Reconstructive special cases.

"If an operation becomes difficult, it isn't performed properly." -

Boston Children's Hospital, Harvard Medical School

I read these lines on a wall of the operating room during one of my internships at Boston Children's Hospital, Harvard Medical School in 2010, where I was looking in awe over the shoulder and at the golden hands of John B. Mulliken, a surgeon specializing in pediatric facial surgery and a pioneer in the research and treatment of hemangiomas and vascular malformations.

In addition to all the invaluable experience gained during this internship, this simple yet mercilessly "correct" sentence has remained a faithful companion to this day.

Among my patients there are stories of countless, sometimes frustrating previous operations, mostly a succession of the best intentions of the colleagues who had previously treated them and then the lack of the "improvement" the patient had hoped for.

This can (unfortunately) happen.

More than 25 years have passed since my doctorate in 1997 and I have spent a lot of time in hospitals, operating theaters, outpatient clinics, wards and research laboratories:

Most complications happen to patients by fate and nobody, really nobody, can do anything about it, not even the patient. Apart from that, in my experience, this is not the most important thing for patients for a long time - in contrast to doctors who usually ask themselves first and foremost what they themselves did wrong, or could have done differently or at least better. As part of my own training and that of younger colleagues, I dealt with mistakes, harm, guilt and responsibility early on. After all, learning from a mistake is one thing, standing by it, and if a complication has actually arisen due to a treatment error, sticking by the patient in the successful treatment of the complication was an essential part of my many years of training.

In such complex cases, it can be helpful and necessary to involve experienced colleagues from other specialties, to operate together or even to hand over a patient.

And so, for example, patients with complex orthopaedic foot and nerve surgery issues or patients with breast tumors, protracted complaints after breast implants, or dermatological "special cases" come to me in the surgery, or I get on my bike and come directly to the surgery of the respective colleague for a joint interdisciplinary examination and patient discussion - complicated cases require at least a quick, simple and uncomplicated approach.

My referring physicians, liaison physicians and my personal contacts are united by the gratitude of our mutual patients - this network should also be a sustainable safety net for "complicated cases" in the future.