The booking clerk at the OR called: the anaesthetist wanted to meet with me.
It dawned on me then that this promises to be a serious surgery. I’ve never met with an anaesthetist before. Most of us can hardly spell the word, although, by my age, most humans have had occasion to fall under his spell.
Dr. M has no office–just a well-organised desk in a corner of the surgery area.There’s a binder on the desk which turns out to be totally focused on the body I walk around in. He lets me read it. This is good, since I own the body which is the subject of the book and I also believe in patient autonomy. These reports belong to me, whether I paid for them personally or not.
This discussion is about what is going to happen to the body on Monday, and about how to keep the pain under control afterwards. It turns out our understandings about the colon re-section differ quite a bit. I think Dr. P is going to chop out just a few inches, but Dr. M expects a foot or more will have to go. The nice thing about being in a small town which has a biggish hospital is that doctors can actually get hold on one another quickly. So off toddles Dr. M, to talk with Dr. P. While he’s gone, I peruse the binder…and discover the answer to a long-held question.
Fifteen years ago, when I was suffering the indignities and agonies of full-fledged FMS while simultaneously being the butt of approximately 40 lawsuits, I was sent for several IMEs. An Independent Medical Examination is a procedure that supposedly gives the court an independent professional insight into the litigant’s medical condition, to help the court (i.e., judge) decide what factors caused it. But IMEs are often boilerplate, biased garbage. Every lawyer knows that there’s a stable of plaintiffs’ doctors, and a stable of defense doctors, and seldom the twain do meet.
I was sent to the defense doctors, of course, the guys whose job it is to opine that one’s symptoms are all in one’s head. My examiner was doubtless chosen for his cleverness; the defense needed someone who could trap me, the lawyer who just had to be faking her symptoms, into betraying her expertise with the situation. So, as he was feeling me up, which is, after all, his duty, he said provocative things, as if talking to himself, hoping for a reaction. The comment I remember most clearly was his observation that he found hepatomegaly.
That word means the liver is enlarged. A cross-examining lawyer would seize on that word as implying the patient is an alcoholic or some other kind of addict. Hepatomegaly was an invitation to spar with the good doctor. I might argue with him and thereby give him material for the defense theory that I was a malingerer and also, perhaps, release a few facts about me. At the least, if I reacted, it demonstrated my "unhealthy" interest in studying my own case.
I said nothing. No reply. But I worried. As the treatment plant of the human body, livers are tremendously important, and we each have only one. Was mine really in trouble? I’ve worried about the poor thing since 1995.
The binder reported the results of the x-rays and scans I’ve had lately. Not a damned thing wrong with any organ besides the colon. The liver was stated to be normal.
That doctor lied to me. He lied, for the sake of a lousy lawsuit. For an insurance company that paid his bill. Remember this if you ever are forced to submit to an IME. The examining doctor is not your friend. Keep your mouth shut.
Law tries. It tries to be good; tries to help people. Yet it simply cannot understand that the profit motive poisons its systems.
My current doctors have no axe to grind. They are totally on my team–what a relief! Dr. M returned and cheerfully described the choices in pain control. We chatted about ancient history–his childhood and mine–when each of us underwent a tonsillectomy while we were put out like lights by a sweet-smelling snootful of ether. (The stuff is still used, apparently, where more sophisticated substances are not available.) Nowadays, there’s a choice between patient-operated narcotic administration and an epidaural administration of anaesthetic, with maybe a little painkiller to boot.
Here’s the scary bit: the epidaural is a lot like a spinal tap. I think the docs even refer to the procedure as such. As a law student, I had to do research on an almighty thick case where a patient who underwent a spinal tap became a permanent paraplegic. I learned a lot of medicine from that case, but I also learned I never wanted a spinal tap, or a lawsuit.
The time has come to add the spinal tap to the lawsuits that have bludgeoned me. Times have changed: instruments and remedies have improved. Narcotics, on the other hand, are as nasty as ever–if you’ve ever wondered what it feels like to be dropped on a sidewalk like a sack of concrete, try pulling a morphine feed out of your arm sometime. Aughh!
I think I’m going to opt for the epidaural. But it’s frightening.
I think of all the moments in my body’s life when what I understand to be me was not in that body. Never mind the tonsillectomy–what about the times I’ve fainted or been knocked out, and the half-dozen surgeries? Where was "I" in those moments?
Either I did not exist, or "I" was a ghost. That’s what this man does for a living–turn people into ghosts, and then back into people.
Everything will be fine, and the surgery will give up answers otherwise unobtainable. But for several hours on Monday, I will be a ghost. This time, I plan to ask my spirit to pay attention to its whereabouts. Just for once, I’d like to know what the hell is going on.