Catastrophic Fantasies

Catastrophic fantasies can be defined as ruminating about irrational worst-case outcomes supported by ideas with no basis in reality, increasing anxiety to the point of panic. This description would sum up my feelings as I walked into the Royal Columbian Hospital on October 16, 2013, at the beginning of my observership – panic, bordering on sheer terror!  

I was reminded of Michael Clarke Duncan in the movie “The Green Mile”, as I walked down the long hallway on my way to “gown up”, with every imaginable horror running through my mind, replete with visions of fainting across the “blood brain divide” as the cardiac surgeon drew “first blood”.

Part of my contingency planning in the weeks leading up to my observership was to examine my fears and force myself to think through the situation in a rational fashion. I envisioned best-case scenarios and weighed the facts available to me (I get light headed and nauseous at the slightest smell of antiseptic) to develop a realistic plan for coping with this upcoming reality.

After weeks of reflection, there was no doubt in my mind. I was going to make a fool of myself. I was going to either faint, or vomit.

The first thing that struck me as we walked into the pre-op area at 6:45 AM was the sheer number of people crowded into such a small space. As I looked around at the faces of patients being readied for surgery, worried family members anxiously pacing the corridor, nurses and physicians going through medical charts and calmly walking patients through their procedures, porters, cleaners, lab assistants and their carts swiftly moving from patient to patient; I couldn’t help but feel overwhelmed. I thought to myself, how in the hell do you make any sense out of this chaos?

I was impressed with the number of machines and monitors and advances in technology in the cardiac OR (especially after reading the history of anesthesia and the days of ether the week prior). My jaw dropped when I saw the number of instruments the OR nurses were busy counting and I was shocked at the sheer volume and number of drugs, machines and monitors the anesthesiologist was responsible for.

As I listened to him patiently explain what each and every machine and drug does, while watching him draw vial after vial…after vial after vial…of the “chemical cocktail” that puts patients into the drug induced coma most people think of as “sleep”, I couldn’t help but wonder how the human body could tolerate an assault of this magnitude. It all seemed surreal.

My heart warmed as I watched the anesthesiologist touch the patient’s shoulder and kindly ask about his family. He told him he was going to be OK, and that the team would take good care of him. He then turned to me and asked if I was OK.

“Fear be gone”, I said to myself as I stepped up on a stool (on the “brain” side of the divide) to get a better look at the open-heart surgery. I was handed a plastic shield for my eyes, “just in case we get a squirter.” This did nothing to quell my racing heart as I thought to myself, “I’m going to need one of those machines in a minute!”

I was introduced to the cardiac surgeon as the scalpel sliced through to the patient’s sternum. Rather than break out into a cold sweat, I calmed down as I looked around the room and saw the level of confidence in everyone’s eyes. The entire team worked together like clockwork. After a while, I was staring into the chest cavity at a beating heart and the anesthesiologist walked me through the most critical point in the surgery – bypass. He explained the trauma the heart was under and the effect the heparin would have as the blood left the patients body and entered the bypass machine. It was fascinating; the patient was now clinically dead (and I was still standing – imagine that).

I spent time in various OR’s during the day, watching the interactions between anesthesiologists and surgeons during a partial bowel resection, a broken fibula being pinned back together, an angioplasty and a second open-heart surgery. I spent time in the cardiac ICU and with a rover also responsible for pain management.

One of the questions I went into my observership with was, “Will I be able to identify efficiencies?” The answer was yes. It seemed nonsensical that there weren’t enough cleaners or porters in the wards to allow the efficient movement of patients off the surgical floor to make room for more. I was sickened to hear of two very young patients, at the tender ages of eight and ten (crushed femur and open bone fracture), who were waiting for surgery; while the entire OR team also waited with a patient who just completed surgery, for a bed to come available in recovery. A bed on a ward was not available because the sheets hadn’t been changed.

Unbelievable.

The good news is, now that I have experienced first hand what anesthesiologists do every day, I can better explain all of this to the people I advocate with on a daily basis.

I learned a valuable lesson with respect to catastrophic fantasies and am reminded of what Mark Twain famously said:

“I am an old man and have known a great many troubles, but most of them never happened.”

Photo Credits

Photos from the Microsoft Office Clipart Collection

Guest Author Bio

Teresa Sullivan
Teresa Sullivan is the former Chief Advocate for the British Columbia Anesthesiologists’ Society. She possesses a Masters Degree in Business Administration with a specialty in Executive Leadership from Royal Roads University. She is a skilled professional in Mediation and Conflict Resolution and is a trained Adjudicator who specializes in Administrative Law matters.

Teresa has over 20 years of senior executive experience with the Province of British Columbia where she specialized in aligning government’s public policy agenda with strategic planning, financial planning, budget development, and performance management systems – where she realized substantive savings for government and the taxpayers of British Columbia.

Leveraging her vast government experience, Teresa started her own business in 2008, Sullivan and Associates, which helps develop and transforms organizations’ strategic plans into realistic and achievable action items. She provides a comprehensive framework that provides strategic planning, business planning, leadership development, and performance measures, with a strict eye on the financial health of the organization. Teresa works with the leadership team and staff to identify and understand what should be done and measured. Teresa builds internal capacity to build the skills necessary to effectively execute their strategies.

Teresa is the former President of the Victoria Multicultural Society and was responsible for successfully navigating the society’s application for a primary liquor license through separate local and provincial government regulatory approval processes. Teresa built a grassroots network of support amongst business owners, residents, law enforcement officials and inspection agencies to gain municipal and provincial government support. As a result, this was the first primary liquor license approved by the Victoria City Council in over fifteen years.

Teresa was elected to Colwood City Council on November 19, 2011. She is the Chair of the Standing Committee on Economic Development and Vice-Chair of Planning and Land Use. She is actively working with local residents, business owners and land developers to find ways to diversify Colwood’s tax base by encouraging sustainable growth in order to achieve greater economic self- sufficiency.

In her spare time, Teresa does pro-bono work advocating on behalf of children and families with developmental challenges to get the necessary resources to live healthy productive lives.

Web Site: Sullivan & Associates

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