In the good old days!

I underwent a radical mastectomy. That was the surgery of choice in the good old days. Choice meaning, the doctor’s choice and a woman’s only option. In the good old days, women checked into a hospital the night before surgery, underwent blood and other lab tests, signed an almost blank medical release form (we trusted our doctors then) and left herself to the tender mercy of her surgeon. We were allowed to remain in the hospital until our surgeon was ready to release us. A Reach to Recovery (R to R) volunteer would come in and offer instructions on arm exercises, bra fittings, prostheses options and give emotional support.

Today is a different story. Women get to the hospital shortly before surgery. All lab work and x-rays have been done before arrival. Women are placed on the hospital’s conveyor belt, slid into surgery, out to recovery and the floor, just in time to be released before the staff has to change the sheets again. No time for an R to R volunteer. The new breed of doctors may not even be aware there are volunteers to help the patient. The new breed of doctor is valiantly hanging on to what little bit of authority the big insurance companies have left him or her.

In the good old days, an R to R volunteer was called the day after surgery and knew she had 2-4 days to get there. By the time I had my last R to R patient in 1983, I got the call during surgery and the patient was dismissed the next day. The well-informed ward clerk who called me said the patient had surgery the previous day and was due to go home the next. I quickly rushed to the hospital, only to find a patient who was barely awake enough from surgery to know I had arrived. But, yes, she went home the next day.

What was the difference between my own surgery and time in the hospital? None of the patients I served during my five years as an R to R volunteer had undergone a radical mastectomy. Most had simple mastectomies with a few modified radicals. By not removing muscle, there was no longer any need to keep women in the hospital for longer recovery.

What about their emotional status? Who cared? Insurance companies had now taken control over patient stays and doctors no longer could keep a patient in-house when the little snip at the insurance company call center said the patient had to go home. It didn’t matter if one more day would have allowed the patient to be more focused and aware of her surroundings. The extra time would have allowed family members and friends to plan ahead for meals, child care, errands, and other events the patient would have to face. Insurance companies just plain don’t care. The snip on the phone is supervised by a superior who gets a bonus for all those extra dollars not spent on patient care.