When I am in the hospital, one of the most common calls I get as a surgical resident is about bleeding.
Most of the time, the bleeding is not life-threatening, and can be managed at the bedside. It is usually a slow ooze from where the patient recently had surgery or still has some sort of a catheter or a tube.
In these situations, it is usually enough to give it more time. Sometimes, I hold pressure over the area, or give medications to help the body form clots more quickly. This works in the vast majority of cases. When I think that it has resolved, I usually ask the nurse to keep an eye on it to see whether the dressing gets wet again.
But, sometimes, it requires a more definitive solution, such as placing stitches at the bedside to bring the tissue together more tightly.
As you gain more experience, you can often tell early on whether conservative management is going to be enough. Other times, if the bleeding is too brisk, you know that no other measures will help and you will have to bring the patient back to the operating room to find and stop the source of bleeding.
But even when I have a strong hunch that this is the case, it is still hard to make the decision that carries so much weight. Deciding to escalate care means that the patient has to go through another operation. It means calling the family to let them know that their loved one had a complication. It means calling the whole team in, sometimes in the middle of the night.
And what if we were to go to the operating room, only to find that there was no significant bleeding? That happens from time to time, too.
So, in often futile hopes that the bleeding will stop with time, sometimes I just hold pressure and wait.
Similarly in life, we all face problems that we know require a more definitive solution. But doing so requires putting other things down or taking time off from other pressing matters. Sometimes, solving the problem takes money, time, or energy that we would rather spend elsewhere, or having uncomfortable conversations.
In these times, our tendency is to patch it up with temporary solutions and postpone the inevitable, such as when the fingers lift off the skin and the bleeding starts again.
I know that I catch myself trying to save time by compromising such things as eating and sleeping. I know that I sometimes make sacrifices in my personal life to be more productive at work. These are not the definitive solutions I need in the long run, but the ones I believe are more urgent in the short-term.
But having completed half of my training, I am beginning to realize that whether in surgery or in life, the right thing to do is always to pause and fix it properly, even if it is much harder or takes more time. No amount of waiting or surface measures can stop the bleeding when the source is much deeper.
We may be able to stay afloat for a while, but sometimes you have to make the right call.
Jason Han is a cardiac surgery resident at a Philadelphia hospital.