On waking up from anesthesia-induced unconsciousness, I was dressed in an unfamiliar pink surgical bra with multiple Velcro straps. As if I were a doll, someone had clothed my limp body without my knowledge, and I had no idea who. Even then, I had a vague sense, groggy and feeling an odd lack of sensation on the right side of my chest that I had been violated.
“Violation” is an “infringement” or “breach” and also has the negative connotations of #MeToo and sexual violence. Violation, you might say, cannot be the proper term to associate with a necessary medical surgery, one that I had certainly and willingly consented to. As my teenage daughter might say, in her lightly snarky way, “Calm down.”
I almost didn’t write this because I am not histrionic or hysterical, and I don’t want any gaslighting. Feeling violated was just an initial response, inchoate, and, at this point, a wonderful four weeks out from surgery, largely subjugated (but not gone).
Being anesthetized and unconscious, I don’t know who was in the surgical suite. Of course, my surgeon was. And the anesthesiologist. And a surgical resident. And at least two nurses who introduced themselves to me beforehand. At least five individuals, and isn’t it a violation to have multiple people staring at your naked body? While you are unconscious? And, of these five (or more) individuals, I have no idea who dressed me. Or, for that matter, who undressed me … when I first laid down on the operating table, a silver, reflective shower cap-like pouf covered my hair, and a disposable lavender gown plus cotton striped robe and ugly hospital socks completed my outfit; when I woke up, I only had on the afore-mentioned pink surgical bra and a different hospital gown, seemingly with the same hospital socks intact.
Based on the orange color of my skin in an area over my entire chest (both breasts) and right side of my back, down to my belly button, my entire front side was exposed and cleaned off with surgical cleanser (to prevent infection). I was prepped and turned and covered (I assume).
I don’t remember any of it.
None of that is normal, and being a breach of normal, I have come to think violation is the right word. A necessary violation, as the tumor that was growing in my right breast was breast cancer, and I absolutely feel a deep relief that it was cut out.
To have a knife held to you, to have bled, and to have been sewn shut, all under the watchful eyes of multiple strangers – these are all necessary parts of surgery. Overall, I am grateful to my surgeon and her team, and for me, this vague feeling of personal violation, complicated by my own consent, is dispelled by my liking the surgeon and her team.
On the first day of 2023, by chance, The New York Times ran an article about a nurse who sexually abused unconscious patients since at least 2016, recording almost 8-years worth of video of his sexual exploits. The article ends with a quote from a hospital president, “Patients put their trust in us and should feel safe in our care.”
Trust, “an assured reliance on the character, ability, strength, or truth of someone or something; one in which confidence is placed,” is hard for me, especially with people I have met only once or twice. Recently, my friend and I, both cancer patients, had a conversation in which she told me that she strongly disagreed with a family member who stated, “We just need doctors who know exactly what to do medically; it doesn’t matter if we like them or not.” My friend exhorted that it absolutely matters to her, that she needs to like her doctors. The liking – I agree that it is essential – leads to trust.
There are many potential definitions of “like,” depending on the particular use of it. A lot of the definitions apply to the doctor-patient relationship: transitive verb, 1) to regard, 2) to want, 3) to do well in, 4) to approve online, 5) to be suitable; intransitive verb, 1) choose, 2) approve; noun, preference. My preference, like my friend’s, would be to choose and approve a doctor that I can regard highly, that I want to do well with, and be able to approve online (if I so choose) as someone suitable to patients.
I just now have seen the surgical scar for the first time, as it was covered with white rectangular tapes, which my surgeon advised me to keep on for at least four weeks. What I knew of it was a tell-tale ridge beneath the tapes, a ridge slowly flattening out in the normal course of healing. It’s a forever tattoo of a shared experience between doctor and patient that optimally requires absolute trust that the right thing was done, sight unseen. It may not be true for everyone, but that trust started and grew from liking my doctor.
To all the good doctors out there, please remember that it is important for patients to like their doctors. And to all the patients out there, if you feel like I do, I hope you don’t have to settle for a doctor you dislike.
The author is an anonymous physician.