On Being a Patient: Acknowledging Dualism of Sensuality & "Patient" Self

Most of what I write at Health Management Rx is professional and dry, divorcing my sensory experience as a patient from the goals I have for our industry as a professional.

Every once in a great while, though, I'll draw more esoteric material from my personal experiences with trauma, surgery, and recovery.

The physical experience of illness - hospitalizations and surgeries- is certainly dehumanizing and debilitating.

However, if your mind is relatively clear and your condition lasts long enough, there are also moments of extreme lucidity, where the urges of the flesh become paramount, concrete.

Illness laser-focuses your stream of consciousness...everything else in the world slows down around you, allowing significant time to dwell on sensations remembered.

Having been a patient brings a unique viewpoint...and I find it vital and cathartic for those of us who have been there to acknowledge and share how living with a chronic condition changes the way you think and feel.

I want to challenge our perceptions of patients as people completely divorced from needs and wants by illness. Many of us struggle to be people living with conditions, not being driven solely by our diagnoses.

Some of the feelings in this post were excrutiating to acknowledge, and are almost as difficult to share.

Everything is more challenging with a chronic condition, and thus, perhaps, more rewarding - nutrition and voiding, verifying 'normal' range of motion, even the sense of self that evolves naturally from independent movement. You are a plush pile of firing synapses clothed in a flimsy gown.

Simultaneously you become both more aware of your body as a physical, grounded, map of skin and sensuality, but also distanced from its recreational pursuits, the importance of 'fun' kidnapped by baser physical functions like constant low level pain.

Sometimes you can't stand the taste of plain water. The smell of flowers, laundry detergent, and certain foods is overwhelming. Each sensory experience is altered, and so is how we perceive the purpose and function of our bodies, in which 'business as usual' was so often taken for granted.

Because so much of the rest of recovery is often devoid of pleasurable sensation, any truly sensual interlude stands out in stark relief in the mind's eye, to be regurgitated later when you are a sterile patient rather than a physical, feeling, wanting person.

At the best of times, our physical selves may frighten us, and this is when we can predict how they will operate!

When our medical care team is reconstructing our physical selves, Frankenstein-like we wait to see what the new "me" will look like, how it will move. A fear of pain often results in a desire to block out other sensation, including pleasure. Long illness forces the patient to take fresh stock of the way our bodies and minds work together, and how we want to live within our physical selves.

I often felt most connected to my physical body lying naked and prepped on the OR table. At such times, just prior to the countdown, knowing you will wake up with a different physique transversed by fresh incisions, it is impossible to think of much else.

With three close family members recuperating from massive surgeries (a craniotomy, a Whipple, a modified radical mastectomy), I find it suddenly important to articulate that the sensual self does not die during surgery.

Like the rest of our individuality, it can be recovered...it will twinge and fire and make itself known again as the flesh and mind heal together.

These two poems, written during and after ortho surgeries following a car accident, emphasize the sensual side of being a patient, of feeling for self in the shifting tides of treatment and recovery.

To all hurting and healing, waiting for the wanting to return, don't worry - for most of us it does. Stronger than ever.

Harvest 7/13/03

I am post surgery slim-
hips bare sharp scythes curved
around fertile crescent-
one singing frantic arias of longing
for the kidnapped iliac slice-
spooning air,
shifting wet on sterile sheets…
Shafts of dark wheat between my legs,
shafts of titanium spear ankle bones.
Salt of the earth, salt on my brow,
palms, pubis-
side effect of post-op fever,
straining to ignore

the seductive push
of the pain control pump,
foreplay of the finger pulse oximeter,
slipping on, warming to skin,
seeds of slight-pain dream in the blood…
Awareness of recovery room cracker
clinging, like a lover
to the sea-wave texture of my soft palate,
honey of my piquant unsterile breath,
the thirst, envy of exploding fizz,
soda’s carbon coming on my tongue.
Don’t mess, young vulnerable doctors,
with my subjective pain scale-
I’ll have to show you
my pleasure’s past ten.

The Resident

I waltz into pre-op
with only a slight hitch
that becomes a slide.
You are shaking my hand,
a young orthopod.

You aren’t yet filled
with the grand medical air
that floats out of reach
for most mortals.

Our clasp of fingers
is warm and moist and tasty.
For an instant, the
contact is grounded,
human to human
woman to man.

No patient patience here,
you are almost my age,
and our eyes speak well,
complementary, complimenting
shades of blue and gray.

All this passes us by
as you see again the form
of the usual suspect,
and we click to the format
expected and accepted,
now not rote
but protective roles.

Too much sharing
in that look,
a current of interest
that has no business
in pre-op
or even post-op,
You, a new physician,
snap back
to that doctor place.

I slide up the gurney,
slip off a moonboot,
try not to think of you
as I strip off clothes
and skim on
a flimsy sheer sheet.

Soon you will see me,
a separate crooked ankle
needing a bone graft.

And even though
I will lay
silent and naked
on your table,
(my eyes
you will work harder
to cut our connection
than you will
remembering the proper way
to harvest hipbone.

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