Saturday, December 25, 2010

Tomato soup no longer included

I am feeling substantially better this Christmas day, having endured outpatient surgery about a week ago. I have been lucky so far in life not to have required much medical care. Reflecting upon this recent surgery has brought back memories of a surgery experience in Athens, Georgia several decades ago. That was an inpatient experience. The themes are similar, with variations.

In Athens I was visited by a nun and by the assistant to the CEO of the hospital. I think a visit by a nun was common. When the assistant to the CEO entered I had the clear impression that his projected but unspoken question was, "Why are you here?" I was working as a consultant for the hospital across town at the time writing a certificate of need application that involved a competition between the two hospitals. My sense was a possible concern that I might somehow be spying for the other hospital. If that had been the case I certainly had chosen an unlikely implementation of such intent.

I still remember details of that experience decades ago. I remember actually seeing the operating room prior to anesthesia and thinking to myself the title, "A Clean Well Lighted Place" from a short story by Ernest Hemingway. The evening before the anesthesiologist had visited me in my hospital room. The intent of the visit was surely to comfort me but I was not comforted by his coughing. I felt no sense of professional bonding with him. The surgery itself apparently went well. My best memory of the experience was the tomato soup served that evening, and the additional serving of it the kitchen prepared for me later in the evening upon my request.

My recent experience in Albany had similar themes, although it was outpatient surgery. I noticed that a blanket I was given prior to surgery in a preparation room was warm. That was nice. It was the "tomato soup" of this experience. But again I had some issues regarding the anesthesiologist. In the "theater of blue hairnets" I was lead to understand that a particular person would be my anesthesiologist. I was able to briefly tell him of my concerns and felt comforted by his professional manner and understanding. Another caregiver spoke well of him, which I found reassuring. Then when it came time to "roll" again I was approached by another person who appeared to me to be an apprentice. When he said something about anesthesiology I explained that I was not his patient. Apparently the first person I had spoken to had been called out of the room and I had made no reservation for his services! That conversation with the person who appeared to me an apprentice was not following an upward pathway as I tried to express my concerns. Then another person unknown to me appeared who stuck me as being more experienced and I concluded (correctly or not) that he was really my anesthesiologist and that the person I did not intuitively trust was his associate, assistant and/or apprentice. The patient representative who had so efficiently introduced herself and disappeared was nowhere in sight. I was hardly in a position to argue in my blue hairnet as I was rolled around the corner into a corridor, the end of which I did not see. I assume that there was a clean, well-lighted room at the end of the corridor, but was not awake to see it. Thankfully, my surgeon who I trust had visited me prior to my conversations with others described above.

I guess there are three themes here. One, in three decades things have changed but much has remained the same. Two, small things matter. I remember two bowls of tomato soup over thirty years later! I will remember the warmed blanket hopefully for at least another thirty years. Three, relationships matter and there is little time for relationships to take shape in an outpatient surgery. Patients generally get to choose their physicians/surgeons but apparently not their anesthesiologists. It seems to be luck of the draw. I even wonder if surgeons get a voice in the selection of an anesthesiologist. I know this. If I have to have any additional surgery I am going to ask my surgeon if he or she has a preferred anesthesiologist, and if so, try to reserve the services of that person!

No comments:

Post a Comment