska is home. I went to high school here at Bellevue East. I went to college at the University of Nebraska at Omaha. I went to med school at Des Moines University where I found a passion for anatomy and general surgery. I pursued my general surgery residency in Columbus, Ohio.

Aaronson: You've lived in so many places. Why is Nebraska "home"?

Parks: My family lives here. I have spent the majority of my live here. Omaha and its surrounding towns are a great place to raise a family. It's a great place to live and a very friendly city.

Aaronson: I couldn't agree with you more! After all, if it is good enough for Warren Buffet, it is good enough for me! Let's move on: you are general surgeon.

Parks: That's correct.

Aaronson: What kind of surgeries does a general surgeon perform?

Parks: General surgeons perform operations on the following organs: thyroid, breast, anything within the abdomen -- gallbladder, appendix, colon, and spleen. When highly complex operations are required, a specialist is called in. Hepatobiliary surgery would be an example of this.

Aaronson: Ah, I understand. So the more complex the word, the greater the number of syllables per word, and an increased number of words required to explain the operation, makes it more likely that a specialist will be called in.

Parks: That basically sums it up...

Aaronson: Tell me what you do for fun.

Parks: I'm a father of four. So right now I spent my free time raising my children.

Aaronson: Where is your main office located?

Parks: I'm based out of Papillion. My office is located in the Midlands 1 professional building.

Aaronson: I think the Midlands campus is gorgeous.

Parks: I agree. Alegent did a beautiful job. I would call it a true overhaul. I remember Midlands Hospital from before. It is truly amazing what Midlands has become.

Aaronson: Not only does it look nice, but there's also a lot of substance going on behind the scenes. For example, the radiology department has all of the latest and greatest equipment. The intensive care unit is brand spanking new. In addition to bedside care, patients are monitored electronically by critical care doctors for the majority of the day. Efocus has helped me out on many occasions. For example, I was performing kidney dialysis at Alegent Bergan Mercy hospital and was called by a Midlands bedside critical care nurse for a kidney related emergency. Efocus helped stabilize the patient as I drove to Papillion. Another thing I like is the fact that the Alegent pharmacy is now located in the hospital -- it used to be across the street. The pharmacists there are a tremendous resource patients can use for information, and their accessibility can't be beat.

Parks: A good radiology department is critical to the success of a surgeon's practice. Radiology studies help the surgeon know where to go in the body and what to focus on. The radiologists help me to make for example, an exploratory laparotomy less exploratory.

Aaronson: Of all the surgeries you perform, which one is your favorite?

Parks: I love to take out gallbladders, especially those done laparoscopically.

Aaronson: Is there anything else you would like to say about your practice? Anything in particular that you would like the public to know about you?

Parks: My training has prepared me to take care of a variety of surgical diseases. I've been trained to use the latest surgical techniques to give great care to the patients I see. I'm available at Midlands, Lakeside, and Bergen Mercy. I want people to know that I will do everything in my power to take the best care of you possible.

Aaronson: I have had the opportunity to work with you on a few occasions. And your passion to do a great job translates to great care at the bedside. You have a very good bedside manner. You're there for the patient. You spend time with the patient. In sum, you are a really nice guy.

Parks: Thank you.

Aaronson: My pleasure. Well, I appreciate the time you spent today. Agreeing to an interview on a Saturday is above and beyond the call of duty.

So for everybody out there interested in learning more about Dr. Parks, feel free to click here. Alegent.com allows you to schedule an appointment if you wish. Another option is to go through your primary care provider.

My high school friend and I used to love the phrases “it’s not rocket science” and “it’s not brain surgery,” metaphors that allow you to compare any task to what is implicitly considered the most complex, mentally taxing jobs one could ever aspire to.  In medical school—for about 5 minutes, anyway—I set my sites on mastering neuroanatomy.  But when I couldn’t keep straight the differences between the spinothalamic tract, the fasciculus cuneatus, and the pineal gland (and what exactly is brain sand?) I gave up my dream of being a brain surgeon.  My friend, in what I believe was just an effort to spite me, went on to work for General Dynamics as—you guessed it—a rocket scientist.  Since those days when I limped through my neuroanatomy final my friend never let me forget my shortcomings.

