Saturday, June 6, 2009

Emotions Affect Communication

My 9-year old son, Nicholas, had heart surgery in Boston three weeks ago on May 21st. Before he had the surgery, he had an MRI on the 19th. Holly, his mother and my wife, went into the procedures with him. After it ended, she told me something that I had forgotten. Nickie had had a previous bad experience with an MRI in Pittsburgh, specifically the IV needle, and Nickie was a little frightened in Boston. The nurse at Children's Hospital of Boston used a "numbing patch" so that he wouldn't have the discomfort of feeling a needle enter his arm before the MRI. Evidently the patch had some form of anesthetic and it helped Nickie accept the needle. He liked the "numbing patch."

Our family had two days to look around the Longwood section of Boston and we even visited part of Old Boston and the Freedom Trail. But, our enthusiasm was dampened because each day Nickie had a pre-operative procedure and the impending surgery loomed over us. Each time we looked at him, we knew he would be having very serious surgery in a day or two.

On the day of surgery, as Nickie lay on the gurney in Pre-Op before the surgery, I struggled to stay composed and struggled with the right words to say to him. Before I lost control, I leaned close to him and said, "Come back to us, Nickie." Then I lost control of my emotions and had to leave his bedside. The anesthesiologist had given Nickie a sedative but through the fog of that relaxant, Nickie said, when I returned to his bedside, "Why are you crying, Daddy?" That caused me to lose all control.

Nickie came out of surgery at 10:00 pm and we visited him briefly in the ICU. The site was horrifying to my already heightened sensitivity. He had tubes in his mouth, lines in his neck, his chest, his side, his arms, and, of course, he had that long bandage running from his collarbone to his stomach. I didn't have to use my imagination to know what lay under that. But, the doctors told us everything had gone well in the operation and that an echocardiogram after surgery had shown that the new pulmonary valve and re-constructed tricuspid valve were working very well "with little to no leakage."

The next morning I arose early from the hotel where Holly and our son Alex were staying and went to the ICU. Nickie was alert, although the nurses were giving him a slow drip of morphine for pain. He still had the breathing tube down his throat and was certainly unable to talk but he flashed me a "thumbs up." I had to go into the hallway because I became choked up again at the site of this courageous little guy.

In fact, I went into the hallway and called my wife at the hotel to tell her about the "thumbs up," but, because I was so choked up, I struggled to talk, she thought something bad had happened. I straightened that out and was able to reassure her, but I was having a bad communication day that would only become worse. In fact, my sister, Dianne, who had travelled from Florida to be with us during and after the operation, called me minutes after my call to my wife. I told Dianne I was "in the hospital." She thought I had been hospitalized with a heart attack! It took a while for me to explain I was visiting Nicky in the hospital and why I was so joy.

The communications didn't get any better. I went back into the ICU to see Nickie clearly in distress. He was trying to communicate with the nurse and was becoming frustrated because he had the breathing tube down his throat. I went to his side and leaned over, kissing his forehead and trying to calm him.

"Relax, Nickie," I whispered to him, my face inches from his. "Tell Daddy what you need."

I watched his mouth as he tried to form words, but I was unable to understand them. With the tubes in his mouth and down his parched throat he couldn't make his tongue and lips work the way we normally do to form the simplest sounds.

"Try again," I whispered to him.

Again, only garbled words or sounds came from his mouth.

By this time, he became frustrated and angry and again leaned up toward me, his mouth wanting to make a roar of sounds, the veins in his necked distended and a tear running down his cheek, but nothing came out but a dull hiss.

"Write it in my hand, Nickie," I said, holding my right hand up to him.

He used his right index finger to trace letters in the palm of my hand, but, in his pain and slight delirium, he was unable to write in such a way for me to understand, or I was inept at understanding.

"Can someone get a piece of paper and write the alphabet on it?" I asked.

"I will," one of the nurses said, quickly leaving the room.

Just as quickly she returned with a plain white piece of paper with the alphabet crudely written on it.

I took it from her and handed Nickie a pen.

"Point to the letters, Nickie," I said, holding the alphabet in front of him.

He pointed to an "N' a "P" an "H" and stopped.

I turned the paper over and said, "Can you write the words, Nickie?"

He put the pen to the paper as I held it in front of him again and wrote several letters. The first letter looked like an "H" and I couldn't understand the other letters, mostly because he had had to write them while in pain and fatigue one day removed from over six hours of open heart surgery and without a solid writing surface or any support for either the pen or the paper.

"I'm going to give him a little more morphine," the nurse said and I kissed Nickie and ran my hand through his hair telling him "I love you." Then I left the room.

Within a few minutes, my wife and son Alex came to the hospital. After Holly had a chance to see Nickie in the ICU and comfort him, I told her about the incident with Nickie and showed her the piece of paper with the words Nickie had written.

"Numbing patch," she said to me. "He was trying to write 'numbimg patch.'"

And so he was, but I was unable to see it. I had mistaken his "N" for an "H" and I was so emotionally invested and distracted by the sight of my son in pain that I couldn't communicate. Just as when I talked to my wife and sister on the phone, I was sending a message they misinterptreted because they, too, were under tremendous emotional stress.

I realize now that all communication is filtered through the emotions that the senders and receivers are experiencing at the moment, or in the case of Nicholas, the physical circumstances they are experiencing, the pain, the anesthetic, the difficult surroundings. All Nickie really wanted was a numbing patch for his whole body.


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