It’s been interesting doing some reading about recovery from major surgery. The literature I’ve read consistently talks of the value of pre and post operative psychological support – not always possible!) Other helpful factors are a sense of optimism about life in general and in particular, an optimism about the outcome of surgery. A religious world view is also a plus. Other factors include the list we now hear regularly. A happy and supportive marriage. A strong social network. Good physical health. Enough money etc. All in line with Maslow’s work. Papworth scores badly on some of these indicators. They offered no emotional support to either me or my wife. I don’t expect a busy admission ward to run a daily support group for patients and their family. I do think that somebody taking 10 minutes a day to sit with me and ask “How are you?” is not asking too much. Similarly I think that 10 minutes spent with my wife, offering her a space to talk would have been very helpful.  (I came across one study that suggested good psychological support reduced admission time by two days. That’s a lot of time saved and a lot of discomfort avoided. When I raised this with a senior nurse the response was “We’d love to. But we’re just so busy.” Menzies work in the 1960’s made a clear analysis of the reasons for this busyness in hospitals. She saw it as defensive. If I am so busy doing my nursing duties, then I have no time to face my own mortality. If my day is spent measuring urine output, checking BP and heart monitors etc, I give myself no room to feel about my patients. Nor to become attached to them. To worry about them . To care about them.If I am the aortic division in bed 3, I am not a whole person. If I am only a surgical problem, I have no past, present or future. I am not a real human being with whom nurses have to engage.

Cardiac surgery in particular challenges all of me. Breaking my leg is inconvenient but it does not challenge my whole existence. Cardiac surgery-along with other major trauma- goes right to the heart! It threatens my whole being.The heart is so much more than another muscle. It sits at the centre of my being and governs all other systems. It also stands for my inner life. How do I see myself? Who am I ? What is at the heart of me?