Satyalove’s Weblog

reach inside

lay it all out for me

blood and shit and warmth and wet

what beats steady

what’s still/scarred

sinew and sweet and bitter and bile

sort me into buckets and jars

burn and scatter

salt and store

reach deeply

turn me inside out

fold back my corners

bind me

set me free

make me watch

let me see

last week, i had a patient….

last week, there was a patient…

last week, a pre-op mtf transexual (a biological male who identifies as a woman but has not yet had surgery)…

last week, a pre-op mtf transexual (with anoxic brain injury status post cardiac cath in preparation for a sex change operation) came to our OR to get a surgical trach for permanent mechanical ventilation. from the time she arrived, she became both a joke and a commentary on the absurdity of resource wastage in the american medical system. “Only in America would something like this happen!” “Look! He has on toenail polish!” “Why do you keep calling him ’she’? “What is the difference between sex and gender?!?” “He doesn’t have any family?!?” “Only in America!!! You know, we’re the ones paying for this!” “Well, does he have a penis?” “He’s 62 years old…what’s the point?” “We should report this case to the…”

last week, a woman (who had sustained severe brain damage when her heart stopped during a routine evaluation prior to corrective surgery) was brought to our operating room so that a permanent breathing tube could be placed in her windpipe and a machine could breathe for her. she had waited 62 years to have a deformity corrected, had left her homeland and been estranged from family and friends for this opportunity. she had done her nails and her hair as she prepared for the new life of which she had always dreamed.

last week, a woman lay helpless in her hospital bed, unable to communicate, her body only moving in response to pain. she lay there with hair disheveled, toenails outgrowing their polish. she lay there alone, her body and her person at our mercy

last week, a woman lay helpless in an operating room bed and was humiliated, insulted, disrespected, and sexually interrogated

last week, i – also a woman, also brown, also suspiciously queer…

last week, i tried feebly to restore a woman’s dignity through small displays of respect

last week, i didn’t play along but futilely played against

last week, i failed…

last week, i failed to bring honor to what was likely a painful life crawling quickly towards a painful death

last week, two women were helpless in an operating room – humiliated, insulted, disrespected, and sexually interrogated

In Letters to a Young Doctor, R. Selzer says of patients with whom you establish a relationship on a hospital ward: “These patients would risk everything, their lives even, to save you.”

In dealing with issues illness and end of life, a space opens where distractions of daily life can fall away and humanity in all of its frailty and splendor can be laid bare. The simplest of ceremony can be imbibed with new meaning. Casual touch can achieve supernormal intimacy. And we, with power and professionalism build walls of technology and jargon, process and rational decision-making. We pour ourselves into efforts to control what is uncontrollable and to evade what is inevitable: dying and death. We protect ourselves, and possibly our patients, by making ourselves less human in the most human of circumstances.

And we do this for the good of the patient. We don’t want to be distracted or have our rationality overcome by emotion. We don’t want to impose our human presence where it may not be welcome, where perhaps we fear it is not worthy of intruding. We have chosen a training that prioritizes healing at a certain distance – chemical, surgical, mechanical. A training that defines life fundamentally by beats, breaths, and brainwaves. And yet, we have chosen a healing profession. What – in us – seeks to fix what is broken, to rescue, to serve, to save?

Merriam-Webster gives two definitions for the word “savior”: 1- one that saves from danger or destruction and 2- one who brings salvation. Perhaps in seeking to save our patients from physical danger and destruction, we are seeking from them a certain uniquely human salvation for ourselves.