Surgery! That isn’t a word any of us really want to hear. It is a little scary when you need surgery for any reason, even if it is minor. Thoughts of complications, not waking up, and more, may go through your mind and send chills through your body. No one wants surgery, even if you want the results that a particular surgery will bring. For me, the fears are always compounded with how they are going to treat me. Will I be able to communicate with the doctors and nurses? Will they even try? Will they care that I am afraid? Will they ignore me and pull and tug on me and act like I’m a medical practice mannequin because I can’t see and hear? So much goes through my mind that sleeping is difficult and fear rises long before the day arrives. Recently, I was told I needed surgery again. This time on my neck, which is scary in many ways all on its own. What would happen?
The surgery was scheduled for removal of an adenoma (tumor) of the parathyroid at The Norman Parathyroid Center located at the Tampa General Hospital in Tampa, FL. I had to leave my state of Georgia to get this surgery. All I could do was tell them that I was deaf and blind and needed a medically certified ASL interpreter who would do tactile ASL. I have been in hospitals before and denied interpreters despite the ADA law. I knew it could happen, and I knew the problems it could cause if I didn’t understand the directions that medical staff needed me to follow. All I could do was show up at 7:00 am that August morning and pray.
We arrived on time to the surgical center’s floor. I stepped off the elevator already feeling like a fish out of water because I chose to leave my guide dog at the hotel to keep from scaring him too much. Little Joe would have been allowed in compliance to ADA, but I didn’t want to cause him stress. To my great surprise, a hand gently touched my shoulder and then slid down my arm and under my hand. My hand was guided through the signs HELLO MY NAME and then letters formed in my hand and mind N I C H O L E, Nichole. I INTERPRET FOR YOU NOW DAY (Today). Ah, fear began to drain away. That was a good start, but I have had great interpreters before and still had nightmare stays at a hospital. I remained cautious.
We sailed through the initial check-in with the help of a nice lady who was patient and friendly. She didn’t give me the usual impatience or hint of frustrated energy. The questions were answered, but there was a light-hearted air to the conversation and even a few laughs from all involved, even at my occasional jokes.
Next, I was taken to a curtain-walled “room” among the line of similar “rooms”. As I was brought in, I noticed first that the usual discomfort I had was much diminished. Tampa General Hospital has an unusual layout where they literally let the outside come in. Located on a point of Davis Island in the bay, the hospital uses windows everywhere possible, letting in the natural light and using less artificial light. It gave a peaceful feeling which I’m sure helps with anxiety in addition to cutting electricity costs. The views for the sighted go a long way, too, because even in the pre-op and recovery rooms on my floor, the outside wall was entirely glass letting the view of the bay speed recovery. We took a picture to share. I wish all hospitals had views like this. It is more like a luxury hotel than a hospital, but that is a good thing, right?
The nurse greeted me with a cheerful and caring voice as I arrived. She told me that she would be with me every step of the way. She explained every aspect of the room to me as far as the medical equipment and what would be used and why. The interpreter added other details of the mundane arrangement of the room, as is her job. The nurse then said the doctor and anesthesiologist would be in shortly. I was given detailed instructions about getting undressed and in the hospital gown and booties, and then asked if I had any questions. Pretty routine, right? Sounds no different than what happens to other patients, right? Well, that is my point. I only need a way to understand what is happening, so you can treat me as you would anyone else.
Doctor and anesthesiologist came in and asked the routine questions and explained the surgical process and possible complications. I, of course, had to sign that I understood that “something could go wrong.” The conversations were lengthy and took longer than normal, and even though my husband was in the room and many staff usually will just talk to him instead of me despite my objections, the staff at Tampa General talked to me and after, only after, I showed my understanding would they turn to my husband and ask if he had any questions. This practice made me feel not only involved but important, which I should be in this case because it was me and not my husband who was having the surgery. Yes, the conversations were lengthy and somewhat slow, but both professionals took the inconveniences in stride and came in and out as they had to deal with the other surgeries of the day (8 total with one other taking longer than normal as did mine, which was much longer than normal it turned out because I had two tumors and one wrapped around the nerves to my larynx- voice box). I didn’t ever feel that they were annoyed, angry, or any of the things that I have felt with other doctors and staff in other hospitals. When I don’t have an interpreter the instructions they give aren’t followed. I have no idea what to do or what is happening. With an interpreter like this time, the difference was that I could communicate. They could tell me in a way that I could “hear” and I could know enough of what they said to consider it and ask questions as I needed.
Unfortunately, having good communication doesn’t always ensure good understanding. It helps, of course, but the attitudes of the medical staff in any negative way prevent the interpreter from being able to do their job properly. The medical staff and the interpreter worked together as a team this time caring down to the smallest detail if I understood and if I was feeling safe and secure. The interpreter was even allowed in the operating room (OR) wearing scrubs as she should have been. Some hospitals will get an interpreter, but they won’t allow the interpreter in the OR. The ADA does allow interpreters in the OR until the patient is asleep because there are still instructions being given and things happening that need to be explained to the patient to prevent anxiety. The practice, when allowed, works well. The difference was amazing. Yes, it was routine sounding for many of you, but for me it was a unique experience. I liked being treated the same and my procedure went well with no fear and less of the usual nervous tension.
Besides the use of an interpreter and the caring of medical staff, a few things happened that helped me that might seem trivial to some, but the allowances went a long way toward my comfort and ease. I was allowed to keep my sunglasses and hearing aids on until I was asleep in the OR. The medical staff also made sure that after the surgery before I woke up that my sunglasses were back on and my hearing aids back in. Bright lights give me migraines and actually cause instant pain in my eyes. Recovery would have been made worse if I had gotten a migraine, plus the pain would have added to my anxiousness throughout the tests and pre-op and especially the OR. The hearing aids may or may not help. I use them when around people and in new places. Any noises I pick up I use in processing what is going on around me. Having them on gives me confidence that I am in control and can figure out what is happening.
These added allowances were not a problem for this staff. During surgery, they kept my glasses and hearing aids in a little box with my name and data on it like the medical ID bracelet we all wear. The staff made sure they got the box when I went into recovery. In fact, they went further than expected. They not only heard me when I explained why I wore the glasses and hearing aids, but they took it to heart and made sure I didn’t wake up with bright lights in my face and heard whatever sounds I could by putting the glasses and aids back on. Very few staff would have thought about that. It mattered to them because it mattered to me.
One more thing that made this experience unique for me and might be the most important was that the doctor touched my hand (after getting permission) several times as he talked to help me know he was there and attentive and caring. The explanations were important and helpful to let me know where I was and what was around me. More important than the explanations, though, were the little touches to show they knew I was human and allowed me to feel human. I can’t see your smiles, but I can feel them through your hands.
This is what happens when doctors, nurses, and hospital policies come together and do it right. I can feel safe and secure during a scary situation which helps me heal. It really doesn’t take that much, but it begins with that all important skill of listening with the heart.