I deal mainly with cancer and airway problems – for me, this was the raison d'etre for going to medical school. I remember I was told that once you graduate you become more clinically detached, but actually the inverse happens: as you go on, you realise your own inability to live for ever and you become more clinically involved with the patients, so it becomes more personal.
On Mondays, I do a clinic for "rapid access" cancer patients – those who are suspected of having cancer and need an early assesment. The majority of these patients won't have cancer at all, but because they have had an emergency letter telling them to come in, it can be frightening. A lot of the work is allaying their fears. In the afternoon, I had multi-disciplinary meetings with thyroid surgeons.
Tuesday is an operating day and this week I treated people with thyroid cancer doing two microlaryngoscopies – examinations of the voicebox. On Thursday, I was in theatre again carrying out a total thyroidectomy (removing the thyroid gland – a large gland in the neck that secretes hormones) and a neck gland dissection and a lymph node biopsy. This type of operation can take around five hours, but it's never a problem to stay focused. It's only when you get home you even realise you are tired.
The lady I operated on had come in with an eight-week history of severe pain and hoarseness, as she has an aggressive form of thyroid cancer. She is about 74 years old. She had to give consent to have an operation to potentially remove the voicebox and be given an artificial one. Communication is such an essential part of a human being so it is very important that the patient is part of the decision-making process regarding their treatment.
At the weekend, I was operating at the Harley Street clinic where I deal with snoring and nasal obstruction. This is quality-of-life surgery, but the people I see have tried everything and have sometimes reached a marital-breakdown scenario. We see a great range of people, from actors to bankers.
Dr Myles Black is a snoring expert at The Private Clinic of Harley Street, www.theprivateclinic.co.uk
