People coming to have their surgery are often overcome with fear, and that’s very understandable. Some are pale and shaking due to the high levels of adrenaline in their bloodstream. Their heart rate and blood pressure are way above normal, their eyelids are retracted, their pupils large, and they are either inappropriately garrulous or deathly silent.
We used to give pre-medication to patients in order to make them more relaxed, but there were problems with this. Getting the dose right was difficult, it was given too early or too late, and it led to sickness and delayed waking at the end of the operation. The latter is very important in day-surgery, where the patient must go home at the end of the day. For all of these reasons, pre-meds have fallen out of fashion, and are reserved for especially difficult cases.
The weird thing is that anxiety is just about the worst state to be in prior to anaesthesia. Induction of anaesthesia is a very unstable time, which is made much more dangerous by anxiety and adrenaline which can cause an increased risk of myocardial stress, arrhythmias, airway difficulties, raised metabolic rate and many other hazards. Fear is meant to protect us from danger, but when it increases our danger, there is something wrong.
A good theatre team has the right interpersonal skills needed to meet a patient in their crisis, and impart to that person some impression that they are not having to face things all alone, that they are among friends who care, but who also know what they are about, and have long ingrained experience. This all has to be achieved in just the few minutes between the patient arriving in theatre, and the start of their anaesthetic.
Sometimes humour helps. Once, I told a patient that she seemed very anxious to me, and she confirmed my impression. “Well”, I said with a twinkle in my eye, “that’s a sure sign you are not a lunatic, then!” It worked, the spell was broken, she laughed and relaxed a bit.
The Bible contains several verses about anxiety:
Worry weighs a person down; an encouraging word cheers a person up. (Proverbs 12:25)
Can all your worries add a single moment to your life?
Don’t worry about anything; instead, pray about everything. Tell God what you need, and thank him for all he has done. Then you will experience God’s peace, which exceeds anything we can understand. His peace will guard your hearts and minds as you live in Christ Jesus. (Philippians 4:6-7)
Give all your worries and cares to God, for he cares about you.
(1 Peter 5:7)
These are the words we all need as pre-medication, as we approach the major operation called “the present moment” in our lives, however awful it might be. We may lose all control, but God never loses control. We must cast out from ourself all that prevents us from placing all our trust in Him. The Divine Mercy is infinite, after all.
Perfect Love casts out fear. (1 John 4:18)