A story out of Rhode Island caught my eye this week.  The largest hospital in the state was just fined $150,000 after a surgeon mistakenly performed surgery on the wrong fingers of a patient’s hand.  The penalty would not have been levied had this not been the fifth wrong-site surgery since 2007.  In a previous screw-up a head and neck surgeon managed to operate on the wrong side of a child’s mouth during surgery to correct a cleft palate.  As you ponder how this sort of thing happens you may find yourself thinking “It’s not like it’s brain surgery, after all.”

Actually it is.  As you can see from this chronology I pulled from The Providence Journal, the majority of the incidents at Rhode Island Hospital (and others in the area) involved mistakes made by neurosurgeons.

Dec. 12, 2001: A Rhode Island Hospital neurosurgery resident drills holes in the wrong side of a patient's head, in a procedure to relieve bleeding on the brain. The CT scan was placed backward on the viewing box.

2004: A Miriam Hospital anesthesiologist inserts a catheter on the wrong side of the neck of a patient about to undergo a procedure to bypass a blocked artery.

March 2005: A Women & Infants Hospital obstetrician removes the ovaries of a woman who was supposed to have only her uterus removed, confusing the woman with another patient who had the same last name.

September 2006: A neurosurgeon at Roger Williams Medical Center drills into the wrong side of patient's head in an emergency procedure to drain blood after an injury.

January 2007: A Rhode Island Hospital neurosurgery resident and a nurse place a drain on the wrong side of a patient's head to remove blood.

July 30, 2007: A neurosurgeon at Rhode Island Hospital cuts open the wrong side of a patient's head, also to drain blood.

Nov. 23, 2007: A Rhode Island Hospital neurosurgery resident starts to operate on the wrong side of a patient's head in a bedside procedure to drain blood on the brain. Health Department reprimands the hospital and fines it $50,000.

So, if the brain surgeons can’t get it right what’s the likelihood that the rest of us can?  Every year more than 40 million patients are admitted for surgery at U.S. hospitals, while another 31 million undergo outpatient procedures.  With this volume of surgical arts and crafts shouldn’t we expect that mistakes like these are nearly inevitable in at least a few cases?

If you’ve been a patient for any procedure in the last couple of years you may have noticed a new protocol called a “surgical time-out.”  This is where the entire surgical team halts everything for a moment to verify that they’re doing the correct surgery on the correct site on the correct patient—preferably done while the patient is awake and able to voice any last minute objections.  The surgeon also has to personally mark the site intended for surgery.  A nice wrap-up of the guidelines is available at this link.

When we first initiated this I thought it was a little silly and redundant.  After all, there aren’t many places I can actually hide a pacemaker and most people’s hearts are located in the same general vicinity.  It’s not like I plan to amputate anybody’s limbs or try to drain brain fluid.

But even in my narrow realm every patient is a little different.  The pacer sometimes belongs on the right instead of the left and I occasionally do heart catheterizations through the artery in the wrist rather than in the leg.  Other issues are brought up in the time-outs as well, such as drug allergies (antibiotics are a particular concern), laboratory anomalies (is the kidney function adequate for the dye we use?), and patient-specific preferences (does the patient prefer more or less conscious sedation than usual?).

Since the new guidelines were initiated only 5 years ago it may be too early to tell if there has been a decrease in surgical errors in this country, but I have to believe it will make an impact. 

Let’s hope it does in Rhode Island, anyway—and soon.  Not only have our colleagues there botched up the care of a handful of patients, they’ve also managed to demystify the unimpeachable aura of brain surgeons.  Now if only I could just find some dirt on those rocket scientists.