Archives for posts with tag: surgery

When I was a kid I used to run out of books to read pretty often. I no longer have this problem because I always, always have homework to do, and when I’m somehow done with that homework, there is always an interesting book around that my mother-in-law has recommended (or even sent in a care package).

Thanks! An embarrassment of literature!

But, back to my childhood…I used to read pretty much anything I could find between trips to Barnes & Noble or the public library or the library at my high school. As a result, I read such scintillating classics as Dr. Atkins New Diet Revolution (almost every adult I knew was on the diet at the time, so there were copies around everywhere to read). Once in a while the public library or school library would have one of those boxes of rejects sitting outside, and I would pick up a couple of those to read just in case I ran out of something I had actually chosen for myself. Those books were on an assortment of topics that were totally random, but I didn’t mind because I like to read that much. That’s how I ended up with a copy of What Southern Women Know (That Every Woman Should). This is the sort of book that has advice on how to control your significant other by doing things like returning your new dress if he says he doesn’t like it. Brilliant.

Anyway, I only bring it up because I think that book is the first time I remember learning about the criticism sandwich. I think the author made reference to a dish of southern origin called vinegar pie? Of course, I read it so long ago that I could be wrong about learning it from that book; I could be recalling a passage from an etiquette book (I have a small collection of them too) or maybe from one of those American Girl magazines. Either way, I always liked the concept of the criticism sandwich, where you say something nice, then slip in the thing the person could use some work on, and close up with something nice again. The compliment “bread” softens the blow of the hefty criticism “filling.” I bet there is science somewhere that would say it’s actually easier to take criticism when you’re feeling fluffed up from flattery, but I’m not going to go find that science right now. Instead, for evidence I’ll say that it worked well for my students, both with teacher feedback and peer feedback. Like this:

You should be so proud of yourself for finishing this draft on time!

I can’t figure out how the information in your third and fifth paragraphs helps prove this argument.

If you use the same concluding sentence structure from your really clear second and forth paragraphs in the third and fifth paragraphs too, your reader will definitely be able to follow your argument more easily.

I’m clearly having trouble remaining on topic today because the reason I mention any of this is that I wish scary information at the hospital were delivered in a kind of bad news sandwich. The hours between being admitted to the hospital and going into surgery were terrifying. I was in a lot of pain, the kind where intravenous drugs dull the ache without quelling it. Anxiety about missing school and not doing work actually crept up while I lay there agonizing about everything from scarring to infertility.  My husband was tired and missing school and I felt guilty for burdening him. My belly groaned in hunger and had no idea when I would be allowed to eat. Bad news, or the promise of it, kept coming and coming and coming.

Doctors said things like if it’s malignant (cancer!) we’ll have to bring in specialists from another hospital. Or, since it looks like the cyst is twisted around your ovary, the ovary might be necrotized and gray and then we’ll have to take it out. I became more panicked as I considered each additional data point about my condition from the worst-possible-scenario-perspective. I felt even more exhausted and afraid. 

I don’t blame the doctors for shooting straight, of course, because they need to provide patients and loved ones with information about what could possibly happen. It would be worse to go into surgery expecting everything to be quick and easy, and find out afterward that a complication the doctor could have reasonably predicted actually did occur. Some people anticipate loss to mitigate grief.

Still, I could have used some good news wrapped around my bad news. I’m not a doctor, so I don’t know exactly what good news there could have been, at least until after the surgery. But maybe they had eliminated the possibility of something particularly insidious, and could have shared that tidbit with me.  Maybe they had done very similar surgeries before many many times and could have mentioned that, we’ll need to do surgery right away, but we have done this type of surgery on similar cases ten times this year and it is often successful and without complications before discussing the complications. I don’t know what would have worked, but I remember clinging pretty tightly to one nugget of information that seemed vaguely promising, cysts are relatively common, even in young women. How bad could something normal be, even if it had expanded and grown beyond average proportions?

I’m going to try and remember, whenever giving really bad news from now on out, to try and frame it with some good news too. I’m sure there are some other people, like me , who could benefit from a little support in keeping back the anxiety beast.

How would you like your bad news delivered? Do you use the criticism (or bad news) sandwich? Have you ever had vinegar pie? 


This is the unbelievably sweet get-well card my classmates signed for me.

