Medical Challenge: Colleagues as Patients

He is young, has lovely children, and both he and his wife work with me on a regular basis so when I got the call on my way back from vacation, I didn't hesitate to do a reverse " house call".  He arrived MRI in hand and I looked in astonishment as this muscular, fit man and tried to make it a cohesive picture.  He did have minimal signs of myelopathy so I knew something had to be done.
I spent a long time with him and his wife-I tried in vain to have them see a second opinion (and choose them over me).  For me the surgery was a 9 on a scale of 10 in terms of difficulty, 8 out of 10 in chances of complications (many agonizing) with the added stress of knowing him so well and working with him every day.
I was touched by their trust.
Surgery went great! Complete decompression, benign tumor, no deficits...went home after just a few days.

Then the trouble began-not unexpectedly, the patient developed a CSF leak, very hard to manage.  Given the location of the tumor and the large defect in the dura laterally, a seal was impossible.  First time I patched and glued.  Second time I did lumbar drain.  Third time I did double patch, double glue, muscle graft and simultaneous lumbar drain.  Finally I put permanent lumbar drain in.  I think he may finally be over the hump.  If so, he will be able to return to work soon-I will see him, smile inwardly at his unwavering trust but still wonder if next time, I will insist close colleagues get care further afield.