PBS’s ‘This Emotional Life’: Excising the Fear From Surgery

“He who is not everyday conquering some fear has not learned the secret of life.” — Ralph Waldo Emerson

The words “fear” and “surgery” are inextricably connected. Not only that, but hospital stays in general are full of unfamiliar experiences that can easily jeopardize even the strongest sense of emotional well-being. To be a patient in the modern age means to give up control and place yourself in the hands of another, whose job it is to lead you through the maze of treatment options and back to recovery.

Still, nothing so typifies this fear and uncertainty as when the doctor utters that one word: surgery. At the same time, however, the Harvard School of Public Health reported in July 2010 that more than two billion people worldwide do not have access to adequate surgical treatment. Perhaps through a better understanding of surgery in the modern age, this, often misunderstood part of a hospital stay, can look and feel more somatic and less traumatic.

Should you or someone you love face the option of surgery, it is important to remind yourself of the many technical advances made by modern medicine in recent decades. For example, 50 years ago doctors faced huge obstacles when operating on a beating heart, since stopping the heart for more than a few minutes often results in brain damage. Today, technology not only makes heart and other formerly unthinkable types of surgery possible, many of yesterday’s riskiest procedures are now considered standard. Our skill level has risen considerably.

To reduce the fright that goes along with going under the knife, it often helps to see a procedure in black and white, especially in terms of success rates. Each year cardiothoracic (cardio=heart, thorax=chest) surgeons perform more than 500,000 coronary artery bypass grafting procedures (CABG), making this the most common type of heart surgery. Indeed, many political figures and celebrities have entrusted doctors and hospitals to heal their heart, including photographer Ansel Adams, author Isaac Asimov, basketball coach Red Auerbach, former first lady Barbara Bush, talk show host Johnny Carson, former president Bill Clinton, businessman Ben Cohen (of Ben & Jerry’s), actor Patty Duke, former US Secretary of State Henry Kissinger, singer Peggy Lee, talk show host Dave Letterman, journalist Bill Moyers, talk show host Regis Philbin, Dame Elizabeth Taylor, actor Burt Reynolds and actor/comedian Robin Williams.

Just a few doors down from the heart, classic (open) appendectomies have been performed by the thousands over the last two centuries — and the number gets higher when you add the laparoscopic procedures done since 1987. One Texas hospital even reports that it has performed 500 craniotomies (skull/brain surgeries) per year over the last three years.

Don’t Forget Anesthesia

If you’re still not convinced that surgery can be simple, don’t forget about the advances in anesthesia. Derived from a Greek word meaning “without feeling,” anesthesia refers to the state of being temporarily without sensation or awareness. Anesthesia enables you to undergo these surgical procedures without experiencing pain or distress. Anesthesia, however, does have risks depending on what a particular surgical procedure may necessitate.

Whether a surgical team uses general anesthesia (medication that renders you unconscious and prevents you from feeling pain during your procedure), conscious sedation (medication that also prevents you from feeling pain, but it enables you to stay drowsy and awake), regional anesthesia (medication that blocks pain in a specific area), or even local anesthesia (medication that causes you to lose sensation in a small area for a minor procedure), fear of the anesthesiologist probably pales in comparison to the fear of a surgical procedure without one.

Surgery Really Can Be Simple

When most people think of surgery, they envision something Frankensteinian, or even a wacky doctor’s game. Today, however, surgeons can perform extensive procedures with almost no cutting by using measures that are less invasive than ever before. This is why a prospective surgical patient should understand what is referred to as the “invasiveness” of any procedure. For the most part, surgeries break down into three categories: non-invasive, minimally invasive, and invasive (or open).

Non-invasive procedures do not break the skin, penetrate a body cavity or remove biological tissue. In other words, there are no incisions. Most of the tests done during an annual physical fall into this category: taking your pulse, monitoring blood pressure and listening to the heart and lungs. Non-invasive procedures usually don’t scare patients.

Minimally invasive procedures usually involve tiny incisions and minimal body intrusion. The procedure could be relatively simple (getting a shot, for instance) or more involved (like endoscopy — used to take images or small amounts of tissue, aka a biopsy, by inserting a small scope into the body via an existing anatomical opening). These surgeries can take longer to perform but often involve shorter hospital stays, and many can even be done on an outpatient basis.

Invasive (or open) procedures involve making an incision (usually a significant one — in other words, bigger than a tiny cut) in the patient’s body. This is what people often think of when they imagine surgery. It’s also what we most often see on TV, and what has been done throughout history, until the late 1980s.

Though the prospect of undergoing any type of operation can certainly be frightening, and each does come with its own set of risks, surgery today is not what it once was. Many of the most complex modern surgical procedures can be done using minimally invasive or tried and true classic open techniques. By taking the time to inform yourself as to the type of surgery and procedure involved, you will be better able to envision each element of the process, thereby removing the sense of dread that comes with the word and reducing the experience to a series of simple steps.

This Emotional Life is a two-year campaign to foster awareness, connections and solutions around emotional wellness. Join our community at www.pbs.org/thisemotionallife.

