Monday, November 21, 2011

Medical magic

Nov 20, 2011

Three surgical procedures which went smoothly set me thinking about things one can learn from them
 By Ignatius Low

There are times in your life when you want to lift your skinny arms to the sky and thank the heavens for the gift of good pharmaceuticals.

Oh wait, the legal ones, I mean. No, no, it's not that sort of column.

Or is it?

The first time I took valium was for Lasik, a medical procedure that has become almost as cheap as a smartphone these days but no less life-transforming.

At the time, however, I paid the equivalent of several smartphones to engage one of the best surgeons in town. These are my eyes, I said to myself, as I emptied the bank account to sit in his swish office at Camden Medical Centre.

My nervousness must have been apparent at a sort of 'dry run' of the surgery we did. This is what paying top dollar buys you - the chance to lie down in the operating room before the event, with all the implements in your eye, while highly paid doctors and assistants talk you through every step of the way.

But, as I was to discover later, it was the promise of valium that would really make the difference.

'We find that it relaxes our more nervous patients and makes the procedure easier for both parties,' the surgeon said, smiling.

In the end, I wasn't just relaxed.

I went on a trip to outer space where an alien breed was conducting benign experiments on me. The whirr and click of the machines were soothing and the blinking lights - oh, the lights! - were so beautiful and captivating.

After it was all over, blurry people in surgical masks were fussing over my eye, smoothing it down with a brush and mumbling exciting-sounding commands. I half- expected them to call me Scully.

Today, my vision is perfect but my memory of the operation is tantalisingly hazy. By all accounts, Lasik was to have been a scary experience but the only word that really comes to mind for me is: Wow.

This is perhaps why I was so game to try another wonder drug when it was suggested for another common medical procedure.

This time, I was at my trusty dentist, an ex-classmate I have known literally half my life.

He has done very well and is also at the top of his game. In an interview, he once described himself as a 'humble mechanic' who removes and replaces the faulty bits in people's mouths.

For me, that faulty bit was a big molar that was so decayed it couldn't be saved. He suggested an implant, which put the fear of God in me right away.

If you don't already know, a dental implant is a titanium screw which they put into your jaw where the lost tooth used to be. Once it is in, and fused with the surrounding bone, you can put a crown (a sort of artificial tooth) on it and voila, it's as if the years of laziness and neglect never even happened.

But before we get to that happy conclusion, the patient has to endure an hour-long procedure that involves a fair bit of slicing and drilling.

'It goes better for you and me if you are relaxed,' he said, a by-now familiar refrain. 'And I've worked on your teeth long enough to know that you are not relaxed.'

'Valium?' I asked hopefully.

No, he replied. We will actually put you to sleep - with propofol.

My eyes widened. 'The drug that killed Michael Jackson?'

'Um, yes. But it's really very good,' he replied. 'It costs a bit more because a medical doctor trained as an anaesthetist will have to be there for the whole operation, but trust me, it's worth it.'

On the day of the operation, the anaesthetist came with a big suitcase and a big smile. He put an IV line in me, hooked everything up and pretty soon a milky white liquid was coursing through my veins.

'Like soya bean milk' was the last thing I remember him saying before I went to sleep and had a nice dream about planning for an overseas vacation. Then someone was shaking me awake.

After general anaesthesia, many patients report feeling nauseous and some throw up.

But I was in a wonderful mood. I remember telling another patient who was with me in the recovery room about my dream and soon we were chatting and laughing about our jobs and lives.

Later, I asked whether propofol always felt like this. They told me that patients are in such a good mood, they have actually ended up going on dates with strangers they met in the recovery room after surgery.

Again that word - Wow.

I confirmed my theories about propofol last week when I went for knee surgery to fix an old problem that had gotten worse with age and too many squats at the gym.

When I was told that I would be put to sleep for an hour or so, the first word out of my mouth was a hopeful one: 'Propofol?'

When they said yes, my heart skipped a beat. I felt that I had won another minor prize in the lottery of life.

This time, the anaesthetist likened it to a 'champagne buzz' before I went under, for a larger dose that meant that the medical team had to regulate my airways.

Again, I woke up feeling incredibly fine after what was a deep and satisfying nap. I checked my phone for messages five minutes after I was wheeled back into my room.

'Are you okay?' a colleague had asked.

'Yeah, I just came out. Good mood now!' I texted her, before wolfing down a three-course dinner of soup, shepherd's pie and cake.

The thing is, the three procedures I went through were common enough for there to be so many horror stories about pain and complications.

Yet my own experience was more than all right. Borderline pleasurable, even.

MJ certainly knew he was getting the best, and it's easy to see how he could become addicted.

Okay, so maybe it wasn't all just about the drugs.

All three doctors who attended to me were expert practitioners with many years of experience. They not only did very neat work that ensured quick healing, but each of them has also made an art out of post-op pain management.

What's my point in all of this?

I don't know really. Maybe it is just to point out that there are these little shortcuts in life that one can take and that it is perfectly okay to want them.

Or that one should never judge the rightness or wrongness of something until one has experienced it for himself.

That it pays to pay a little more for important medical procedures; or simply that happiness can be a chemically altered state of mind (legally procured, of course).

You decide.

Me? I'm just happy with these little bits of what was nothing less than medical magic.

[Happiness is a chemically-altered state of mind.]


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