A Reflection on Loss, Leadership, and Lessons in Surgery

A few years ago, we established our Abuja center to extend our services and better serve our patients in the northern region. I was then in Abuja—not as the lead surgeon, but in a supporting role—while my team conducted a new series of plastic surgeries. My role was to supervise, guide where necessary, and step in for the more technical aspects if required. We had built a capable surgical team, and I trusted them completely.

Among our patients was a young woman—vibrant, intelligent, and full of promise. She was a lawyer and a professional cook who had come for liposuction and a Brazilian Butt Lift (BBL). Her surgery began like any other, but I noticed she was bleeding slightly more than expected. Over time, we’ve observed that many of our Abuja patients consume large amounts of garlic, ginger, and turmeric—natural supplements with blood-thinning effects. As a cook, she may have used these frequently in her diet.

Recognizing the increased bleeding, I asked the surgeon to slow down. We paused the procedure, reinfiltrated the area with more tumescent solution, and reduced the extent of the surgery. When we turned her over to continue with her back and arms, the bleeding persisted. Again, we reinfiltrated again with tumescent fluid again and made the decision to stop. It was a difficult call, but patient safety must always come first.

She was returned to the recovery ward after the surgery, and as part of our routine, we conducted post-operative blood checks. Her PCV (packed cell volume) was lower than expected, and her pulse rate was elevated. We promptly sent a blood sample to the lab for grouping and cross-matching. Blood was provided and transfusion commenced.

A few hours later, her respiratory rate began to increase. We were still in the operating theater with another patient, but our anesthesiologist attended to her immediately. He assured us that she was stable, administered medication, and attributed her symptoms to a possible mild reaction or stress response. When I finished in theater, I personally checked on her. Though she said she was feeling fine, I could see she was breathing faster than normal. I suggested we transfer her to an intensive care unit (ICU) for closer monitoring.

Our Abuja clinic, like many day surgery centers, does not have a full ICU—though we do have a ventilator and other support equipment. The anesthesiologist felt she would improve with supportive care and chest physiotherapy. Still, out of caution, we initiated ventilator support for a few hours.

Eventually, we made the decision to transfer her to a nearby hospital with ICU capacity. She was stable at the time of transfer, and I was informed that she was doing well. Sadly, by Sunday morning, we received the heartbreaking news that she had passed away.

Many thoughts ran through my mind. Could we have done more? Would the outcome have been different if she had been managed in our Lagos ICU where we have more advanced support? What else could we have done better?

To this day, most people do not know that I was not the primary surgeon in her case. But because the surgery was conducted in our clinic and under my supervision, I have always taken full responsibility. Leadership is not about shifting blame—it is about owning outcomes, learning from them, and doing better.

Her passing has left a deep mark on me, and I carry the memory with both sorrow and resolve. I share this not for sympathy, but to reaffirm a core principle: that medicine must continuously evolve with humility, reflection, and a commitment to doing better.

We have since strengthened our protocols, improved patient risk screening, and deepened our commitment to early escalation of care. Our goal is not just to perform surgeries—but to provide safe, holistic care every step of the way.

May her soul rest in peace. And may her memory continue to guide our hands and our hearts.

Dr. Rasheed Ayobami Aranmolate
Plastic & Reconstructive Surgeon
Medical Director, Grandville Medical & Laser
www.gml.com.ng