DMCRUZ’S MAR [15-07]:Social Capital as a Tool for Surgery

Medical Anecdotal Report
Index Title: DMCRUZ’S MAR [15-07]
MAR Title: Looking inside the recuperation process of a young amputee through his significant others and doctors
Date of Medical Observation: JULY, 2015
Tag: Social Capital as a Tool for Surgery
Category: Professional/Ethical – Reinforcement


When I was 16 years old, the world was my magic lantern, and by its green spirit of glow I saw and experienced the wonders of childhood. I wasn’t able to miss my childhood and I was able to sing with the birds, read beneath the clouds and see my destiny in grains of sand. I was so carefree playing in the sun and not living a nightmare in the darkness of the soul. Football, basketball, warcraft, ragnarok, yugi-oh deck cards , xbox playstation , getting dirty and all messed up in the rain and mud with my playmates-yes, indeed that was my childhood and looking back on it, it was a happy memory. Why did I reminisce on this? On my tour of duty last week, I came across this 16 year-old-boy from Ilocos Norte who was diagnosed with large spindle cell neoplasm, right knee and he was scheduled for an above the knee Amputation. I was shaken by this and I was looking on how the boy will accept the situation. Putting myself on the shoes of the patient, I was a football player when I was the same age as him and losing my extremities is unimaginable. Unknowingly, I have extended my deep concern with the patient. I kept myself updated on his status and I participated actively on the preparation of his surgery. As I have noticed, even presented with the idea that soon he will lose one of his extremities, he was full of positivity and delight. And looking in to it, I was amazed and starting to question myself where this positivity was coming. The day of surgery came so soon and on my rounds and visit to the patient postoperatively, I saw that there was an abrupt shift of the patient’s atmosphere to gloom. Observing him carefully on the first few days post operatively, he was admixed with feeling of physical and emotional pain. He was on the process of denial, anger, bargaining, depression and trying hard to accept the situation. However day by day, I have felt that he was returning to his usual cheerfulness and positivity. On the other hand,  I have observed that his parents was always talking to him that their support will be never ending, and indeed they were showing it to the patient through words and actions. His father always pull out jokes and happy thoughts about him being discharged and how his other family members were so excited to see him soon. They were telling the patient how they are very thankful that the disease that may take their precious boy away is far gone now because of the successful surgery. With this, I have now finally answered that the source of the positivity of the child pours from the support of his significant others, his primary social network.

(Physical, Professional/Ethical, Psychosocial)
(Discovery, Stimulus, Reinforcement)

Social Capital refers to connection among individuals, social networks and the norms of reciprocity and trustworthiness that arise from them. It is a term used by economists. However in the healthcare settings, it pertains to the whole social aspect of support that a hospitalized patient have. This includes the significant others, relatives , and the primary care givers which also include the doctors , nurses , the heath team with their attitude towards care of the patient before, during and after the illness. It is proven by numerous sociologists that social connectedness is thought to play an important role in overall health and well-being. It was hypothesized that social network size and other measures of social connectedness would predict perceived pain intensity, unpleasantness, and anxiety in patients recovering after major surgical operations and influence postoperative complications and length of stay.

According to a research by Hinshaw et al in Journal of the American College of Surgeons, people with more active friendship networks felt less pain and anxiety pre-surgery and post-surgery. As a result, they used less pain medication, felt less post-operative pain/anxiety and had faster recuperation times. According to the study, Patients with larger social networks were 16% less likely to spend 7 or more days in the hospital. Research findings suggest that the effect of social networks on surgical outcomes can be mediated by their effect on levels of preoperative pain and anxiety.

In conclusion, I came across with the attitude that with the patients significant others, we surgeons should be a part of the patient’s social capital and we need to prepare the patient preoperatively and continuously support them post-operatively by having an active friendly relationship. Trust must be build up in the patient-doctor relationship, and empathy not sympathy must be shown to the patient. Be a pillar of support to contribute positivity on the patient, hence actively participate on their emotional and physical recuperation.

ROJoson’s Notes (17jan20):

Moral support from significant others is important in the restoration of patient’s health and wellness.  The significant others can come from anybody trusted by the patient. Attending doctors and health care staff are equally important as the relatives and friends of the patient.

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