Practice pitfalls: Avoiding 2 out of 3 isn't bad

Near my office, there is a small print shop with an interesting sign on the wall.

Illustration: Ryan Ostrander

It says: "Dear customer: You want our work to be good, fast and cheap. Pick any two."

I have often thought about that sign, and how choosing any two of those options automatically prohibits the third.

I've even thought about putting up something similar in my office. However, I decided that we could never offer such an option. That's because we want all our work to be good. Furthermore, I have a strong aversion to working cheaply. And, lastly, haste makes waste. (To coin a phrase.)

Things go wrong when we try to hurry our work. For example, one day my friend, Chance Deepcut, had a very full surgical schedule. He knew he could finish it if he "pulled out all the stops." He told his surgical technician to speed it up as well.

Things went smoothly until the third procedure, when the spay incision suddenly turned into a surprise cystotomy. Apparently the hurried tech forgot to express the bladder.

Wait a minute! That incident didn't just happen to Chance Deepcut. It happened to you. In fact, it happened to all of us — at least to those of us who have been in practice a few decades.

For another example, let's look to our friend and colleague, Dr. Skewer.

He was doing an open reduction on a fracture and inserting a Steinmann pin. Working the chuck with his right hand and bracing the stifle joint with his left, he worked up a sweat driving that pin through bone.

Moments later, he was rewarded with the sight of the pin protruding through the distal femur right where he wanted it. Unfortunately, that sight included the visualization of the pin protruding from the top of his left hand. But wait! That wasn't Lance Skewer. It was you again, along with all the rest of us. Piercing a bone pin of some sort through the web of tissue between your thumb and palm is a mandatory veterinary right of passage.

If you fail to see yourself in these examples, perhaps you will in what happened to Dr. Pursuit.

She assured the owners of a kitten that it could be safely spayed at 12 weeks of age. Now, in the middle of surgery, she just couldn't find the right parts. Where were the uterus and ovaries? Was this kitten born without the right stuff? Of course not! Dr. Pursuit ... I mean you ... No, I mean all of us ... were spaying a young tom cat.

Oh sure, you can blame the technician who failed to do a pre-op sex check carefully. You could also blame someone else for not checking the bladder on that instant cystotomy case.

However, when all is said and done, the responsibility lies with you.

Now, you may feel that I have been picking on you. You may even claim that you never made any of these mistakes. Frankly, I don't believe you.

However, I'm willing to give you the benefit of the doubt. Maybe you didn't do them all. So, like the sign says, pick any two!

Dr. Obenski owns Allentown Clinic for Cats in Allentown, Pa.