He wasn’t angry. He wasn’t throwing a tantrum. He was in a state of life-or-death terror.
How terrified is a child who needs to control all things that happen to his body, when he finds out that he is going to a hospital and given medicine to make him go to sleep so deeply that he won’t wake up no matter what happens, and that while he sleeps a doctor will prop his mouth open and do surgery on half of his teeth? How much more afraid is that child when he finds out that neither his mom nor his dad will be in the room with him and that he will be there, unconscious and helpless, in a room full of strangers?
I’ll tell you how terrified: that child will be approximately as afraid as is possible. That child will turn pale and clammy, vomit repeatedly, succumb to a migraine, and stay awake most of the night screaming and begging his parents not to make him go. His fear will spiral so far out of control he’ll require two nebulizer treatments to ease the asthma attack caused by his fear, but he’ll have to pause those breathing treatments to run to the bathroom because his guts will be in revolt.
When I called ahead to the outpatient surgery center a few days before my son Carter, seven-years-old at the time, was scheduled to have his teeth fixed, I asked to speak to one of the prep room nurses. After I made sure she would be there the morning we were coming, I told her, “Carter has extreme anxiety disorder. He’s probably going to need a dose of Versed as soon as we get there. You’ll know him when you see him; he’s a little guy for his age with red hair. He’ll probably be screaming his face off.”
The nurse replied, “All kids are afraid of surgery, you know.”
I gritted my teeth. I did not say, no shit, you wizard. I said, “Yes, I know. I have three older children who have none of these issues, but Carter really will be more afraid than most kids.”
“Don’t you worry, Mrs. Jones. We can handle him. We’re used to dealing with scared kids.”
Unwilling to argue, I thanked her and hung up. When I recounted the exchange to my husband he said, “Hey, you never know. Maybe the nurse will turn out to be the first person he’s ever met who can talk him out of being afraid.” We laughed, bitterly. How many people have assumed they could force our son to pull himself together?
We arrived at the hospital and by the time we walked through the doors of the surgery center I was soaked with sweat. Moving Carter from the car, across the parking lot, though the hospital’s main lobby (with its throng of staring people), down several corridors, and into the surgical waiting area had been a workout no gym could provide. He kicked, bit, spat, flailed, and most of all, he screamed. He wasn’t angry. He wasn’t throwing a tantrum. He was in a state of life-or-death terror. I’m sure that if we could have measured his stress hormones, the levels would have been comparable to a person who’s been run up a tree by a grizzly bear, only to find that grizzly bears can climb.
We entered the prep area and the nurse I’d spoken to the week before came right over to us. “He needs a dose of Versed right away,” I panted.
“Oh, I don’t know about that. Let’s see,” and she took Carter from me, who, in his flailing, caught her ear with a fist and knocked off her glasses.
She put his feet on the ground, knelt, grabbed his shoulders, and gave them a little shake. She put on a super serious, I-don’t-take-this-kind-of-shit-from-kids-like-you voice and said, “You stop that right now, young man. We won’t have any of that here.”
I was half hysterical by this time, frantic for someone to give my son some medicine to ease his panic, but also disgusted by this know-it-all-nurse (did she think that I don’t also possess a fierce, I-don’t-take-this-kind-of-shit voice?) and eager to watch her roll out everything in her bag of tricks before she finally had to admit I was right. I knew she’d get bruised, maybe even bloodied, in the process, and that every other patient in the prep area would be disturbed, but what were my options, really? She had the key to the med cart, not me, so I asked which bay was ours and I went to sit down in the chair by the gurney.
The nurse wrestled a still screaming Carter onto the gurney and told him to take off his clothes. When she let go of him to get a gown, he scrambled off the bed and bolted for the door. I let her bring him back, but his red face, covered in snot and tears, foiled my resolve to let her handle this her own way and when he grabbed for me I hissed at her, “Give him some Versed. Now.”
She wouldn’t. I assume she had her identity wound up in this process, something like I am a nurse who is very, very good with kids and I can always make them calm down before surgery because she was tenacious. He had torn the sheets off the gurney, bolted for the door three times, pulled the nurse’s hair, and bruised us both, but it wasn’t until he bit her that she sighed and went for the Versed.
She came back with the syringe of pink liquid and said, “This is a big dose. He’ll be asleep in ten minutes and then you can relax until it’s time for him to go back.”
I cracked up, and loudly. I couldn’t help it, since I was on the ragged edge myself after a nearly sleepless night and the horrors of watching my child in so much pain for hours. “That won’t put him to sleep,” I said.
“Oh, it’ll definitely put him to sleep. I’ve never had a child who didn’t doze off with this dose of Versed.”
“Then you’ve never given it to a child who was quite this afraid.”
“Well,” said the nurse, “We’ll just see. I’ll be back in ten minutes.”
She returned in ten minutes to find my son wide awake, though much calmer. He let me help him out of his clothes and into the gown. He was willing to wear the cap to cover his hair as long as his teddy bear and I each wore one, so I tucked my hair into one and he even smiled a little. When the anesthesiologist came to insert his IV, he had to give Carter a little more Versed because he panicked at the sight of the catheter. “Wow,” said the anesthesiologist, “with this dose, he’s had the max safe dose for his weight. He was the one screaming out here earlier? I can’t believe he’s still awake.”
“He has severe anxiety disorder,” I said. “That Versed has to compete with a huge quantity of stress hormones and nature is always more powerful than medicine.”
“No kidding,” said the anesthesiologist. “If he has to come in again, you should call ahead and let us know about his anxiety disorder. We could meet you at the door with some medicine to calm him down.”