Even at the age of 27, I remained much the same simple naive ingenue I had been as a child. This state persists even now. Here follows an example true story to make the point.
I had established a solid spinal block on a man in his sixties who required surgery on his hypertrophied prostate gland which was giving him continuous difficulty in passing urine and really needed to be fixed. The operation is quite simple to understand. A normal prostate is about the size of a plump apricot and it surrounds the urethra, the tube leading urine out from the bladder to errrh the outside world. It suffers a design flaw because it frequently enlarges with age, growing both outwards but also inwards, thus narrowing the urethra and making it hard to pee.
A urologist can access the urethra and prostate with a narrow telescope containing ingenious optics and a manoeuvrable loop of wire…. If a picture is worth a thousand words, then a movie must be worth a million:
The surgeon simply cores out the prostate from within, taking slivers of tissue away with an electric current which both cuts the tissue, and seals off the bleeding blood vessels at the same time. The pieces of dead prostate, which resemble shrimps, float away from the field of view because there is a continuous flow of non-conductive clear fluid emerging from the business end of the telescope. An isotonic insulating solution of the amino acid glycine is used during the procedure to both sufflate the prostate and bladder, but also to concentrate the electrosurgical current to the point of contact between the wire loop and the offending tissues. Often bubbles of steam are seen, but occasionally sparks too!
Urologists perform about 25% of all surgery in the UK, and are thus very busy people. A trans-urethral resection of the prostate (TURP) is one of the commonest procedures, but the same tech is used to resect bladder tumours (TURBT).
Because the irrigation fluid contains no sodium, and is readily absorbed into the circulation, there is a serious risk of causing an electrolyte imbalance, hyponatremia, if the procedure is prolonged much beyond an hour or so. Low sodium levels in the blood present with confusion, agitation and distress, symptoms totally more easily spotted if the patient is awake rather than rendered comatose by a general anaesthetic: Duh! This is the reason why spinal anaesthetics are preferred for urological procedures.
My patient was a retired Professor of politics, philosophy, and economics. He was the most excellent and interesting of company, as he adjusted his conversation down to my level of understanding. Our conversation ranged over a wide area, but he eventually asked me to define where exactly my political, philosophical, and economic sympathies lay.
I had never quite been put on the spot like this before, but I polled my few functioning neurons to provide an answer worthy of his hearing.
“I suppose I am a Christian anarchist“, spake thus I, after several seconds of dreamy vacancy behind my eyes.
My private audience of one looked hard at me, puzzled by my response. “What kind of beastie is that?”, he queried, while looking like he was captive in the presence of a madman.
As I mentioned above, I remain a simpleton to the present day. I examined my two word answer carefully: I was certainly a Christian, because I had earlier received an unmistakable inner locution confirming to me in my alone-ness that all the words of the Old and New Testaments ring true, and that there really is a God-with-us, Emmanuel.
My understanding of “anarchist” was much less understood by me. To me it meant a person who was willing to destroy anything that stood in the way of some higher purpose. Bearded hell’s angels chucking dynamite at anything that offended them, was one mental image. A better one was any ordinary person who dedicated their life towards destroying everything that is contrary to the flourishing of the Divinely Created Human Being, Body and Soul, and this was the answer I gave.
Alas, my answer was not received kindly by my patient, for he could not understand my reasoning nor reasons; he was just too ideologically constrained, I suppose.
We had got on just fine while he benefited from my kindness and competence, directed towards his bodily and other flourishing. We only fell out when our encounter entered the world of sterile concepts and ideas, which is the dead sea occupied by too many clever folk.
Humans do best when they meet “cor ad cor loquitur”: Heart speaking to heart. Amen.