I recently became that person. You know, that person who needs a doctor. For those of us who live our lives on the flip side of that dynamic, we well know how much energy goes into honing the skills that nuance the science and tech of our care. All the active listening, shared decision-making, tapping into one’s empathy, or sympathy, not to mention truly actually caring and wanting to make things better for those to whom you are about to cause inconvenience, expense, pain and fear in order to reach that coveted endpoint, occasionally results in debility or death anyway. And despite the endpoint, the service of skillfully navigating patients through their process often matters to them more. Which makes finding oneself the consumer of (receptacle for?) medical care all the more important to experience and understand.
I have bad knees. Or rather, they’ve been sacrificed to a lifetime of soccer, being generally active, and perhaps composed of questionable-grade protoplasm (if my mother’s end-stage knees are the direction in which I’m headed). The first ACL was ruptured playing soccer at age 19. The alternate ACL was ruptured playing soccer, last year. Apparently over 100,000 anterior cruciate ligament reconstruction surgeries are performed yearly in the US, making it one of the most commonly performed surgeries, and my ACLs were surely unmemorable to anyone else but myself.
Implicitly trusting in the excellence of my surgeon was, to my surprise, not difficult. Compulsively watching multiple versions of “ACL Reconstruction with Hamstring Tendon Autograft” videos on YouTube did not faze me. But it was the damn mesh panties that had me shook. What I mean to say is what struck me most in these experiences of being surgerized was the oxymoronic inhumanity of realizing the fact that being a body, with biological functions, needing to be fixed as well as to be kept alive while doing so, far outweighed anything I had thoughts about or wanted to say, about anything. Prepped for surgery first by shedding all clothing and ornamentation that might reflect any sign of individuality or personal preference, I was given a taupe hospital johnnie in size approximately 3XL, with a pair of beige non-skid hospital socks. After briefly considering the fact that I would be dressed in a loose drape that’s fully open in the back, unconscious in a roomful of dressed people I inquired discreetly about undergarments and was handed a pair of mesh panties. As the mother of two biological children who were both born in hospitals I am well acquainted with the mesh panties, and also surprised myself in that moment, really being convinced I had forfeited the remainder of my modesty several years ago.
Anyway sitting in pre-op in my neutral tones, answering questions from my nurse, I suddenly felt efficient hands quickly plunge down the front of my toga, pressing firmly around on my chest. Jolting a split second before realizing she was placing cardiac monitoring leads, I thought how nice a warning would have been. Similarly, a few seconds later when she again reached from behind to press a scopolamine patch behind my ear, I again wished she could have issued a succinct statement of intent before touching me in ticklish places from behind. Likewise, when my anesthesiologist with the kind face came in to perform an adductor tunnel block, his affect put me at ease immediately. But as soon as it came time to start probing for the saphenous nerve he was all business, reaching over and flipping my toga up to the groin. Seriously, three words would have really changed my impression about this whole process. As it was, those damn mesh panties felt like the last tenuous layer keeping my business from becoming everyone else’s. And I wasn’t even delivering a baby.
Fast forward 10.5 months to ACL reconstruction numero dos. After the acutely injured ACL was successfully repaired (and I had decimated my yearly out-of-pocket max in one fell swoop), I turned my sights on investigating into whether the chronic ACL might also be a good candidate for (free, before year-end) surgery. Miraculously during the all the time I had continued to pound my ACL-deficient knee through adulthood, more soccer games, workout regimes, hikes, road races, skiing, cycling trips, sprint triathlons, a not-insignificant stint with the Crossfit cult, the menisci and cartilage had remained intact and I was deemed appropriate for surgery.
Fast forward to surgery day and everything went as before, except everyone is now masked, no one could accompany me, and all the faces were different. When I saw the folded pile of beige at the end of the bed, I took it as a good omen that a plastic baggie of mesh panties had been placed on top, without me even asking. Awash in Fentanyl and Midazolam I actually don’t really remember the adductor canal block, and while being wheeled into the OR a nurse asked me where I’m from, why I live here, and what do I do? “I’m a doctor,” I replied. The nurse anesthetists made simple statements like “we’re putting the mask over your face,” and “the med is going to burn when it goes through your IV.” When I said “oof!” quietly, as the IV really did sting and burn, I felt one of them hold my hand and stroke it comfortingly. The last thing I remember exclaiming before waking up much later in PACU was “My God! You people are so NICE!” followed by several audible chuckles.
Note to self: it’s the little things that are noticed, and that count.
(Editor’s Note: The Physician as Patient Series is exactly what is says it is. If you are a doctor and want to share your medical story then email me.)