Surgery in the Offing?

If you haven’t had surgery recently, there’s a good chance you might.

Recently the World Health Organization estimated that worldwide there are approximately 234.2 million “major surgical procedures” performed each year. Of this number, a modest 31,000+ are performed in the main operating rooms at the UVA Hospital. I recently had back surgery at UVA, and as I was being wheeled through the labyrinthine corridors toward my encounter with the surgeon, I asked the anesthesiologist how many operating rooms they had. His response was “about 35—and most of them are busy most of the time.” In researching this article I also found out that there are approximately 26,000 inpatient admissions to UVA Hospital each year, and the average length of stay was 6.7 days.

This article is not intended to chronicle a day in the life at UVA Hospital, however. Instead, I want to make some informal comments and pass along a few observations from my recent experience there.

Sixty years ago the sociologist Erving Goffman published a series of four essays collected in a book entitled Asylums. In these essays he examined what he termed “total institutions”--mental hospitals, prisons, boarding schools, monasteries . . . quite a collection. These are institutions in which we are separated from the larger social world and cede control to “others”--and these others have almost total control over our lives. We are, for example, told what to wear, when (and sometimes what) to eat, when to get up, and when to go to sleep. For obvious reasons I thought of Goffman’s book while I was lying in bed at the hospital. The lack of control can vary between the benign (“I’m being taken care of”) and the terrifying (“Why are others in control of almost every aspect of my life?”)

If you anticipate staying in a hospital for a few days, you will want to make sure that before you get there you memorize your name, your date of birth, and the name of the procedure you’re having, for you will be expected to answer these questions about twenty times each day. This is, of course, a security measure—you wouldn’t want to go in for an appendectomy and find you got the patient-in-the-next-room’s heart transplant. And if on that twentieth time you answer the question “And what procedure are you in for?” with “a pedicure,” expect a stony silence.

You will be told that post-surgery you will need to rest. Do not expect this blissful condition to begin in the hospital. Techs will arrive at untoward hours to draw blood and check vital signs, you might have a visit with an occupational or a physical therapist, nurses will be delivering meds, doctors (including some you’ve never seen) will be stopping by to check in on you. And if you’re lucky you won’t have a roommate who likes to watch game shows on tv.

Don’t expect much privacy in a shared room. You will be separated from your roommate by a thin curtain, and behind this sound-permeable curtain his doctor may have discussions with him about things you have no interest in, appetite for, or understanding of. And his visiting family might be a bit louder than you would like. Just sayin’ . . . .

Finally, do expect a compassionate staff that is doing all it can under difficult circumstances (understaffing, 12-hour shifts, ongoing concerns about Covid) to provide you with the best care they’re able to. Find out the names of your nurses and techs (they’re on the white board in front of you) . . . and thank them for what they do.