A patient presented to her obstetrician's office with ruptured membranes (water broken). She had a history of C-section and now would require another one, a few weeks before expected. The patient suffers from a severe history of anxiety and takes routine anti-anxiety medications. When the obstetrician in the office told her the obstetrician on-call would be doing her surgery, the patient broke down in tears because it was not the surgeon she had scheduled her future surgery with.
The patient arrived at the hospital and had her office obstetrician agree to come over and do the surgery after the office closed. It was not optimal, but the patient felt better about it. However, as she waited through the afternoon the patient became more anxious in anticipation of the surgery. At that time, the obstetrician on call spoke with her and she became interested in proceeding. As the anesthesiologist, I then went in to evaluate and consent the patient. She was very anxious but pleasant. Ms. Rodriguez was there and was sitting in a chair (often a forgotten comforting technique) and calmly speaking with the patient. Just her sense of confidence and calmness was clearly putting the patient at ease. I completed consent and went to obtain a number of sedatives to use if needed in the case.
Ms. Rodriguez worked tirelessly to prepare the patient for surgery but simultaneously did not make the patient feel rushed. The patient was quite anxious about getting a spinal for anesthesia, but she was actually exceedingly calm as Ms. Rodriguez held her hand and talked her through the steps I was taking once in the OR.
The patient then lied down under spinal anesthesia and became nervous about her body becoming numb. Again, Ms. Rodriguez turned her attention 100% to the patient. So often I see medical personnel turn to a computer or some form of documentation; and while Ms. Rodriguez did her duties later in documentation, she realized the patient needed her full attention and she never wavered.
Throughout the case, I kept waiting for the patient to have a sudden flash of anxiety. Any time a hint of such a situation arose, Ms. Rodriguez was immediately caring for the patient in a beautifully compassionate, gentle manner. It should also be noted that the circulator RN "station" is on the complete opposite side of the room from the patient's head; staying in touch with the patient's emotional needs is not as easily accomplished as Ms. Rodriguez made it seem.
Amazingly, the patient never needed sedation. She smiled throughout the surgery. And unlike her first C-section, she was fully awake, aware, and able to experience the birth of her child. She kept commenting how amazing it was and how she did not remember anything from her first child's birth. Coincidentally, the obstetrician was the same one from 2+ years prior and he remembered how terribly anxious the patient had been; he was amazed at how well she did in the surgery despite her severe anxiety leading up to the surgery.
As an anesthesiologist who has seen many such scenarios, it is my unwavering professional opinion that this entire experience was a credit to the compassionate and diligent care of Ms. Rodriguez. Due to her efforts, a likely struggle became a beautiful operation, anesthetic, and birth.