Undraped

He was nervous about having his uterus and ovaries out.  I had gotten on well with him in the surgical holding area.  I didn’t get to ask what I really wanted to, instead skimming over shallower subjects like where he was from and who each person was who had to examine him before surgery.

He finally asked me if I had ever treated a transgender patient before.  I told him that I hadn’t.  I added that he would probably forget me in the haze of people while I probably would remember him for the rest of my life.  I’ve been saying that a lot to patients lately, since each one is usually my first something.

“How do you feel about seeing me?” he asked.

Seeing him?  I didn’t feel anything different, I said.  This was true for him as an individual.  On a larger level–seeing what he represented–I did.  I have strong feelings about our national squeamishness about sexual orientation and gender identity.  This was not the time or place to mention that, as he was getting drowsy from his first dose of medication.

Twenty minutes later, he was asleep in the OR and completely undraped, ready to be prepped for the incisions.  All of a sudden, he materialized as an individual patient, allowing himself to be opened up and treated.  No longer was he a political or social statement on society, or necessarily all of the qualities I wanted to project onto him.

www.withassociates.com

About thirty seconds later, the resident said to me, “You need to find things to do.”  It was rare feedback, because I am usually the one moving the bed to the hallway, putting boots on the patient to improve circulation, and taking apart the table.  I looked up, and all of those things had been done in the half minute my mind had been undraped with the patient.

I get it. The OR is not a place to reflect, if only for seconds.  Patient care depends on it.  I get it, but on some level I think I resent it.

The rest of the surgery was no different from any other.  His uterus and ovaries looked beautiful and healthy, and of course this was irrelevant.

Sometime during the closing of the incision sites, I thought of the Na’vi casual-yet-profound “I see you.”  For some reason, I saw this patient when I looked at his body rather than into his eyes.  Humanization and objectification entangled themselves in ways I’m still trying to sort out.

“How do you feel about seeing me?” he had asked, and I had answered.

Ask me again.

 

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5 Responses to Undraped

  1. EMoon says:

    This is brilliant. Thank you.

    When I first went into EMS (volunteer, rural system, hadn’t expected ever to do that, but…) I had similar experiences…sometimes a person was more a person when unconscious than when awake. (Conscious or semi-conscious drunks moaning the same cusswords over and over…feh. Bad attitude, argued with myself, but…feh.) The dead acquired a weight of meaning they might or might not have had in life. Not always, but it happened, and it left me in a strange place until it wore off, but it was not forgotten.

    I hope he had a smooth recovery. I hope we all recover from national squeamishness about gender identity.

  2. Aaron Stupple says:

    Wow, great thoughts. Thanks for sharing your insight, I really enjoyed it.

  3. So strikingly told! I’ve never had a transgender patient, but also at our hospital they don’t really do elective surgeries. I also find sometimes that having to focus on the patient’s physiology seems to take away from holistic care of the patient. But I suppose holistic care is kind of pointless of they code in the OR.
    Anycase, I enjoyed reading this. If working with a transgender patient intrigued you, you should read “Luna” by Julie-Anne Petersen. It opened my eyes.

  4. JustAVisitor says:

    A well written account. I’d say it would do well for people to think more about this type of situation. We are too accustomed to what society has labeled the-way-things-are or normal. Thank you for sharing.

  5. Cleo says:

    So beautifully written- simple and intriguing. I came across your blog quite by chance. I’m not in the medial profession – I teach language and literature. Looking forward to more ; )