Sunday, February 8, 2015

There is a narrative structure to a Pre-Op, and then the surgery. Plot, theme, conflict, setting and character. All unfolding neatly in familiar pattern.

You're scheduled for an appointment to meet first with your Pre-op nurse, then your EKG technician,  then your Pharmacist's aide, then your Pharmacist, then your Anesthesiologist's assistant, and then your anesthesiologist. Each of them verifies your date of birth, reviews your record, makes suggestions about your prognosis, the surgeon's expertise, notes how he's quirky. 

Your blood pressure is up. They all say that.

You're heavy, obese, large, fit, depending on the interviewer. 

You have diabetes.  You have sleep apnea. That means you're a category. In this case, that category is high risk. That means everyone triple checks your chart.  They comment on your blood pressure. 

You tell them each that your blood pressure has never been this high.  You're anxious.  They each say you need to go your doctor and get your meds increased. Then they check your history and repeat the test. Turns out you're anxious.

But you're still a category. Being high risk means you will be in the hospital longer.

You see them all, one by one, a series of events in a tiny room equipped with a small bed, two chairs, a computer and desk, and a monstrously large and fire engine red hazardous materials disposal unit mounted on the wall that looks incredibly complicated.

You do not move. The morning slides by with a series of polite knocks on the door, brief interviews, shaking hands, massaging hands with antibacterial soap, repeated questions, and then an suggestion of who will arrive next.  A series of events with nondescript characters, self-effaced characters in a variety of medical wardrobes, no one, suspiciously, sporting the stand-by white jacket  and stethoscope. Each wearing a Photo ID clipped to their chest, but you can't read the print. All of this is a mechanical process that leads, in the abstract future, to some planned event, the result of which will, in a sense, complete your story. The procedure went well. They found more damage. They had to cut you open.  Things got complicated. They found something they didn't expect. This is the climax.

Then the denouement.  You wake up and blubber through your pain meds and anesthetic. You get post-op instructions and they send you home with a home care sheet of instructions that's been photocopied far too many times. 

Then the epiphany.  You're in excruciating pain. This is all private, and then you realize the brutality of what's just taken place. Someone, some team of experts, executed their process. They tore holes in your body and probed your tissues with miniature steel tools and a live-feed video camera. They cut your tendons, trimmed and burred the floating flagellates of torn tissue, they drilled screws in your bone, they pumped a cortisone ooze into you. They stapled you shut and outfitted you in a special sling and then sent you home.  

You are a strange commodity -- you go to a factory, they perform a procedure, and then you leave.  Value-added. New and improved! Good to go. Your shelf life extended.

And then, the falling action, or "wrap -up": physical therapy.

All of this is a repeatable structure, a sequences of processes and protocols designed to separate you from the thing it is that's bothering you, as well as yourself from the process and the procedure, and to then, by the execution of expertise, return you to yourself wholly, perhaps, intact -- now you're fixed, resolved, or complete. 


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