Well the anes handled this situation poorly, but I agree with his logic over yours. If your venous access is that poor/difficult, then at some point you need to consider a central line. I dont think its appropriate to stick somebody 20 times hoping for the elusive IV.

My rule is this: Floor nurse gets 2 sticks. Best IV nurse on floor gets 2 sticks. ER nurse gets 2 sticks. Gas doc gets 2 sticks. If after 8 sticks you still cant get venous access, then its time for a central line, regardless of how “small” the surgery is. Its either that or postponing surgery.

but!! omg. the wound got infected, and i was re-hospitalized. and i have the worst veins known to humanity – in the 8 days i was hospitalized, i had 14 IVs. those are just the ones that WORKED – i had twice that many blow on insertion. so, before the first surgery to clean out the infection, the nurses couldn’t get an IV started. the anthesiologist came over to try. he grabbed my right hand and i told him that i had already had two IVs there in the past 24 hours blow, could he please look somewhere else. he got pissed and decided that i needed a central line. i said no i didn’t, a regular IV would work, it was a small surgery. he said “Hand or central line, or no surgery”. i’m lying there, been awake for over 40 hours, with possible MRSA on my hip (and maybe in the bone) and this fucker starts power trips. he throws a cloth over my head (and i’m crying, at this point, BEFORE he starts, which he ignores) he has two nurses hold me down, and doesn’t use a local, and yells at me every time i flinch or wiggle, won’t answer any questions, and just hurts me. i have PTSD, and my literal biggest trigger is being held immobalized like that. then the fucker can’t EVEN GET THE CENTRAL LINE TO WORK. he just walks off, leaving my head covered, and i have what is essentially a basic IV in my neck, while the rest of it does’t work right, and it infiltrated in 8 hours. i guess i’m lucky it lasted for the surgery.

it still makes me cry. well, it was exactly 2 weeks ago, so i guess its okay to still cry. i’m waiting to find out how to file a formal complaint. i mean, who the hell does that? ignore that their patient is CRYING and yells at them for flinching in pain? especially when they are SUPPOSED to use locals for that sort of thing?

I don’t know. This wasn’t even my most traumatic medical experience. No, that would have been my orthodontist inserting sandpaper between my teeth and rubbing it up and down. Without asking permission. While I was obviously in pain. This was two years ago, and when I got out of that office I decided that I was never wearing the retainers he made me again, that I did not care if I was undoing eight years of work on my teeth, I was never associating with that man and his creations again. I was crying. I’m a survivor of rape and frankly, that experience was the closest I’ve ever mentally gotten to being back on my rapist’s couch after the fact. Especially since the orthodontist’s whole MO seemed to be, “you’ve been a bad girl forgetting to wear your retainers, you’ve given me no choice…” Even though I was eighteen and could damn do as I pleased, particularly when it came to people who had never shown me respect. The fucker.
Sort of made me realize that if I ever have kids, I’m taking their complaints about ‘authority figures’ like doctors seriously. If my mother had listened to me say that my ortho was creepy and mean when I was ten, he’d've never had the ability to do that when I was eighteen. I’m looking into them, not dismissing them.

I’m a graduate student in medical ethics, and I really want to help doctors make the connection between sexual trauma and the practice of medicine. If you physicians-in-training have any suggestions for me, I’d be grateful.

Michelle, I’m not a physician in training, but I am working on a PsyD and professional ethics are an area of specific interest for me. I think the thing that a lot of professionals lose sight of is that they’re working with a patient, not a puzzle. We come from competitive fields, we’re among the intellectual elite, we have training that qualifies us to make the kinds of calls that the average person wouldn’t dream of making, and we see things that others don’t quite quickly. Its very easy to feel superior. One top of that, our average day consists of dealing with the worst parts of someone’s month/year/decade/life, and we need to give ourselves emotional distance if we want to avoid burning out.

Think about that recipe: a sense of superiority and entitlement, incredible power, and emotional distance from those we treat. Couple that with the fact that our patients generally don’t want to see us, they literally have no other choice. Take away the fact that we’re talking about a medical procedure and you start to see the same themes that you see when someone discusses sexual abuse. Think about the little sayings, the mnemonics, the acronyms, the dark humor; a patient goes into a hospital or a doctor’s office already a little dehumanized, and no matter how good a doctor is some of that is going to be picked up by the patient.

I guess for me one of the things that really hammered home why ethics were so important was a professor I had that described the process of therapy in a very different way. She cut out all of the euphemisms and jargon, and just laid the experience out. You’re having the worst day of your life and now someone is going to take away all of your defenses, ask you to tell them all of the things you keep secret in your daily life, and then they’re going to analyze that data. They’re going to drag you in front of all the things you’ve run away from, all the things so painful you’ve pushed them away will be out in the open, there will be no defense, and you must trust this person implicitly. You don’t hear descriptions like that a lot, doctors are constantly distanced. Take away their supports, push them out of their comfort zones, make them look at what they do in the worst possible light.

Yes, THAT. Bless your heart, bint, for expressing what I feel, yet have been unable to really articulate, about my experiences with surgery.

And also? Dental procedures. Damned dentists just take over your mouth, put those dams in with your jaw stretched out, and again, cutting, blood, total loss of control. It’s no wonder I’ve not seen a dentist for ten years.

I do know from a friend that she does a detailed run-through of what the operation will entail before you go under, and I suspect that if I had to go under general, she would let me have a friend in the room to speak for me. Sort of a surgery doula…

New question: are there surgery doulas?

Actually, I really want to thank you because without your revelation, I’m sure this would all just be haunting memories that I held inside. I’m glad that your surgery went well, very glad.