I've heard that phrase many times over the years, and it deserves a closer look.
What does it really mean? Can someone really be too sick for surgery? First, the statement must never be taken in isolation. There are many questions which need to be addressed. Why are they too sick? What's the contemplated surgery? Why are we considering surgery at all? Is the problem we plan to fix the very thing that is making them sick? And what happens if we don't fix them? As with all surgical interventions we must always weigh the pros and cons, with or without intervention.
For example.
An elderly gentleman needs a hernia repaired (Of course there are typically far more emergent situations). He may well be ‘high risk’ for surgery. So, if it is elective, that is not an emergency, then we have time to improve his condition before surgery. That often takes time.
But time is not always on our side. Say the same gentleman comes into the ER, in severe pain from a strangulated hernia, that is it is stuck and its blood supply impaired, then the risk/benefit balance changes. He may have just as many medical risk factors (if not more) and so just as sick, but now if we wait, the bowel dies from lack of blood supply, and our patient will rapidly follow suit.
Every surgery is a balance of risk against reward. A patient might well be sick. But ‘too sick’ is a dangerous statement, especially in an emergency, and that decision belongs to the surgeon (who understands what surgery entails), in conjunction with the patient, and family. All providers supply vital data and as a team the goal is to improve the odds. But waiting is usually not an alternative.
Truthfully, no one is ever too sick for (emergency) surgery as it depends on the risk of not having surgery. In many emergencies no matter how sick the patient is surgery may be their only viable option.