Just catching up a bit and reading Sterile Eye's entry "Breaking the Ice" made me think of the way I interact, or don't, with patients whose surgery I assist on. I wish I was better with patients. I'm fine if I find myself forced into a face-to-face with them but typically I avoid any interaction before they roll into the O.R. Deep down (or maybe not so deep) I am a sociophobe. I seldom go to pre-op and meet the patient. Once in a great while if I am talking to the surgeon or anaesthesia before the case, and they happen to be in pre-op, I may inadvertently meet the patient. Thank goodness for consents which inform said patients that surgeons may utilize assistants during surgery.
Once the patient rolls into the operating room I am fine with interaction, I often introduce myself there, if the circulating nurse doesn't do it for me, and I stand by the patient during induction, holding a hand or touching their arm. If a patient is having some anxiety, I can see it in their faces even if they don't verbalize it and I try to give some reassurance either in words or a smile and a squeeze. I think knowing that our conscious interaction has a time limit makes me more comfortable.
There was an incident some time ago that had me promising to myself that I would never again get familiar with patients or their families pre-operatively.
Our case was delayed while we waited for the surgeon, I was still scrubbing at the time, and my good friend was the circulator on the case. We both spent time waiting in the pre-op area and, while I never spoke to the patient or the family, they knew that I was involved with the surgery in some aspect. There was a lot of eye-contact made and some smiles exchanged and when their loved one was finally rolled down the hall to the O.R., I helped push the bed. This was a very emotional case for me. The surgery was to be a palliative one to try and give the patient and family just a little more time together before the inevitable. I held the patients shoulders during the epidural. From a local tribe and allowed to carry a talisman into the operating room, the patient chanted in Native tongue while the epidural was placed. I helped to lay the patient down and stood there holding an arm during the anaethesia induction. I said my own chant in my head for the patient before I let go to go scrub in.
Unfortunately there was nothing that could be done for this patient and it still brings tears to my eyes whenever I think about it. We simply opened and then we closed. For several days afterwards, it seemed that I would see the patients family in the hallways of the hospital and they would recognize me. My stomach would do one of those chemical flip flops when we made eye contact because I suck at condolences and somehow I felt so helpless to help them, as if it had ever been on my power to do so, and because I was afraid they would want to speak to me, and because I didn't want them to see me cry.

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