The Kids Are Not Alright, Apparently: The 2010 “Trouble In Toyland” Report0

For the past 25 years, the Public Interest Research Group (PIRG) has published an annual survey of toy safety. In its most recent report, PIRG provides safety guidelines for consumers when purchasing toys for small children. The report also identifies potentially dangerous toys on sale. [audio:http://hospitalstay.com/wp-content/uploads/2010/11/05-The-Kids-Arent-Alright.mp3|titles=The Kids Aren’t Alright]

The following information is taken directly from PIRG’s Executive Summary:

In April 2010, the President’s Cancer Panel – a group of three distinguished experts appointed by President Bush to evaluate the nation’s cancer program – raised the alarm about our ubiquitous exposure to toxic chemicals. “The American people – even before they are born – are bombarded continually,” the panel wrote. In effect, our lives have become a giant, uncontrolled experiment on the relationship between toxic chemicals and our health. … Read more →

Watching the Brain Respond to Acupuncture0

With the aid of functional magnetic resonance imaging (fMRI), a specialized MRI that measures the hemodynamic response (change in blood flow) related to neural activity in the brain or spinal cord, researchers can now capture images of the brain during acupuncture.

The study was presented at the annual meeting of the Radiological Society of North America (RSNA), showing pictures from patients experiencing pain with and without acupuncture. … Read more →

When Clean Is Too Clean0

A new report from the University of Michigan School of Public Health suggests that children who are exposed to antibacterial soaps in large quantities may suffer more from allergies if the soaps contain Triclosan. The same study also linked overexposure to Bisphenol A with a negative impact on the adult immune system.

Triclosan is a chemical compound typically used in soaps, toothpaste, pens, diaper bags and medical devices. Bisphenol A (BPA) can be found in many plastics. Both chemicals are considered “endocrine-disrupting compounds” (EDCs), which can cause harm by mimicking or affecting hormones. … Read more →

Lost Hospital — Santa Teresita Hospital, Duarte, California1

In 1930, the Carmelite Sisters of the Most Sacred Heart founded Santa Teresita Hospital. Originally a tuberculosis sanitarium, the hospital was located on a three-acre plot in Duarte, California (Duarte had a population of 300 at the time).

The Hospital was named after Saint Therese, a French nun who died of tuberculosis. In Spanish she was called Santa Teresita (“the Little Flower”). … Read more →

Lost Hospital — Tuolumne General Hospital, Sonora, California2

Tuolumne General Hospital opened in 1849 as a full service, acute care hospital, providing a complete range of medical, surgical, and diagnostic treatment.Tuolumne catered to the residents of Tuolumne County and neighboring rural counties of the Mother Lode.

Originally one of the oldest healthcare systems in the nation forged by an informal partnership between local governments and merchants, the Hospital was first built to provide care to the “sick and destitute”. … Read more →

Lost Hospital — Philadelphia General Hospital0

The Philadelphia Almshouse (later renamed the Blockley Almshouse), founded in 1729 was the first public hospital in America.The Hospital cared for the sick and mentally ill while feeding the impoverished. In 1767, the facility moved to a larger building and was called the Philadelphia Bettering House.

Eventually renamed Philadelphia General Hospital (PGH) in 1919, the original Blockley Almshouse buildings were replaced with a modern hospital. The original patient wards were 40 beds long, divided into four separate sections on two floors. There was a pharmacy on the first floor, an asylum in the basement, and operating rooms on the third floor. … Read more →

The Decline of Mental Health in America1

This past year, 19.9% of adults in the United States (45 million) have suffered from mental illness, according to a survey  by SAMHSA (Substance Abuse and Mental Health Services Administration).

Add to that, 4.8% of the adult population in the U.S. (11 million people) have battled serious mental illness in the past 12 months.  According to SAMHSA, serious mental illness is defined as “one that was diagnosed and considerably undermines at least one of life’s major activities.”

This same survey (2009 National Survey on Drug Abuse and Health or NSDUEH) determined that one million Americans over 18 attempted suicide, 2.2 million made plans to end their lives, and 8.4 million gave the matter serious consideration. … Read more →

Lost Hospital — Douglas Community Medical Center0

Douglas Community Medical Center in Roseburg, Oregon, was built in the early 1950s. Community leaders in both areas wanted a secular alternative to long-established Catholic hospitals within their borders.

Led by Roseburg Forest Products owner Kenneth Ford, the hospital provided a secular alternative to Catholic hospitals in Oregon. Even as the ownership structure of the hospital changed after 1985, the facility still maintained its community status: patients went there to be treated by friends and neighbors. The corporate changes, however, ultimately proved to be too much for Douglas Community. … Read more →

Lost Hospital — Arkansas State Tuberculosis Sanatorium, Booneville, Arkansas1

By the end of the 19th century in the United States, tuberculosis was a highly contagious, misunderstood, and practically incurable disease.  Its mortality rate was about 80%.

In May 1909, the Arkansas Legislature passed Act 378 to construct the Arkansas Tuberculosis Sanatorium.  The Act provided for in part: (1) the establishment of the facility to provide treatment for tuberculosis patients; (2) $50,000 for the purchase of the site, equipment and construction for the Sanatorium; (3) $30,000 for operational expenses for the facility; and (4) establishing criteria for admission of patients, including proof that any patient has tuberculosis and is a resident of Arkansas. … Read more →

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