General philosophy

Abstract

At this moment-just as you pick up this book and begin to browse through its pages-there are thousands of surgeons around the world facing a patient with an abdominal catastrophe. The platform on which such an encounter occurs differs from place to place-be it a modern emergency department in London, a shabby casualty room in the Bronx, or a doctor's tent in the African bush-but the scene itself is amazingly uniform. It is always the same-you confronting a patient, the patient suffering, in pain, and anxious. And, you are anxious as well-anxious about the diagnosis, concerned about choosing the best management, troubled about your own abilities to do what is correct. We are in the twenty-first century-but this universal scenario is not new. It is as old as surgery itself. You are perhaps too young to know how little certain things have changed-or how other things did change-over the years. Yes, your hospital may be in the forefront of modern medicine; its emergency room has standby, state-of-the-art spiral computed tomography and magnetic resonance imaging machines, but, practically, something has not changed: it is the patient and you (often with the entire system against you)-you who are duty bound to provide a correct management plan and execute it. © Springer-Verlag Berlin Heidelberg 2010.