“Major Surgery: Facing the Fear"

A Memoir by Bill Boggs

I’ve never considered myself a particularly brave person. I’ve taken plenty of career risks and had some daring adventures, but when it comes to hazardous or physically dangerous activities like skiing, bungee-jumping, skydiving, or mountain-climbing, I watch from a safe distance. In the Army, I trained to be a medic in the National Guard, hoping that would keep me as far away from danger as possible. I was grateful that it did.

I’d also been lucky in having excellent health that lasted over many decades. People who knew me would marvel that I’d lived a long life and never spent a night in a hospital, let alone undergone surgery.

 But a few months ago my luck ran out. The prospect of surgery had haunted me for some time, but when the pain grew so severe I could scarcely walk, I had to face the fact that I couldn’t put it off any longer. Filled with anxiety, I scheduled a four-hour operation to replace both of my hips.

Suddenly everything I’d ever dreaded about hospitals was playing in my mind like the climactic scene in a black-and-white horror movie, endlessly set on repeat. Every aspect of what I was facing terrified me: being put to sleep, being sliced open, having my body taken apart, and having artificial new equipment installed inside me. And, oh my God, there would be a catheter! That thought alone was so horrifying it seemed at least as bad as the surgery itself.

I had about a month to deal with the massive, pervasive anxiety. One of my daily meditative affirmations is “I will savor this precious remaining day of my life.” The question now was whether I could actually salvage the month ahead instead of ruining each day in a frozen panic about the approach of my surgery.

I did not want to arrive at the hospital on that fateful morning in a state of acute anxiety that would carry negative energy with me to the cold slab of the operating room table I was visualizing.

And what kind of plan could I concoct to help me deal with the certain discomfort I would experience post-surgery, when the expected recuperation process would entail four nights at the hospital and a likely 10 days in a rehabilitation facility?

What could I draw upon that would enable me to manage the intense fear I felt? As John Wayne put it, “Courage is being scared to death, but goin’ out and saddling up anyway.”

As I contemplated how I could go out and “saddle up” in my own way, I began to develop a personal program for facing such a challenge.

Now safely in the recovery phase, I know these methods helped me, and I offer them to others in the hope that they might also be of some benefit to those who might need them.

Cultivate Empathy and Gratitude: In the weeks leading up to surgery, as I was hobbling around Manhattan, I was increasingly aware of the many people I encountered who were far worse off than I was. Within minutes of leaving my apartment, I’d see a man with no legs or a woman struggling with crutches and braces or a child with deformed feet.

These afflictions might not lend themselves to being remedied with surgery the way mine could be; some people’s problems were intractable. I started feeling grateful for the fact that I would be helped, which made me feel “lucky” to be having my hips replaced. Virtually all the current research on happiness indicates that gratitude is an important component, and I found it to be a crucial tool. The more I focused on feeling grateful for my blessings instead of angry or scared about my problems, the happier I felt.

Control Your Imagination and Live in the Moment: Most fears are created by the negative use of the imagination, and many of them prove to be a total waste of energy. As Mark Twain once observed, “I’ve been through some terrible things in my life, and a few of them actually happened.” As I progressed through pre-operative preparations and post-op recovery, each new stage offered a confirmation of that wisdom. Nothing was nearly as bad as I had imagined it would be. You can’t know ahead of time whether something you dread will turn out to be even worse than you anticipated, or not nearly as bad. But what you can know is that focusing on what lies ahead takes you out of the present.

When we project our fears into the future, we take ourselves out of the present moment and deprive ourselves of fully experiencing what is going on around us.

We create an imagined scenario that frightens us, and we dwell in that purely mental reality rather than the one that actually exists. The counterculture icon Ram Dass expressed the challenge of mindfulness with memorable succinctness: “Be Here Now.” To the extent that I could practice mindfulness and be present in my day-to-day life instead of projecting my fears into the future, I knew I’d reduce my daily anxiety as the countdown to surgery continued. And it did.

 Choose to Have Faith in a Positive Outcome: Rendered unconscious by anesthesia during surgery, I knew I’d temporarily have no control over my destiny. It was comforting to compare the experience I was about endure to the familiar challenge of getting on an airplane and relinquishing control of my fate to the skill of the pilot and the smooth functioning of the equipment he relied on. Also comforting was telling myself that having surgery was like taking a trip where I would never be alone. My daily reminder was simple: “I am going on a long journey and people are going to help me every step of the way.” As I focused on these truths each morning, I could feel my anxiety subside.

Summon Inspiration From Those You Admire: By lucky coincidence, the date of my surgery turned out to be my late father’s birthday. He died many years ago from complications of diabetes. With a damaged heart, he was facing the choice between death by gangrene or the amputation of his right leg. My dad had been a professional athlete and even at age 80 was remarkably strong. The prospect of a gruesome amputation must have been horrifying to him. And yet when my mother and I discussed with him what was about to happen all he said was, “I’m not too happy about what they told me this morning.” That was it. No hint of fear. No complaint. No self-pity.

