1
I took Introduction to Psychology in college in 1961-62. The lecturer was the last Freudian in the department, a real leftover from past generations. Even in his own Intro class, however, he could spend only 30 minutes or so on Freud, not happening to point out that Freud was important by then more to students of art and literature than to psychologists.
But when he talked of Freudianisms, it was worth paying attention. I particularly remembered his example of "sublimation," the defense mechanism converting an unacceptable impulse into a socially useful action.
His example was an extreme sadist who became a well-respected surgeon. That communicated the point about sublimation concisely and well, I thought.
2
My wife has suffered with an intestinal disease for years, with occasional flare-ups not only causing pain and frustration but also locking her up at home, often in bed, for days or weeks at a time.
Usually, we understand it is a tough sell for GI physicians to convince such folks that surgery is the best option. But when A----- went to her new GI here in our new hometown, she was the one pushing for surgery and he merely had to confirm she was right. After removal of her diseased organ, she would have to wear an outside appliance and empty or change it regularly, but gone forever would be the pain, the lockdown, and the danger of colon cancer.
He didn't hesitate to recommend the surgeon either: Dr. Brodgrin, leader in the field. Whenever we told someone intestinal surgery was scheduled in two months, they would ask about the surgeon and sigh appreciatively when Dr. Brodgrin was named. She really is well known.
3
Well, it turns out that A-----'s surgeon is the classic example my Psych lecturer was talking about. A highly skilled surgeon, known over the world for her innovations and bold new techniques... But she is basically, yes, a sadist.
We met with her to schedule the surgery. That went fine. We'd made the right choice. Then, as the time approached, we had questions... There was no one to ask. "Oh, Dr. Brodgrin will tell you about that before the surgery," we were told. Then a session was scheduled for our orientation to the process: great! But Dr. Brodgrin was not present. Her nurse had a set script to read to us; she was not interested in answering questions. "You must talk with the doctor before the surgery," she said.
On the day of the surgery, further reassurances. Dr. Brodgrin did appear, but not until after the anesthesia drip had started. A---- was able to say, as she had attempted to do several times, that she wanted to see her internal organ after it had been removed. "Oh, sure," everyone said. Dr. B herself did not reply.
After the surgery, assistants came by, nurses. A "fellow" or two, talking with each other more than with A-----. Finally, the doctor dropped by for two minutes, to say the surgery had been easy. That was what mattered: it had been easy for her.
She couldn't show A---- the organ she'd removed, which had been thrown out. She actually seemed to enjoy the anger, sadness, and disappointment this process was provoking. Later, when we tried to tell her about the absence of follow-up training, advice and counselling, she pointedly didn't listen.
4
At the post-op session a week later, of course there were two "lesser" medico's before the doctor sallied forth herself. One of the young "fellows" did express sympathy about the irritation caused by a stitch or two that wasn't disolving normally in the outer incision. He said they would take care of that before we left.
Dr. B, on the other hand, seemed amused at the claim of an errant stitch. She laughed it off. When A----- persisted in seeking aid. Dr. Brodgrin put her finger on the stitch and rubbed it around, as A---- squirmed and moaned, laughing ironically at her patient's discomfort.
"That'll just take care of itself!" she announced as she led her little entourage from the room. (The young "fellow" we had met earlier surreptitiously pulled out the prickly stitch when no one was looking.)
5
After-care in the case of those who have had an intestine or a bladder surgically removed is even more important than in other kinds of procedure. There are devices to be used in very delicate places and situations, and it's only by trial and error that everyone can hope to learn how to take care of oneself forever afterwards. There are also many different products, different sizes and shapes and functions, and so on, which the individual needs time and encouragement to get to know.
We in our area are fortunate that there is an active social group who meets regularly to share tips and advice. A----- was especially fortunate to find this group - on her own - shortly after her surgery.
After about 8 months of our attending these meetings, someone divided us up in break-out groups: those without bladders, without colons, etc. There was one group for spouses of the surgery patients. So there I was when a newcomer politely but firmly shouldered his way into the focus of our little group's attention. He must have been about 70, tall, white-haired, dressed casually but in quality clothes.
I suspect he and his wife - the patient - had not been married long, and that each had outlived their first spouse. Neither had been particularly active religiously, but their childhood religious backgrounds had been very different. He was from a very traditional protestant main-line church (Episcopal, Presbyterian, Methodist...) and she from a more evangelical tradition. That hadn't seemed important at their later stage in life together.
6
"My wife had been suffering a long time," he was telling us that night, "before they discovered the cancer." Her son had been living close by and was a good support, as Erik (I'll call him, not knowing his name) worked with his relatively new wife through this crisis.
"They started a rigorous course of chemo, then radiotion therapy," he told us, "to be as sure as they could be about the cancer spreading." At the same time, they learned an old childhood friend had organized a prayor circle to pray for her in her illness. She mentioned the friend's calls, apparently, but didn't say anything particularly about them. Her son and her husband accompanied her to therapy each time, and followed along with all her meds and her symptoms and all that. "After the course of treatments were done," he concluded, "her doctored went through a whole lot of new tests to see if they had done any good, getting ready for the surgery to remove the diseased organ itself."
The doctor said he had never seen any results like these, but the tumors were no longer there. He said they were sure to reappear, this time with the likelihood of having spread to other organs, but for now they were gone. The surgery had already been scheduled, with the presumption that it would proceed as planned.
When they got home, the wife said she knew all along that the prayer circle was going to save her. She had been praying too, and she knew the tumors' disappearance was the work of His divine hand.
Our speaker said that her son and he had persuaded his wife to go ahead with the surgery, since it seemed so likely the cancer in it would reappear if they didn't.
7
The surgery had been done about 10 days before our meeting when the husband was telling us about it. He, his son-in-law, and his wife had had an emotional adjustment to learning the process of using the appliances (the creams, the seals, the removable bags, etc.) - which all of us there were accustomed to ourselves - but it was only that evening, as he had driven his wife across the city to our meeting, that she had said bluntly: "You made me have that operation. I didn't need it. God had healed me already."
8
No one said anything immediately after Erik finished, but the emotional support around our table for him was palpable, it couldn't have been missed.
One other spouse had been coming to the meetings since I started myself. He always seemed engaged but never spoke except to clarify something his wife might have said. As Erik told us his story, this man became more and more engaged, inching his chair forward, leaning on his elbows on the table. In the seconds of silence after Erik's story, he said clearly and firmly: "You did the right thing."
I suspect Erik knew that already, but it was the right thing to say. And lord knows, his wife's surgeon wouldn't have said anything!
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