Scary Cases in Otolaryngology

I find myself reviewing this book within hours of operating on the only hearing ear of a university lecturer, scheduled for surgery by a colleague. Finding him, instead, on my operating list, I emulated my juniors and wandered the operating theatre corridors, thumbing a message onto my phone, via this ‘text’ business. ‘I leave it to your clinical judgement’ was his reply.

This brilliant book is filled with anecdotes of such ethical dilemmas, complications, errors and disasters. Obviously, for a US-based book, medicolegal issues and their avoidance are not overlooked (we are rapidly catching up in this regard), but are discussed in a very open and non-confrontational way. Chapter 9 ‘Malpractice Defence from the Expert Witness Perspective’ is packed with sound advice for any clinician facing litigation, hopefully then less scary! The titles of other chapters do convey just how well thought out the content of this book is. ‘Tunnel Vision; Too Little Too Late’, ‘Helping Your Colleague; No Good Deed Goes Unpunished’ and ‘Helicopter Flight; a Scary Tonsillectomy Bleed’ all give a flavour of the text.

The book is based on a series of Scary Cases Conferences that have been held annually on Halloween, since 2011, in Boston. Clinicians are prepared to stand up and bare all, sharing their experiences of when things have gone wrong and the lessons learnt.

Illustrations of surgery and imaging are very well reproduced, perhaps most memorably in ‘Skull Base Injury; a Scary Harpoon’. My favourite chapter illustrated the perils of failing to see the ‘bigger picture’, in a tale of a difficult arterial line, but I will not produce a ‘scene spoiler’.

This is a very entertaining book, but also very thought provoking. A recurrent message is that things can and will go wrong. In such cases, do not be afraid to ask for help, avoid surgery on friends and colleagues, document everything, and learn from your experiences. I loved this book.