He did not want to upset my mother and me, and he summoned the steely stoicism of “the greatest generation.” My dad’s fortitude was a sterling example of courage and grace under pressure that inspired me to set a behavioral target for myself.

On the day of surgery, I wanted to behave in such a way that my girlfriend (who would accompany me as far as the operating room door) would be able to tell my son that his father was brave and actually joking around during the hour before the operation. I acted as if I were unafraid. That pretending helped enormously. I got some laughs.

I treated my time in the pre-op room as if it were an acting exercise, and I had everyone there convinced that I was not the least bit scared. During the 90 minutes I was waiting, I had to go into the bathroom twice. Alone, and not acting any more, I shuddered, overcome with a spasm of cowardice. I felt afraid, but I literally pushed away that angst, took a couple of deep breaths, left the bathroom, and resumed my act. Pretending to be confident made me more confident, which helped to keep me calm.

Enjoy the Consolation of Music: Music has always had a powerful influence over my mood. I had my iPods with me in the weeks leading up to surgery, and I kept them by my side during all my days in hospital and rehab, using music to divert my attention from fear or discomfort. As my theme song I chose “The Best Is Yet to Come,” and I was actually singing it as I was wheeled into the operating room. In several challenging situations after surgery and in the rehab hospital, I turned to music to boost my spirits or distract me. In one very stressful situation, I found that Monty Python’s “Always Look on the Bright Side of Life” served as a reminder of that goal.

Be Creative With Memory and Imagination: I practiced the power to transport myself through memory. In a general study on well-being, David Kahneman, a Princeton University psychologist, said, “In the end, memories are all you keep.” I created a kind of theater in my mind where I recalled, in as vivid detail as I could, a rich array of adventures with my friends and family. Reliving long-ago capers took me far away from where I was and what was bothering me, particularly in the middle of the night in rehab while trying to fall back to sleep.

Controlling the Intake of Information: My dread of general anesthesia was greatly reduced when I learned that my operation would involve a spinal block — an epidural — for the lower portion of my body, and that I would simply be put to sleep with the drug Propofol. The fact that Michael Jackson died while sedated with Propofol actually did not alarm me. I had faith that the Hospital for Special Surgery in Manhattan, one of the best medical institutions in the country, was a very different setting from Michael Jackson’s bedroom at Neverland.

Importantly, I made a conscious decision not to learn all the details involved in performing hip replacements. I choose to keep that process an abstraction. The pictures of the replacement prostheses in the hip replacement booklet were enough for me. I passed on watching a video that showed the actual surgery being performed. The likely scenes of hacking and sawing at bones (my bones!) would have rerun in my mind with excruciating consequences.

But how to deal with my greatest dread, a hyper-phobic fear of a catheter being inserted in my penis? Simply thinking about it made me cringe and go knock-kneed with a stabbing sympathetic pain in my “netherworld.” Doctors and nurses told me, “It’s nothing, you’re asleep when it goes in.” This failed to reassure me. “But what about being awake when it comes out?” I asked. Every woman I know who ever endured a catheter told me, “You’re being silly — it’s nothing, don’t worry.” But every man I asked said, “Let’s not talk about it.”

So how bad was the moment of removal? Well, when the catheter was taken out I had my face jammed in a pillow and “Always Look on the Bright Side” blasting in my ears. I can’t say it was pleasant, but it only lasted half a second. The ordeal I’d imagined was something like pain on a torture rack in a medieval dungeon. Indulging in that fear turned out to have been a highly unproductive use of my rich imagination, one that needlessly exacerbated my negative feelings and wasted energy that could have been applied to far better goals.

In the end, with the whole experience safely behind me — the lead-up, the clock ticking in pre-op, the post-op pain and physical therapy, the horrible constipation from painkillers, the unbearable skin itchiness from an allergic reaction to them, the two weeks of living in hospital rooms, the challenge and discomfort of sleeping on my back — I came away feeling proud that I had prepared myself and had prevailed. What had once loomed large in my imagination as a fearsome event turned out to be a major growth experience. I had triumphed over the destructive power of dread and self-doubt by finding creative ways to cope mentally with physical and emotional distress, and the experience left me a better man. I’d grown.

Two weeks after the surgery, with the help of a cane, I walked without pain out of the rehabilitation hospital toward the car that would take me home. I said to myself, “I did it.”  

Bill Boggs is an author, a four-time Emmy Award-winning television producer and host, and a professional speaker. His interviews with a number of notable people can be seen at his website, billboggs.com.