My father recently reflected on our family’s introduction to the scary world of American surgery. I thought the thesis captured my own fears, frustrations, and internalized irony.
It soon will be the twelfth anniversary of my father’s coronary bypass operation, and of more important note, he is still around to share in the festivities. With the emphasis on patient privacy and insurance portability, I must protect certain facts and figures. For this discussion, let us just note that his care was rendered at a major Harvard teaching hospital whose initials are similar to a Chinese food additive. I remember distinctly “the call”; Dad had some chest pain, went to hospital, had angiogram, doctors saw some things they think should be dealt with, and thank god, no sign of cancer. Although I had practiced cardiac surgery for sixteen years and never once encountered a malignant tumor of the coronary arteries, I reassured my mother that that was good news.
The prodigal son swiftly flew to Boston and arrived in time for the preoperative rituals. I was present when the female Physician’s Associate was performing the history and physical examination and watched my father’s ashen look when she donned glove and surgi-lube to assess … I confabulated a newly discovered and important prostatic-cardiac reflex and he seemed to buy it (trust me, Dad, I am a doctor). Next, the anesthesia resident sallied forth with his discourse on how this important part of the team would monitor critical parameters and give various potent medications. Unfortunately, the kid was about ten years younger than the standard second wife, sported a long ponytail of unwashed hair, and looked like he needed a dermatology appointment for acne more than the stethoscope he wore like a shawl around his neck. Not so reassuring and Dad asked the future Dr. Kildare when the real doctor was coming.
Next came what I call the “patient must be informed of all the facts” Nazi, armed with pamphlets, videos, and time lines: “Bill (they always call patients by their first name), this is what to expect after surgery if nothing goes wrong.” She never did get to the obvious corollary, but proceeded to illustrate in technicolor what tubes and lines would be inserted in what cavities, blood vessels and orifices. What the old man wanted to see was a gravitas-oozing, partially gray, neatly pressed long white coat of a doctor in calm, clipped, accented, reassuring words saying, “Do not worry, it will be fine, you are doing the right thing and we have a very competent team of professionals to take care of all contingencies.” The final issue was somewhat his fault, it seems he had some questions about his last will and testament. No problem, my oldest son was a recently minted attorney at one of those blue-blooded Boston law firms populated by expensive mouthpieces that could make Ted Kennedy seem like a tea-totaling swim instructor. They arrived en mass, the suits, paralegals, stenographers all marching in formation. The sound of Italian leather on hospital corridor reminded me (remember it is December) of an obscure Nutcracker suite, “Dance of the Gucci-plum fairies.”
Unfortunately, “Bill” had already been premedicated and therefore was not of sound mind and coupled with the body being in no great shape, modification of the will was not in the cards. Well, he did, and has since done, great. Truth is often stranger than fiction and I will never mention to him that he has been immortalized in the first edition of a medical magazine. What does it all mean? Personally, I haven’t a clue, but do remember an old Talmudic proverb that states just because you ask a question does not mean you get an answer. Peace, good health, fair seas, and the wind from abaft of abeam.