Look, modern day surgery is pretty great. Don't believe it? Take a look back at the history of surgery to gain a bit of perspective.
In the 1800s Robert Liston, for instance, was famed for the speed at which he could do amputations, being able to whack off a leg in about two and a half minutes. We know this because he'd ask witnesses to "time me, gentlemen" before picking up a bone saw and really going to town on the patient, who of course wasn't anaesthetized. There are stories (some likely exaggerations, some not) that in his rush to get an amputation of a leg over with, he accidentally cut off the testicles of his patient at the same time, and that he once sliced off the fingers of his assistant (not learning from the testical hoo-ha) who then died of gangrene.
He was known as one of the best surgeons out there and had an astonishingly good mortality rate for the time, as speed meant the patient was less likely to die of shock or blood loss. So now that you've got it into perspective that the guy who might hack off your testicles used to be considered the best in the business, let's talk about some problems in modern surgery: You are more likely to die if you have surgery on your surgeon's birthday.
A team of researchers from the University of California, Los Angeles, publishing their work in the BMJ decided to look into whether outcomes of surgery differ from a surgeon's birthday to outcomes of surgery performed on a normal day. Obviously, this was a study of the data, rather than giving a surgeon a birthday hat, a triple heart bypass and telling them to "get cracking". The team looked at 980,876 procedures performed by 47,489 surgeons between 2011 and 2014, 0.2 percent of which had taken place on the surgeons' birthdays.
The initial characteristics of the patients (condition, severity of illness, age etc) were similar between patients operated on during a surgeon's birthday and on a normal day. The patients' mortality was tracked for 30 days after surgery. They attempted to control for other factors that might be at play, such as birthdays occurring on particularly busy days for surgery or that their analysis might be skewed by the surgeons with particularly high mortality rates (by excluding these days and surgeons in a re-analysis of the data).
The team found that the mortality rate for surgery was 5.6 percent on normal days, vs 7 percent for patients' birthdays. After adjusting for patient characteristics and usual outcomes for the surgeons, the rate was 5.6 percent vs 6.9 percent.
"Among Medicare beneficiaries who underwent common emergency surgeries, those who received surgery on the surgeon’s birthday experienced higher mortality compared with patients who underwent surgery on other days," the team wrote in their study. "These findings suggest that surgeons might be distracted by life events that are not directly related to work."
As bad as that sounds, the team points out that distractions are already known to affect clinical outcomes, this study was just able to quantify that by choosing birthdays as a possible distraction to look at for surgeons. So, if you see a surgeon and they're wearing a party hat don't flee in terror: It's perfectly feasible the surgeon without a party hat could be distracted by something much worse.