Vulnerability

Surgery is one of the most vulnerable experiences for not only the patient but also the surgeon.

Last Wednesday I rode the metro by myself to the hospital, which is nestled in the claustrophobic slew of medical buildings in Central West End. I listened to music on my way there. I had a class on this campus in my first semester of graduate school. My old apartment was about a mile away. I still occasionally pick up tissues for my experiments from another center only steps away from where I was headed. I can jump into a different but beloved world by crossing the street to Forest Park. So, it still felt like an average Wednesday morning for me.

I signed in at the front desk on the third floor. I learned that my driver’s license expired this month. I sat down. I expected the hospital to run behind – is that not what hospitals do – but had to close the book with which I planned to kill time because my name was called within minutes. This place is efficient, I thought.

Before I knew it I was laying on bed number twenty-two, a nurse digging an IV into my right arm. It took her a couple of tries. Several nurses and doctors popped in and out to ask me questions I already answered in my pre-op “appointment” via phone last week. I remembered how terrible I am at remembering names. I remembered how people with medical authority always smile, nod, and move on, as if the information magically no longer matters, after I tell them that I can only guess the answers to their questions about my medical history.

I entertained myself between pre-operation interviews by reading In Memory of Memory by Maria Stepanova. The rest of the floor was relatively quiet, so the only other interruption was the heart rate monitor dinging every few minutes when my heart rate dipped too low for its liking: 46 bpm. I grinned with satisfaction from knowing that I am in excellent cardiovascular shape. Unlike most other patients, I do not rely on daily medications, which the nurses appreciated. Less for them to write, fewer potential complications.

I liked feeling special in those ways, not so much in others: the nurse who joked with me less than an hour earlier while inserting the vessel through which drugs would render me unconscious frowned when I confirmed that I did not already have children. I was fortunate to not experience any other semblances of disappointment from the other nurses and doctors. Still, that stung a little and resurrected the reality of the day that I in hindsight so clearly avoided confronting, even as I braved everything alone and presumably had every reason to dwell on a life-changing decision.

But all in all I was a patient like any other. Nothing out of the ordinary happened.

I saw my doctor’s face for the second time in my life – the first being five weeks prior, when he surprised me by approving my request for a bilateral salpingectomy – and played it cool. He skipped hello and asked me what I was reading. I loved that. I showed him the book. He had never heard of it, asked what kind of book it was. Historical nonfiction, sort of, I told him. It was a normal workday for him but entirely something else for me.

He reminded me of his faith in me knowing what is best for me, that this will render me permanently infertile, which we already thoroughly discussed last month. No pushback or other comments on the subject; he jumped to what I should expect moving forward, like any routine procedure. He said farewell, that I may or may not remember seeing him in the operating room thanks to the imminent pre-anesthesia cocktail.

Finally, the anesthesiologist introduced herself to ask me about my prior experiences and of course to review the potential risks. I respond well to anesthesia and for better or for worse do not wake up acting funny. Still, that list always provokes interesting thoughts.

Then it all began. There was no time to acknowledge how vulnerable I felt. I feel like I am not even doing so until now, writing this sentence several days post-operation.

I like anesthesia because I like sleeping. Unfortunately, I am physically unable to take naps, so I appreciated the rare opportunity to do so.

A sleeping person is a vulnerable person. Few witness this act, save for a family member, partner, or close friend who, regardless if accidentally or deliberately, appreciates a sleeping person’s pure, childlike innocence. Of course, that person can wake up. Not so much during surgery, which demands not only the weirdness of letting go that accompanies sleeping in front of people whom you do not know so well but also total surrender to the surgeon.

I have tasted that feeling before when I was anesthetized for tonsil and wisdom teeth removal surgeries, yet this time was different. My vulnerability amplified: I was wearing nothing except a hospital gown, I had no visitor who could comfort me immediately before or after surgery, and, most of all, a male doctor whom I had met only twice was about to operate on my reproductive organs.

Needless to say, I trusted him enough to do this. I had over a month to change my mind if that were not the case. However, it was not until I came home when I realized that he is just as if not more vulnerable every single day at his job than I was in the operating room.

Even though I live in a liberal area, my state is very much red. I sometimes call Missouri “Texas Jr.” So, it was important for me to find someone who would listen to me.

Like any other young woman interested in sterilization, I found this doctor using The List on the childfree subreddit, whose members anecdotally contribute the names of medical providers willing to perform procedures such as vasectomy, tubal ligation, bilateral salpingectomy, and hysterectomy on young people. Approval is a gamble otherwise – virtually impossible in many cases – and it is still not guaranteed that any of the doctors on The List will give you the green light.

Needless to say, he earned my respect during my first visit. However, my postoperative homework stunned me.

Over a decade ago my doctor took on the role of medical director at arguably the most dangerous Planned Parenthood site in the country, the single remaining abortion clinic in Missouri whose license was jeopardized for several months in 2019.

At the site he is one of six abortion providers, of whom only one other is publicly known. His decisions in this political climate – to enter the limelight as a dedicated abortionist in a state whose lawmakers vow to jail people like himself for longer than a rapist, to outrightly defy the state’s inappropriately mandated pelvic exam, and to defend a patient’s right to privacy and self-determination – are unfathomable to me. I realize that this is what I prize most in other people, their willingness to be vulnerable.

It breaks my heart to have stumbled upon the anti-choice webpages that vilify not only what he and his wife, who is also an abortionist but across the river in Illinois, do but also who they are as people.

He is the bravest person I have ever met.