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 2 billion people world-wide 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, fifty 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.

Craig Boyd Garner Bio

Craig is an attorney and health care consultant, specializing in issues surrounding modern American health care.

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