THANK GOD FOR THE MEDICAL PROFESSION
James R. Fisher, Jr., Ph.D.
© December 16, 2011
Tuesday, December 13, we arrived at St. Joseph’s Women’s Hospital in Tampa, Florida, run by the Sisters of St. Francis of Allegany, an order founded in 1934, a few minutes after 5 a.m. We would be at that hospital for the next seventeen and one-half hours.
At 8 a.m., Jennifer, our daughter, was rolled into the operating room where she would remain for the next ten hours undergoing radical bilateral mastectomies and reconstructive surgery. She would spend another hour in recovery after which we would see her, groggy and somewhat nauseous. Her vital signs (blood pressure, temperature, color and breathing) were in normal ranges, as she settled into her spacious private room.
This is a new wing of the hospital with all the rooms private and with a veritable army of nurses, nurses’ aids and other specialists attending to Jennifer as she spends the first hours of recovery after this radical surgery.
During this long waiting period, we were directed to an open visitors’ area off the main lobby where a board called “family legend,” much like the electronic board at the airport provided the surgical status of patients. We could check the legend to see periodic updates on Jennifer’s status:
“Pre-op in,” “OR in,” “Recovery In,” “Phase II in,” “Recovery Out,” and “In Diagnostic Area.”
In addition, Linnin, Jennifer’s husband, was given a special cell phone that looks a lot like what you get in a restaurant as you await your table. He was given updates as the surgery progressed. This included reference to the lymph nodes being okay, when surgery on one breast was completed, and the other started, and then finished. The routine was repeated with the reconstructive surgery. This public relations service couldn’t have been more appreciated.
So, going on six o’clock a perky, petite little woman comes by our area, and I was the first she encountered reading away. An outstretched hand was put in my face. “Jennifer is doing fine. It won’t be long until you can see her in room 5101.”
If you can imagine, this pretty little women looked like a high school freshman, yet I learned later that she was 38, or a year older than Jennifer. It stood to reason after four years of pre-med in undergraduate school, four years of medical school, three or four years of specialized training in surgery, and then a two-year residency that she had to be much older than she looked. She was still in her jumper suit and could have easily been taken for a nurse’s aid. It was the first time I met her but I could see why Jennifer liked her and had such confidence in her.
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The good Sisters of St. Francis, instead of having visitors of patients in surgery quartered off in some remote area, considered the anxious state of such visitors and thought creatively. They designed a waiting area in the main lobby accessible to the cafeteria, coffee shop, specialty shops, and on this day, to a charity bizarre where they were selling beautiful costume jewelry and accessories for $5 a piece. BB spent $48.77, as she liked the variety available and knew it was for a good cause. I tagged along, as she looked and registered approval, which was my role, but not difficult as I liked everything she liked, which should be no surprise.
Most of the people in this visitors’ area could be seen to be talking on cell phones, watching CNN on the large television screen, texting, sleeping or incessantly talking. I like to read with classical music in the background or an opera playing quietly.
This one lady, I swear she talked for three solid hours without as much as taking a breath, a medical miracle. But for me, it was perfect background noise as if I had Aida drumming into my ears as I read. I managed to read “The Keeper of Lost Causes,” a 400-page novel by the Danish writer Jussi Adler-Olsen, and a good part of “The Psychology of Revolution” (1896) by Gustave Le Bon, a current favorite of mine. I also managed to read my back issues of The London Review and The New York Review, and so I was not too far out of my element although in different ambient circumstances.
It is also my nature to ensconce myself as far away from and parallel or behind the television screen so I can read. My other motivation for such a vantage point is to watch the people. I am not at all into talking to people but into writing stories in my head as I study them, their dress, expressions, ethnic origins, manners, and how they relate to each other.
There was a large Indian woman with her son, and his three children snuggled so close together on two chairs across from me that they seemed to be a single heap. The children, all small, were drape like a shawl around her, while the son stared blankly at the television screen as if in a hypnotic trance. Tired. They all spelled tired, bone aching exhaustion. My wonder is how far they had to travel to this hospital. They also looked impoverished but with no evidence of complaint.
Although they were sitting right next to the non-stop talking machine, it didn’t seem to disturb them but rather to put the grandmother and children to fitful sleep.
