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A Piece of My Mind
March 7, 2001

Moral Wounds: Complicated Complications

Author Affiliations

A Piece of My Mind Section Editor: Roxanne K. Young, Associate Editor.

JAMA. 2001;285(9):1131-1132. doi:10.1001/jama.285.9.1131
The Patient

Imagine my surprise—no, my shock and disbelief—when I learned that my hoarseness was attributable to unilateral vocal cord paralysis. In anticipation of my partial thyroidectomy, I'd been worried about cancer, not a damaged vocal cord. I'm a verbal person, likely too loud at times, and gregarious among those I know and those I don't. My voice also is essential to who I am in my profession as a medical social worker and academic. My surgeon was known for his technical competence and compassionate bedside manner. Why did he not warn me of this risk? He explained many other possibilities, including temporary hoarseness, but never said my ability to speak might be affected. Only after I could barely speak above a whisper did I learn that vocal cord paralysis is a primary complication of thyroidectomy. I'm convinced my surgeon's intentions were good; low statistical risk and the fact that none of his patients had experienced this complication may have led him to believe there was no reason to cause me needless anxiety.