The Inadvertent Comment

The other day a surgeon I actually really like was putting in a G-tube on a patient, which is required when they cannot feed themselves by mouth. The approach involves an incision and dissection down through the upper abdomen to the stomach. As he operated, he said, 'you know, it's really nice to finally have a patient who's thin'. We're in the midwest; most of our patients are over 200 pounds, and it is not uncommon to have someone north of 400 pounds, which makes operating quite difficult, and much more dangerous.

The woman had stage 4 squamous cell cancer which was preventing her from eating by mouth. No wonder she was thin.

Insensitive? These types of comments are the ones that get people all mad. But really, I had ample evidence that this surgeon was, though maybe not warm and fuzzy, compassionate. We're just human. His mind was preoccupied with the task, not the big picture, and when he has a long, curved needle in his hand, that's absolutely for the best.

Without thinking I've asked people with ET tubes down their throat how they are doing, or other questions that require an answer rather than a nod. I've accidentally dropped names in the cafeteria, although I'm getting better at that. I've made jokes or light of injuries that may border on insensitive out of a desire to lighten the atmosphere in a room, even though there is evidence that jokes do not help patients feel better about their conditions.

People are right to point out insensitive comments to health care professionals; we often come to wear callous veils to protect ourselves from the stream of injured humanity we see, especially in the critical care or surgical professions. I don't think that there is a way to consistently re-assemble people without detaching a bit. Some situations become so absurd that we end up laughing because we don't know what else to do, and because if we didn't, we'd instead go slightly bonkers. It doesn't excuse us or decrease the need to remain sensitive to the patient; but if you happen to overhear something to which you object, the context might be helpful. Maybe the doctor who seems callous, is; but it may also be that they are distracted or have a point of view that differs from your own.

"You're going to find that many of the truths we cling to depend greatly on our point of view". --Obi-Wan Kenobi.

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