Illness is democratic, and is blind to socio-economic status. To confirm this, there was a bell curve from struggling to well off people looking anxiously at the Family Legend and checking the status of loved ones. It was a quiet group even the children were quiet. It was as if they understood a common bond ran through everyone like they were in church.
A little African American boy broke the spell running, laughing, jumping, stumbling, falling, picking himself up, and repeating the whole process again as if it was his job to put some levity into our weary faces. He looked at me momentarily, cocked his head aside, said nothing, and then went on. I wondered if I was ever like that little boy.
* * *
Linnin, BB and I went out for lunch. Linnin wanted to go to a Spanish restaurant and my expression indicated that was not my choice. Bland describes my diet, and I am not adventuresome when it comes to food, while Linnin and BB are something of connoisseurs. We settled for The Village Inn, where I had breakfast at 3 p.m. and so did Linnin, while BB had a soup and sandwich. Dinner was in the hospital cafeteria for BB and me, while Linnin went out and brought his Cuban food back, where we ate together.
Linnin is a tall, slim and handsome young man, two years younger than Jennifer, and of a happy disposition and loving nature, and absolutely a joy to be around. He doesn’t have to say a word but creates positive vibes. As difficult as this is for us, I can only imagine what he is going through.
Forty years ago BB’s mother had radical bilateral mastectomies. By radical, I mean they destroyed the breasts by vertical incisions through the breasts and the nipples, removing manually the cancer, lymph nodes, some muscle, connective and fatty tissue. Today, through medical science surgical advances, they make small incisions under each breast saving the nipples, followed immediately with reconstructive surgery. Once Jennifer is in full recovery it will appear as if she never had the procedures at all.
Meanwhile, she will have a challenging recovery period once she starts her chemotherapy. I must add at this point that approaching this surgery she was more stoic, composed and accepting than we were. It is her nature to accept problems as they occur, to deal with them, and to move on. She has been a little adult most of her life, and now it augurs especially well for her. No anxiety, no gnashing of teeth, no hyperventilation, no heart palpitations, only, “let’s get on with it and get it over with.”
* * *
When I was a boy, we looked up to our doctors as if they were some kind of gods. We trusted them, respected them, believed in them, and followed their instructions as being wiser, more informed and our medical anchor to health and well being.
Over the last sixty years, I have seen this confidence in their competence eroding. I have seen doctors and nurses, nurses’ aids, and other specialists treated poorly. Yet, the science and art and care of medicine have continued to improve and evolve despite this building negative legacy of feeling.
Over the years, I have heard doctors accused of making too much money, which is terribly misleading, that medical care is too expensive, which it is, but not the fault of medical staffs, that doctor practitioners, not licensed physicians, are the ones that see most patients, and on and on. No mention of their dedication and concomitant fatigue, or that there is a shortage of doctors.
Spending seventeen plus hours at this hospital seeing doctors in their color coded jump suits, walking through the halls with bent shoulders, ashen complexions, tired eyes, but resolute spirits staving off their tiredness with light banter among them, I marveled at how inconspicuous they were, and how little they stood on protocol.
These physicians understood what engineering philosopher William Livingston calls the “purpose of a system is what it does” (P0ASIWID). They carry out their role unobtrusively, quietly, effectively and efficiently, spending long hours in surgery, visiting hospital patients, and seeing patients in their offices, leaving little time for themselves.
It is not only a long and expensive preparatory process to become a physician, but a requirement to constantly update skills as new technology and techniques are developed. Then there is always the threat of malpractice suits brought on by carpet bagging lawyers.
While watching these physicians drag themselves through the hospital, and out to their cars, I wondered how many visitors sitting here have any idea how grueling and demanding this profession, a profession that many envy from afar, but few appreciate up close the sacrifices that have had to be made along the way to reach this pentacle of achievement, or the astronomical student debt that may accrue in the process.
On Wednesday at 6 p.m., we were able to bring Jennifer home, only twenty-four hours after her surgical ordeal because of the skill and competence of everyone at St. Joseph’s Women’s Hospital.
Pivotal to everything were her doctors. It wasn’t simply their ability, which obviously they must have as well as the required aptitude, but their resourcefulness, resilience, energy and compassion to self-forget their own needs to deal with those of others. Medicine is a noble profession of everyone in the chain of service from building maintenance to healthcare deliverers. I was moved to write about it, as I pondered those seventeen plus hours when our Jennifer came through a difficult operation with flying colors. Thank God for the medical profession.
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