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Today's Practice | May 2013

When Disaster Strikes

At 35 weeks pregnant, I did not expect my water to break. But when it did - in the threshold of my doorway, not even 10 minutes after getting home from work - immediately I sprung into action. First, I called my doctor's office to report the news. Second, I called the fitness center and asked the woman who answered to get my husband, who was swimming laps. Third, I made a list of all the belongings I needed to pack in my hospital bag.

It was only after all these things were done and as I waited for my husband to get home that panic set in. I was about to have a premature baby and any number of less-than-optimal outcomes could occur. I worried that our daughter did not have enough time in utero to fully develop; I worried that her heart and lungs would not be strong enough for her to survive or that she would be born with a defect. I worried that a complication would materialize during the birthing process. Although these fears seemed endless, I found courage to push them aside and believe that everything would turn out all right.

I would be lying if I said that I thought this at the time, but looking back on the day of my daughterís birth, I cannot help but draw parallels between my experience and what it must feel like for our readers when a complication occurs in their operating rooms. Perhaps a similar process ensues, a strategic calm before the storm of managing a difficult eye surgery, or maybe the process is reversed, with initial panic followed by jumping into action to develop a concrete plan for a safe and effective procedure.

Regardless of the order in which these thoughts take place, the bottom line is that our natural instincts are to resolve the problem using the tools and devices we have. Sometimes we can do this with a level head, whereas other times panic takes overóeven if for a brief moment.

This month, our cover series explores how ophthalmologists react when disaster strikes in the operating room by showcasing several real-life cases and detailing the outcomes. For instance, Soosan Jacob, MS, FRCS, DNB, shares her resolution of a subluxated cataract, and Kjell U. Sandvig, MD, PhD; Ralf ÿvergaard, MD; Jon K. Slettedal, MD, PhD; and Panagiotis Salvanos, MD, FEBOphth, describe their case of a suprachoroidal hemorrhage. Additionally, Gabor B. Scharioth, MD, PhD, details his managerial strategy for an IOL that, during implantation, damaged the intraocular tissue, and Khiun F. Tjia, MD, provides his strategy for posterior capsular ruptures. The cover series begins, however, with Arthur B. Cummings, MB ChB, FCS(SA), MMed(Ophth), FRCS(Edin); Christopher Gorman, BSc, MB ChB(Hons), FRCOphth; and Ross Hall, BSc, MSc, Cpsychol, detailing steps to develop a winning mindset and avoid stressful situations.

In my case, things could not have gone much more smoothly. I made it safely to the hospital, and 30 minutes later the staff was scheduling my Cesarean section. As the doctors and nurses scurried around preparing for the delivery, I released all of the fears swimming inside my head. I knew that everyone in that room was a trained professional who, like the many ophthalmologists I have had the pleasure of meeting and working with in my time with CRST Europe, would do whatever it took to achieve the best possible outcome. I hope that all of your patients who are faced with an unfavorable complication have as wonderful as an outcome as I did when I delivered a 5 lb, 12 oz, perfect baby girl.