One of the most difficult realities in medicine is not performing surgery, interpreting scans, or making complex decisions. It is managing expectations. Every human being naturally believes that once they come to a doctor—or bring their loved one to one—the outcome should be complete restoration to “normal.” But medicine does not always work in absolutes. Take, for example, a neonate diagnosed antenatally with PUJ obstruction (UPJO). The child is followed carefully, evaluated serially, and eventually operated upon at nine months because of persistent obstruction, even though renal function remains relatively preserved compared to the initial nuclear scan. Postoperatively, the obstruction is relieved.
Drainage curves improve. The scans look reassuring. To us as doctors, this is a successful outcome. But to the parents, success means something very different. They expect: Completely…