One week ago my husband called a taxi-cab at three am to take us to the hospital. This was our third or fourth trip to the ER in the past eighteen months; actually, in the four years since we’ve met, we’ve each suffered a handful of decidedly random health crises. The last time I ended up in the hospital was a few days after being accepted to Harvard. I caught my husband’s stomach virus and couldn’t keep any fluids down. A few bags of saline and some anti-nausea medication later, we were back on our couch slurping popsicles and lamenting the low quality of the movie rentals available through our cable’s On Demand service. We had missed a dinner reservation at new restaurant in Brooklyn.

I thought this trip would be  identical. The symptoms suggested food poisoning – sharp pain bisecting my abdomen, nausea, bloating. On the other hand, the pain was so bad that it was intermittently challenging to talk. After we wrestled with it for three or four hours, Mr. resolved to call a car and we were sitting in the hospital waiting room twenty minutes later.

The hospital I visited in Massachusetts seemed worlds apart from the ones I’ve seen in NYC. This is not to say that all NYC hospitals are the same; on the contrary, there are hospitals I would choose to be rushed to in the City, where the relative affluence of the surrounding neighborhood ensures downright cozy, brisk service, and others where the care is sporadic, the security random, and the staff brusque. In the City the ER waiting room has always meant a parade of tragedies and oddities; a trimmed off finger wrapped in blood-soaked towels, a wailing man reeking of garbage, two twenty-something women drunkenly chastising themselves for eating from the vending machine. The only time I ever experienced a quiet hospital waiting room was when not-yet-Mr. and I hailed a cab to Lenox Hill the evening Hurricane Irene hit New York. While they waited for his test results, the nurses discussed whether they would accept the hospital’s offer to remain in a hotel for the evening.

But here in non-urban MA, at three-thirty in the morning just one other person sat at the bank of peach leatherette chairs by the intake station. His sweatshirt had been pulled taut around his face, Kenny-style. The man declared that he was waiting for daylight to strike so he could walk home. A passing maintenance man advised him to take the bus and not worry about the change, the bus driver would take him anyway, “Mr. Obama will pay for it.” When I was finally taken into the emergency department and given a bed, the space was private, away from the coughs and domestic disputes of my fellow patients. A relatively unharried assortment of nurses and nurse practitioners sipped coffees and shuffled around at steady pace. A physician lent Mr. her iPhone charger.

Last night before bed Mr. and I were reflecting on the time in the ER before they admitted me. I told him I thought we were in the ER for twenty hours, which he quickly demonstrated impossible. Whenever I am in an emergency room, either as patient or nervous companion, whether in a terrifyingly busy or dead-quiet facility, I am always surprised by the slow progress of emergency treatment. I mean no insult, I received excellent, and mostly personable, care throughout my hospital stay. I only mean that for whatever reason – because I have watched too many medical dramas, perhaps, or because “emergency” sounds a lot like “urgency,” – time in an ER seems like the perfect exercise of hurry up and wait. Anticipation, anxiety, and pain conspire to expand each second. Each hour feels like two while you wait for the EKG or the MRI or the ultrasound or the consult or the transport or a wash of plain relief. I am reminded of a passage from one of my very favorite novels, Virgin Suicides* by Jeffrey Eugenides:

On the morning the last Lisbon daughter took her turn at suicide – it was Mary this time, and sleeping pills, like Therese – the two paramedics arrived at the house knowing exactly where the knife drawer was, and the gas oven, and the beam in the basement from which it was possible to tie a rope. They got out of the EMS truck, as usual moving much too slowly in our opinion, and the fat one said under his breath, ‘This ain’t TV, folks, this is how fast we go.’ (Emphasis added.)

Indeed. Though it can induce handwringing misery in a patient, emergency requires an even pace, methodical, measured decision making. Unless a patient crashes, it is probably too easy to cause harm in a rash rush.

What have your ER experiences been like? How have you passed the time while the doctors figure out what is the matter with you or a loved one? Are you afraid of doctors or needles or illness? 

*Why do I call this book Virgin Suicides rather than The Virgin Suicides, as is printed on the cover? During my senior year of college I saw Mr. Eugenides at a reading and interrupted his conversation with a bunch of serious, well-known, very cool authors in order to ask him to sign my copy. He immediately opened it and crossed out the article. I am probably getting this all wrong, but I like to imagine there was some kind of debate with an editor over whether the article was necessary.