The Doctor’s Primal Fear To Err Is Homicide

Part V. The Case of British surgeon (Mr.) David Sellu

Mr. David Sellu, UK colorectal surgeon

The case of David Sellu–a Black surgeon–has bearing on the issue of the doctor’s primal fear.

During a winter evening at private Clementine Churchill Hospital in Harrow outside London, colorectal surgeon David Sellu’s clinic was busy. An orthopedic surgeon asked him if he would see one of his patients. An hour later, he came to meet the man whose death would turn Dr. Sellu into a convicted criminal serving 15 months in a prison cell.

The new patient was a 66-year-old man named James Hughes–who had recently had a knee replacement–was now complaining of abdominal pain. Sellu recalled shaking hands with the man–a retired builder from Northern Ireland–and sitting by his bed to talk about how he was feeling. Mister Sellu—at the time was approaching his 70s–explained to Mr. Hughes that he would need painkillers to get him through the night and then have an urgent CT scan in the morning. Note that surgeons are called Mr. [mister] in the UK, unlike nonsurgeon physicians who are “Dr.”

The scan showed Hughes to have a perforated bowel and would need surgery urgently. Mr. Sellu tried to book an operating time, but the earliest he could secure an operating theater and an anesthetist at the hospital was for later that evening. At the last minute, the anesthetist was delayed with another case. Sellu tried, but failed, to find another anesthetist. Hughes’s surgery eventually went ahead, but not until around three hours after the intended slot and well beyond the morning time Dr. Sellu had initially requested.

During the operation Hughes bled considerably more than expected since–it turned out—he was also suffering from cirrhosis of the liver. By the time the surgery was over–and Hughes was transferred to intensive care–it was clear that he would be expected to have serious postoperative problems.

Sadly, it turned out to be a fight against death Dr. Sellu could not win. Patient Hughes died two days later, without ever regaining consciousness. Dr. Sellu was told the bad news by a colleague by telephone.

I chose to use a pseudonym for personal reasons. I’m a retired neurosurgeon living in a rural paradise and am at rest from the turbulent life of my profession. I lived in an era when resident trainees worked 120 hours a week–a form of bondage no longer permitted by law. I served as a Navy Seabee general surgeon during the unpleasantness in Viet Nam, and spent the remainder of my ten-year service as a neurosurgeon in a major naval regional medical center. I’ve lived in every section of the country, saw all the inhumanity of man to man, practiced in private settings large and small, the military, academia, and as a medical humanitarian in the Third World.

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