“To cut or not to cut” is the ultimate challenge for any surgeon confronted with a
patient who suffers from unclear abdominal symptoms. The decision of initiating appropriate
and timely care with a surgical blade, weighed against the risk of delayed or negligent
care by choosing observation or non-operative treatment reflects the eternal “moment
of truth” for any surgeon on call. The current widespread fear of medicolegal litigation
led to a modern practice of defensive medicine under which–as collateral damage–a
surgeon’s experience and “common sense” approach has been all but extinguished. Who
would be opposed to obtaining a CT scan for every unclear abdomen these days?
It’s time for a wake-up call. Schein’s Common Sense book series provides a refreshing,
pragmatic and compelling advocacy for providing appropriate timely care to individual
patients guided by practical tips and tricks, clinical decision-making, and sound
judgment. The brand-new 4th edition of the Emergency Abdominal Surgery textbook (Box)
brings Moshe Schein’s classic “Common Sense” series to a new pinnacle of quality and
value for the reader. Building on the legacy of the three preceding editions, the
new textbook expands into unchartered territory by emphasizing new concepts and modern
developments, including an emphasis on the evolving role of laparoscopic approaches
in the Acute Care Surgery paradigm.
Book information “Schein’s Common Sense: Emergency Abdominal Surgery“ (4th edition).
Edited by Moshe Schein, Paul N. Rogers, Ari Leppaniemi, Danny Rosin, Jonathan E. Efron;
TFM Publishing, Shropshire, UK, 2016. (ISBN: 978-1-910079-11-9)
The 4th edition has been significantly updated and features three new editors, additional
authors, and new chapters. All existing chapters were extensively revised, expanded
or rewritten. The main value of this encompassing textbook of 752 pages consists of
the practical information conveyed to surgeons “in the trenches” by internationally
renowned experts who have “seen it all and done it all.” The pragmatic approach of
providing valuable technical tricks, decision-making algorithms and intraoperative
bailout strategies is facilitated by the editors’ unwavering humorous style that has
been established in the preceding editions as well as in other textbooks in the same
series (e.g. Schein’s Common Sense
Prevention and Management of Surgical Complications, TFM, 2013, ISBN 978-1-903378-93-9).
Each chapter opens and ends with pertinent quotes, helpful mnemonics and suitable
jokes that convey the content in a memorable fashion. The book’s “common sense” approach
is amplified by the editors’ unique sense of humor that occasionally challenges our
perception of political correctness (e.g. “There are two things in life that we will
never understand: women and acute appendicitis.” or “You can’t make chicken salad
out of chicken shit”). Impressively, the editors are able to walk the narrow margin
of a sound sense of humor by continuously making fun of themselves, as portrayed in
the opening cartoon that depicts the editors from an unfiltered human perspective
(notably, with a bottle of milk, vodka, single malt whiskey and Italian wine on the
editorial board desk). The need to have some fun to establish an honest and transparent
educational approach is substantiated by the editors’ unquestionable credibility.
The opening quote in the preface states suitably:
“Common sense and a sense of humor are the same thing, moving at different speeds.
A sense of humor is just common sense, dancing. Those who lack humor are without judgment
and should be trusted with nothing.”
The professional drawings that illustrate the textbook from A-Z have been comprehensively
published in The Little Book of Surgical Cartoons (TFM, 2016, ISBN 978-1-910079-34-8).
Clearly, these cartoons apply the final touch to a work that has been unequivocally
cast in stone with the 4th edition as a “classic” among all available textbooks of
surgery.
From a patient safety perspective, all 50 chapters focus on practical algorithms and
technical tricks to keep our patients safe. In addition, common complications and
respective bailout strategies are described in sufficient detail to allow even for
junior surgeons on call to “get through the night” safely. Most importantly, this
textbook allows surgeons to navigate the dangerous waters and temptation of providing
unneeded surgery as one of the first and foremost root causes of preventable harm
for our patients. In this regard, the final chapter on the “Aftermath and M&M meeting”
provides the final authority from a patient safety perspective and strong imperative
for open transparent reporting and analysis of all complications that occur under
our watch, whether by errors in judgment or surgical technique, or both.
In summary, this exemplary textbook in its updated and expanded 4th edition represents
an absolute “must” for the junior trauma and acute care surgeon on call, and an easy
and entertaining read for any other adjunctive specialties (e.g. internal medicine
or emergency medicine physicians) at risk of being confronted with the eternal conundrum
in medicine: managing the patient with an acute and unclear abdomen.