It was 2 months before my wife’s 40th birthday and the planning had begun. In general, I have always tried to sequence the planning of important events with enough cushion time in between to avoid facing any conflicts and to also avoid missing out on the opportunity to celebrate life’s most precious milestones. For instance, to the best we could, we planned our daughter’s birth the month before my 6th New York City Marathon, this allowed for enough time to gracefully welcome her into the world and still train for the run and have family by my side to cheer me on the side lines. It was not atypical then for me to concomitantly plan what would be my next surgery and a surprise party for my wife in a sequence where I could still plot out training runs for my 14th New York City Marathon.

It was now 1.5 years from my original surgery. Since that procedure, I had developed an incisional hernia, which became larger over time. Incisional hernias are not unusual after abdominal surgery. The surgical site and repair represents the weakest location of the abdominal wall, and intestinal contents that fill that area can present with a rather large bulge. Prior to the procedure, the plastic surgeon took a photo of my abdomen. Even with deep inhalation, my abdomen protruded far enough out that I could not see my belly button or my urologic anatomy. I was eager to have this treated.

I chose to have my wife’s surprise 40th birthday, the day before my surgery knowing that all the planning would occur before the party behind the scenes. After the joyous celebration, I went in for the surgery the following day. In the rare event that my recovery was longer than normal, I felt that I had better control of events if I made her surprise party first. Additionally, planning for the party and the “elective” surgery well in advance would provide enough time for the recovery and time for marathon training. Low and behold, the surprise for me would be far greater than the one my wife experienced on her birthday.

Having survived the threat of cancer leading to my first procedure, I had no idea that my second surgery was potentially more life threatening. After I left for the hospital for my first surgery a little more than a year before, there was a slight doubt as to whether I would return home. In anticipation of the second surgery, I left my house on the day of surgery already knowing the projects to do around the backyard and inside the house. I kissed my kids who were going to school, knowing that I would be at their weekend softball and tennis commitments. My wife double checked with me on our way into the car saying, “hernia repairs are benign and low risk procedures right?” My response was “Of course, many people go home the next day. There’s nothing to worry about.”

For the first time, I became exclusively the patient, separating my thoughts of being a physician and knowing the rules that patients play by. As a surgeon, I always thought being on the other side meant being on the other side of the OR table. This was the side of the OR table, separated by a surgical drape, where the anesthesiologist worked. Surgeons treated the patient with surgery while anesthesiologists “passed the gas!” My interpretation, however, of visiting the other side had taken on a whole new meaning. At this venture, it meant being the patient and asking questions of my doctor. I became a patient that put my hands in the trust of a surgeon, the same way a passenger directs his confidence to the pilot of an aircraft. Good or bad, I was naive about any risks in the situation; possibly this was a result of the trust I developed earlier considering I survived a great scare and believed that not much could be worse than the previous situation. Needless to say, I kept my A-Team for this procedure as they did right by me for the first procedure. Dr. M would place the mesh for the hernia repair and Dr. U would do the abdominal wound closure.

When getting authorization from my patients for minor or major surgeries, one must get an informed consent. The consent identifies your surgeon, the technical name of your procedure and well as the procedure described in laymen terminology. It will detail the risks of the procedure, including issues like infection, bleeding and other items that are specific for that procedure. While the outcome is quite rare for most elective procedures, it is not inappropriate to tell a patient that death, is always a possibility.

Following my elective hernia procedure, I returned to the recovery room without any delay. It was the same RR and bed spot that I remember bringing my patients to and the place that I visited as a patient only 1.5 years earlier. The surgeon had come to the bedside once again. Last time, he asked me “when was I kicked by a horse?” Ironically, now I felt like I was just kicked by a horse. On a pain scale of 1–10, where 1 was minimal pain and 10 was severe pain, my agony level was an 11. The surgeon, who thought I initially had an abdominal bulge, confirmed that I had multiple hernias. He stated, “Yes, you did have a hernia, but not 1 or 2 or even 3, but 5 of them.” A hernia of this nature is nicknamed a Swiss cheese hernia, based on the visual of multiple holes representing each hernia. The surgical team did not need to enter my abdominal cavity; they were able to perform the procedure from a superficial approach utilizing the mesh.