I completely forgot about International Women’s Day until a good friend from the other side of the county sent me a lovely text thanking me for being an “inspiring female presence in her life”. Wow. This made my day – what a wonderful thing for her to do! So this got me thinking…I have so many inspiring females in my life! Both my grandmothers (one still living but the other also still a presence) my mom, and my close female friends. I do not do well without close female friends – in fact, I would say I need them to survive.

But the inspiring female presence I most thought about today was a recent patient of mine. Most people in medicine don’t think of anesthesiologists as “having patients” because we mostly see people only on the day of their surgery and just for those few hours of the procedure and immediately after. But occasionally we do have patients – those people we see again and again coming to the OR for procedures. Unfortunately, these patients are usually very sick with cancer or some other ailment that requires multiple painful procedures. Fortunately, we are trained to help with those procedures and hopefully make them much less painful or even painless. I digress…

Recently, my “personal patient” as she became know was also known as a problem patient. “M” is a teenager who was recently diagnosed with an aggressive form of cancer. Initially, the chemotherapy did not work so she had to endure even stronger (read: toxic) drugs. Then she developed an awful infection which required surgical intervention. This is where I come in. M had already endured countless anesthetics for lumbar punctures, central line insertions, etc. and since her diagnosis had not been able to leave the hospital. Now she was in for more.

She was very angry when she came to the OR and it took over 45 minutes of talking with her to satisfy her that I understood her concerns and desires about the anesthetic. Finally, she agreed to go to the operating room. I describe this very politely, but it was not. She is prone to vulgar language and so she illustrated many of her points about what people had done wrong in the past with very colorful language! Remember, I work in a Children’s hospital, so people are not used to that. The operation went smoothly and although she was pretty peeved at waking up in the Recovery Room without the exact gown she had on when arriving (thus proving that we had exposed her while she was asleep. Truth: it got some surgical antiseptic on it so we changed it) – she wasn’t too angry.

Unfortunately, things continued to go badly for M and she needed another operation. Our Chief of Surgery informed her of this and she said “NO”. He talked and explained the situation and then left, assuming she had agreed. NOT! When we called to bring her down, it turns out this patient had refused to stop eating. You cannot have an elective anesthetic if you have eaten within 6 hours: it is just not safe. M knew this. The surgeon was pretty angry and so he went to see her. And in her room, she proceeded to take out a bag of Ketchup chips and eat them in front of him! It was awesome. He agreed to let her have another day to think about it. Two days later she did have the operation and I gave her the anesthetic.

But I love that image of the teenager, the almost-grown up, the almost-a-woman, standing up to the Chief of Surgery. She was maintaining control during a horrendous time in her life and she did it with flare! Red-fingered from ketchup flavoring flare. I loved it.

M inspired me with her strength, her rebellion, and yes, even her vulgarity! She did not change who she was just because it would be more polite to do so. She continues to be a difficult patient: questioning, controlling, and cursing. It is awesome. I hope she keeps it up.

Happy International Women’s Day, M! I hope the world gets a chance to know you too. You are awesome.

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