Feature Archive

Going Under the Knife

Surgery's hidden risk.

WebMD Feature

Aug. 4, 2000 -- Bad tickers ran in Joseph Calbreath's family, so at age 73 the retired Air Force pilot and hydraulics specialist opted for a stress test. One test led to another. His doctors told him he did indeed have a problem: a blockage in the coronary arteries supplying blood to his left ventricle, the main pump of his heart. They told him what he needed to fix it: heart bypass surgery.

But there's one thing they didn't tell him: Although his heart, if all went as planned, would work better after the operation, his brain might never work as well.

"He was never the same after that bypass," says his wife, Marian, of Novato, Calif. "For days afterward, he didn't even know where he was. Then, once we got home, I kept noticing strange things." Her husband would obsessively lock and relock doors. He forgot how to operate the controls of the RV. A few months after his operation, he was barreling over the Sierra Nevada mountains and suddenly downshifted into reverse, endangering them both.

Although surgical procedures like heart bypasses and hip replacements were once rare among the elderly, today they've become so commonplace that people over 65 make up more than a third of U.S. patients who go under the scalpel. Now a growing number of studies indicate that the older the patient and the more serious the surgery, the greater the risk that the person will leave the operating room with impaired concentration, memory, and other mental skills. While many have no choice but surgery to save their lives, the risk of mental impairment is significant enough that researchers say it should always be discussed with patients and their families. Unfortunately, too often doctors themselves are unaware of the risk or consider it too minor to mention.