Ooh, I’m in it now.
I sit at my desk, hands on my keyboard. I stare at three or four lines of text that I can’t seem to bring to life, my brain goes into a fog, and I fall asleep. I awake with a start, reorient myself to my text, stare at the same three or four… again and again; lather, rinse, repeat. I’m stuck.
In writing my memoir, I’m dredging memories up through the muck and mud of my life in the first year of this millenium. It’s pretty straightforward to write a recitation of the events, but far less linear, and way more difficult, to describe the emotional and spiritual import.
photo by Ricardo Sorio, for Unsplash.com
Let me tell you what happened that year, or in writer-speak, give you the plot squeeze:
- I separated from my husband.
- I had spine surgery.
- My two-year-old son potty-trained himself.
- My surgical incision developed a lump.
- My surgeon diagnosed the lump as benign sub-cutaneous fat.
- I fell and smacked my jaw on the sidewalk, became unable to hold my head up or chew.
- On second attempt, my surgeon diagnosed the lump properly. New finding: cerebrospinal fluid (CSF).
- Outcomes: Dull headache, cognitive fogginess, and risk for bacterial meningitis.
- Treatment: six-week course of Flagyl, a very strong, broad-spectrum antibiotic.
- I became a Kaiser patient. (My surgeon was not a Kaiser doctor.)
- I had the leak repaired at Kaiser-Redwood City with a different surgeon.
- I recuperated in a triple room at Kaiser Hospital for seven days, firmly instructed not to sit up, stand, or turn over.
- On the sixth day, I was allowed to sit up.
- On the seventh day, I went home, and, like God, I rested.
Thankfully, the rest of the year was uneventful.
Where I’m stuck is in writing about my old surgeon, the one who poked a hole in me, misdiagnosed the problem, dismissed my concern with sexual innuendo, played the victim, deflected blame, then mused about how he’d write a paper about his blamelessness. Gosh, I guess I’m still really angry, twenty years later.
Here’s an irony. It so happens that Edie — who’s not only my physical therapist, but my dear friend — scrubbed in on the surgery as a guest observer. She wanted to see the inside — the way the structures come together — of this part of human anatomy. (Yeah, she’s pretty amazing.) This came in handy when I was trying to figure out if I should sue the surgeon. According to Edie, when the surgeon cleaned up and closed me up, he meticulously checked for bits of vertebra and nerve fiber, looking for leaks and for any little thing out of place. She said he was way more thorough than any surgeon she had observed to date, and that was saying a lot. He really was careful, and did his best — at least while he was observed.
Sometimes life is random, and there’s
nobody to blame. So I couldn’t be angry. Being angry about the leak wasn’t — isn’t — kosher. It felt disallowed.
What I’m realizing this very minute as I write this is that when I disallowed my anger at the CSF leak, I also vetoed my anger at my surgeon’s response to the lump.
Sometimes life is random, and there’s nobody to blame.
In many doctor-patient relationships, perhaps most, there is a power imbalance. The doctor keeps the patient waiting, not vice versa. We patients are already vulnerable — possibly weakened, in pain, scared. Then we have to have an important conversation about our most intimate physical concerns with someone who is likely to have more education, wealth, and/or status than us, who is cloaked in authority, while we’re cloaked only in our skimpy paper gowns. In many cases, including mine, the doctor is a straight, white male, with the attendant (and in his case unexamined) power and privilege.
That describes my situation and state of mind when my surgeon decided to flex his power. I had expressed skepticism about his first diagnosis of the lump. He responded with empty assurances, adding, “You look good, Sandy, but we all have subcutaneous fat.”
I felt so confused inside. I had been trained to feel flattered when a man said something like that — vaguely flirtatious and superficially complimentary — but it felt icky inside, and I didn’t understand why. I was just out of my marriage, out of practice with sexually ambiguous situations, especially ones in which I was of lesser power and status. I was in a paper gown, for God’s sake, scared, angry, and in pain. It wasn’t until I started writing about this that I teased out the strands of my confusion and anger.
Then we must talk about our most intimate physical concerns with someone… who is cloaked in authority, while we’re in pain, weakened, scared — and cloaked only in our skimpy paper gowns.
I’ve since learned that the best doctors decrease the power imbalance through their interactions with patients, while the worst exacerbate it.
When he was forced to correct his diagnosis, the surgeon insisted that surgical error was not the cause, but that the epidural injections I’d had in the months before surgery had weakened the covering of the spinal cord, causing the leak. He mused aloud that he could get a good journal article out of it. He made some other incredibly clueless statements, including my favorite: “This has never happened to me before.” I pushed back at some of these comments, but I swear, I embodied the phrase “protested weakly” when I said, “Dr. X, this is happening to me, not you.”
Now I understand that the cerebrospinal fluid was not flowing properly because of the leak, causing difficulty with cognition. I was unable to think well, to ground myself, to listen to my body, to find my center. I practically vibrated with anger.
Almost exactly a year before this, in September of 1999, I had resolved to handle my anger in new, less eruptive ways, but I hadn’t yet figured out what they might be. This resolution held, but I still was not adept at moving the anger through and out of my body, now that eruption was off-limits. So the anger swirled around in me without an outlet, and I was scared of it.
I think I still am.
The surgery to repair the leak was my third spine surgery, the last before a hiatus of eleven years. I now have a new spine surgeon, with whom I’ve had many positive interactions (and unfortunately, seven more spine surgeries). I have gobs of respect for him, partly because of his accomplishments as a surgeon — he invented some of the hardware he installed in me — but more because of how he treats his patients. We joke that I send him all my lesbian friends — we’re all getting older and falling apart in one way or another — because it happens to be true, although I send him straight people, too. Everyone comments on his attentiveness, his compassion, and his smarts. We disagree about most politics, but we do so respectfully and with humor. I will enjoy writing about our doctor-patient relationship.
The surgeon who initially dismissed the CSF leak now works in the Kaiser system. I hold the hope that Kaiser’s regimen of professional development has impressed upon him the value of mutually respectful interactions with patients.
I have some information that supports this hope: I had a friend on whom he had operated before I knew her, and she adored him. I chose not to tell her of my experiences, because I had no reason to believe that he was negligent or careless, and Edie had said he was, in fact, meticulously careful. Therefore, I had no reason to believe he would harm her, and she was giving me reason to believe he had changed.
I also hope that writing this blog has shifted how I hold and manage my decades-old anger. It’s another step in metabolizing my experiences of the past. I’m still moving the old anger through me, but at least it’s moving, and I’m not falling asleep at my keyboard. As long as I keep telling my story, clearly and honestly, my anger and all my other emotions, will keep moving through me without stagnation. I’ll keep you posted.
Spoiler Alert: This is what my spine looks like now, after a total of ten spine surgeries. I had the fusions done incrementally, because I was unwilling to give up any more of my spine any sooner than I had to.