Empty vessels make the most noise!

Good evening from rather a cold UK!

Today’s blog is based on my experience at a recent colorectal conference I attended in the Kings college London. I usually attend the DDCRS every year as I find it an engaging and useful conference that talks about the lesser talked about colorectal disorders that are nevertheless common in one’s practice!!

This year was no different – an excellent lineup of talks on diverticular disease, an old foe that remains formidable. It was well attended by a host of experts – true experts who had spent much of their lives operating and treating patients. Some were extensively published – Infact I had the honour of listening to the lead author from DILALA trial – A trial on management options for perforated diverticulitis. Needless to say, the talks, discussions, and the rest were incredible. Kudos to the team for putting up such a great show!

One session was particularly entertaining to me – There was a fairly youngish [ and rather dishevelled looking] surgeon from Copenhagen seated in front of me. After an expert’s talk on the evidence base on Laparscopic Larvage VS Hartmanns / Primary Anastomosis, there was a question and answer session. They say Light travels faster than sound, and some people appear very bright till they open their mouth – that is exactly what happened here!! Our friend from Copenhagen opened his mouth 🙂

After summarising to all the evidence, the experts opionion was that one should tailor the operation to the patient as evidence supports bothways, which is exactly right – But our ” expert” from Copenhagen was not convinced, and he criticised the evidence saying that you should always offer primary resection and anastomosis- Interesting to say the least!!

The Expert who gave the talk replied that, with all due respect, there is no clear evidence either way. I must say he was rather kind on this joker; however,it was wasted on the egomaniac as apparently in his hands, primary resection and anastomosis works every time ….Now I am very skeptical of surgeons who use the term ‘ All the time”, “Zero leak rate”, “100% sucess rate” ect ect – As one of my previous bosses used to say ,” If you have not broken a plate, you have not washed enough!!” – that’s very good advice for surgical meetings !!

Did it stop there? No, it got even more entertaining. The lead author from Dilala Study [ major landmark study published in High Impact journals and quoted even today] explained that he will do an endoscopic leak test after dissecting the phlegmon – well, as per our Pseudo” expert” from copenhagen It was a “useless” test as he has done many and there is a very high [ 50% in his genious hands] false negative rate !! Yes…..a More pausible explanation is this joker does not know how to do a proper leak test :). He even went as far as saying that he has published his results – Which neither me nor any other surgeon in the audience is yet to come across – may be in one of those predatory journals that will publish any form of s**t for money!!

I personally think the experts who gave talks were quite nice and lenient towards this joker. Somebody really should have asked him how many he has done and which journal they were published. If you do 10 cases a year and publish your results in “Cureus,” that certainly does not make you an expert in any way, from or scale – One needs to wake up to reality !!

Fortunately by this time the moderators stepped in to curtail the evening ” entertainment” and microphone was taken away ….

While I admire the ” Self Confidence” [ Or ignorance and probably Lack of Insight] i must admit that I felt rather annoyed by this joker – Having an opinion is fine, but just like your P***s you don’t have to rub it on other peoples face just because you have one!. Secondly One should have some insight and respect – In your tiny hospital in Copenhagen you may be the “boss” , but vast majority of us surgeons not part of your “tiny universe” attended the conference to learn and observe what the real experts are doing – Not to listen to your Crap!!

Subsequently I was speaking to my colleague from UK and we both agreed that this joker would not survive a single MM conference in the UK…..how does he get away in copenhagen….I dont know !!

So remember – Be humble! World is bigger than your tiny universe. Its always the Empty vessels that make the most noise….but they are empty. Real experts let their work, not their ego, do the talking !!

Safe surgery till we meet again

LBS