Monday, May 21, 2012

Pre-op

I recently had my post-dental surgery check-up, which prompted me to go back in my notebook and see what I had written prior to the procedure.  Though this is only a minor contribution to the doctor-as-patient trope, it was my first experience of this type.  Some of you may identify with it, so I have decided to share.


I am about to have dental surgery for the first time.  Really, my first time for any surgery.  My first time for sedation.  It’s a very common procedure, which I probably should have done a long time ago.  I am still reluctant, but I can think of this in the context of my relationship with my own patients.  Maybe it will be good for me to be in pain.  I have been blessed with good health, for the most part.  This will be a new experience.  I know that it will not be the same in duration, magnitude, or implication as what many of my patients suffer, but I can still approach it as a chance for learning and empathy.

I rarely deal with the healthcare system from the patient’s side.  I have a major advantage with my level of health literacy, able to navigate this territory and advocate for myself in ways that many patients find inaccessible.  I can only imagine how hard it would be to do all these steps of scheduling, parking, registration, following instructions, asking and answering questions, dealing with insurance and co-pay, completing forms, knowing what problems to look out for during recovery and what to do about them etc, if I did not speak English well, could not read, or had any number of other barriers that routinely burden people seeking care.

I also rarely do informed consent from the patient’s point of view.  I am usually the one explaining procedures and listing the possible complications.  Yes, complications are unlikely, but even something that goes wrong less than one percent of the time happens to somebody.  When I am the one receiving sedation, medications, cutting, and extracting, the risks feel closer to home.  Even in accepting necessary risk, people never imagine that it will actually happen to them. 

I like to be in control.  I would rather be doing than receiving procedures.  It’s hard for me to submit myself to sedation or to the clouded mind of pain medications.  However, just as I need to identify with other people’s pain, I also need to be sensitive to my patients’ vulnerability.  It’s an opportunity to give up control. 

Part of my desire to be in control manifests as a compulsion to be constantly accomplishing something.  I want to be making the most of every moment, moving forward, meeting goals.  Overall, this is good.  I work hard and devote myself to a vocation that helps others.  But sometimes, I have to give myself permission to slow down.  I had to argue with myself that it was okay to take a day off after surgery. 

Ironically, turning this whole experience into a lesson is, in a way, a means to control it.

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