I had my very first surgery ever, just last year. It was a remarkable experience--despite being cut-upon, and the O.R. staff cracking jokes at my expense, even as I was going under. In the mood for some inappropriate medical humor? Well, perhaps not in this public forum; I’ll save it for gatherings less formal and where beer is plentiful. Suffice it to say, I survived and was treated well: great surgeon, great anesthesia and yes, great staff, all of which made for an unforgettable day I’ll always cherish.
But I confess, I had my share of anxiety and misgivings and all the baggage which comes with fear of the unknown. I’d never been under general anesthesia before. To make matters worse, on the morning of the surgery, the anesthetist said I would need an endotracheal intubation (where a breathing tube is placed between the vocal cords and down into the trachea). This was the best means to secure the airway, since I was to be placed prone on the O.R. table to remove a mass from the back of my head.
As an ear, nose and throat doc, I’ve seen thousands of intubations, done a few myself, and understand the nuances of the upper airway, since that’s my specialty. I’ve seen difficult intubations, intubation injuries, laryngospasm, patients bucking and kicking once the tube was placed and so on. I imagined experiencing every conceivable problem I’d ever witnessed with endotracheal tubes in the past twenty-plus years as a doctor. So my head that morning—with the mass needing removal--was not entirely wrapped in the right direction.
It happens I performed most of my surgery at that particular hospital, had a regular “block day” for surgical cases and knew most of the hospital staff. I chose a surgeon who has operated with me on numerous occasions, so I knew I had super-qualified hands cutting into my head. I trusted the anesthesia providers and knew they were very good at intubation and managing anesthesia, seeing them first-hand. You might say I had certain advantages as a surgeon not afforded to most patients.
Yet a bit of fear was still part of my equation. My particular condition was less serious than many others needing longer, more complicated surgery, so I needn’t worry, I told myself. Besides, my position as a surgeon should afford me a calm and rational demeanor when it came to me as a patient. Heck, I’ve been involved with the entire process a gazillion times: from seeing the patients in preop-holding to putting them asleep, cutting and closing, then transporting them to recovery. I should be immune to anxiety, fear--all that other irrational, emotional “stuff” that comes with surgery. Right? Apparently not.
Doctors are human. We sometimes forget this. When the table is turned and you’re the patient, things look awfully different. You’re never totally prepared for this, no matter how many times you’ve seen it on the other side. Fortunately, the hospital staff treated me more like a patient rather than a doctor, didn’t shy away from their routine or defer to my position as a surgeon, but merely treated me like everyone else, with kindness and compassion, though mixing in a bit of chiding good humor based upon our previous interactions.
And so my surgery experience from beginning to end was made more pleasant and less frightful by the outstanding hospital staff. Many times I share this personal experience with patients to allay their trepidation and fears with upcoming surgery, telling them that I too had the same misgivings, having my first surgery under general anesthesia in late adulthood. I think this makes it more humanizing.
Even as a doc, the whole process of surgery and hospital care still amazes me. This was reinforced even more so as a patient. Put the right people in the right place at the right time and it’s truly miraculous what they accomplish. This really hit home when I was on the O.R. table, on the other side.
©Randall S. Fong, M.D.
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