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  • Writer's pictureBethany Crystal

Cranberry Juice & Saltines: A Menu for Post-Surgical Autonomy

First Time AroundI’ll admit it: For my initial surgery five years ago, I went in to the operation totally naive. I falsely assumed that, since I’d previously had my appendix — a literal organ — removed from my body, having a few bones scraped off the interior of my nose would be a breeze by comparison. This was a gross oversimplification of the matter. What I failed to consider was how many damn nerves there are in your face. And how much more all of the pieces in your face connect and touch and hurt. From what I understand, waking up after anesthesia always sucks. You’re groggy, confused, nauseated, and supremely dehydrated. Add to this the complication of having bandages cover your nose blocking your air passageways and you’ll start to get a sense of the heightened drama of waking up from this procedure. Obviously, intellectually, I knew that surgeons would be operating on my nose and face. But emotionally, I hadn’t prepared for the implication: When you wake up, you won’t be able to breathe. But don’t panic. All I knew was, at one moment I was sort of awake. I didn’t really know where I was. I was thirsty, so thirsty that I thought I might die. I was freezing and shivering. I was in in pain, and I was nauseous. And, to top it all off, I couldn’t breathe. I’m so thirsty. These are first world problems, I told myself. You asked for this and they gave it to you. It’s not like you’re actually dying. But I can’t breathe. People in here are actually dying. They have worse ailments and diseases than you can even imagine. There are people here who won’t be going home today. Or ever. You can’t even pretend to have any problems that come close to that. Just. Don’t. Panic. What can I say? I’m an anxiety-prone, millennial woman. I panicked. My eyes starting dating back and forth while I tried reasonably to gesture to someone how much my throat was sore, how thirsty I was. “Don’t inhale,” a nurse told me sternly. “But it hurts,” I croaked out. “Then try coughing,” he suggested. That was quite possibly the worst suggestion someone has ever given me. I coughed. And up came a bloody mess of mucus and membranes all over everything. Then I panicked even more. I remember seeing blood all over myself and not being able to do anything about it. I remember feeling like I needed to vomit and then having all of the nurses leave me alone for a period of time. I remember asking for where my family was at least three times before they brought my mom into the room. And I remember asking repeatedly for water and for blankets. I was so sad. And so frustrated. And so helpless. It doesn’t feel great to feel like you’re not in control. Even when I knew that all of the people around me were just trying to fix me the inside, there was still a little part that craved some validation on the outside, too. I want to be seen. I want to feel heard. I want to feel safe. I want to have my needs met. “Our procedure was a success,” the doctor told me. “We executed the plan perfectly.” “That’s great to hear,” I replied. But I didn’t feel great. I felt ignored.

Prepping for Round Two“You need to listen to me,” I told Jason, my husband, as we were preparing for my procedure last Tuesday morning. “Bring a bottle of water. Put this blanket in your backpack.” I felt like we were stockpiling for a disaster. But I wanted to be prepared for anything. “Won’t they have water and blankets at the hospital?” he asked. A very rational question. He’s good like that. “I don’t care,” I replied. “It might be awhile before they remember to bring them to me. And I don’t want to be sitting there freezing and miserable again.” “Do we really need to bring our own cup too? Maybe I’ll just bring a bottle of water. They can give me a cup.” “NO.” I told him sternly. “Bring everything. We need to be prepared in case they abandon me. Then you can sneak me some water.” “I’m not going to ‘sneak you’ anything in a hospital unless they say it’s okay,” he said. “We’ll see about that.” No matter what happens, I thought, at least this time, I’ll be ready.

The Pre-Surgery ChecklistLater that morning, at the hospital, as I was getting prepped with an I/V, my attending nurse brought over the requisite paperwork to fill out. I looked over a familiar stack of black-and-white legal documents, signing off my consent a half-dozen times. But then she pulled off a blue and red card from her clipboard. It looked something like a lottery ticket or a bingo card. The nurse passed me the card, along with a pen. “Check off what you’d like in your recovery room.” I scanned over the options. It looked like this.

Beverage & Snack MenuApple JuiceCranberry JuiceOrange juiceGinger AleCoca ColaIced TeaIced CoffeeIced Green TeaIced Chai TeaSaltine CrackersGraham Crackers For each drink option, you were asked to select whether you wanted ice or no ice. For Coca Cola, you could opt for diet. For coffee, you were given the choice of cream. Your choices continued even down to the saltines, where you could choose either salted or unsalted. I stared open-mouthed at this tiny card and definitively checked off “Cranberry Juice,” making sure to retrace my lines a second time to be sure it stuck. “You can check as many as you’d like,” she told me. As many as I’d like??? I looked back at the list. There were 11 different options. The idea of offering me an unlimited number of selections on a multiple choice list of prizes just felt crazy. They weren’t going to limit me at three? Or five? What if I went crazy and chose all 11? I felt a kid in an arcade redeeming my tickets for prizes at the end of a day. It was easily the most humanizing thing that hospital could have done for my experience. In the end, here's what my card looked like:

The Person Behind the ProcedureMedical procedures are inherently stressful. Since the product is literally altering a human in some way, getting the job done isn’t as simple as executing perfectly on a plan. There’s a person behind the procedure. Sometimes it’s easy to forget about this part. Hospitals and doctors that remember are the ones that stand out. At first glance, these menu checklists might seem trivial. After all, it’s just a list of drinks they would have offered me anyway. But it’s not about what they did, it’s about how they did it. Having the foresight to ask me in advance, to gamify the way I made my selections, and then delivering on that promise was a true delighter in an otherwise miserable setting. In the end, this one little tweak to their patient experience built trust and added a little humanity to the process all-around. For me, it also severely reduced my anxiety before and after the procedure. And for that, I am very grateful. Don’t get me wrong: Waking up with a face full of bandages still really sucks. But it sucks a lot less when you’re given a little autonomy and control. Even if the only choice you get to make is whether or not you’d like ice with your cranberry juice.

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