Tuesday, April 17, 2012

Great Expectations

On Thursday morning, I sat in an examination room.  I was in Albany for my pre-operation appointment, the final time seeing my doctor before the cochlear implant surgery.  While waiting, I looked at a faded piece of paper on the wall that had been framed.  The document was titled “The Top Ten Things I Can Hear.”  In a child’s handwriting, the list included astonishing items (to me, anyway) like “my neighbor talking to me from across the street” to phrases that made me laugh such as “my sister’s loud chewing.”  I felt grateful.   I was even daydreaming career options for myself in audiology, picturing myself helping a child like the creator of the document on the wall.  I was at peace.

And then the surgeon came in.  This was not our first meeting, so I should not have been surprised by the doctor’s lack of bedside manner.  He is known for being a reputable surgeon, after all; I don’t know what possessed me to think that a warm-and-fuzzy, social worker-version of him would be entering the room.  But I did.

I think he said hello, but within seconds, he was dryly reciting a checklist of surgical risks, and I was not at all prepared.  His lack of emotion left me rather unemotional.  I’m not used to feeling an absence of connection with a person I am talking to, let alone, the person who will be drilling a hole in my head in less than a week.  I wondered, did he understand my responsibilities as a wife and mother and my ambitions as a professional?  Was he seeing ME?  Didn’t he want to get to know ME?

In the next fifteen minutes, additional information was presented that caught me off guard.  The surgeon and I had a brief discussion of  disturbing (though very rare) side effects such as FACIAL PARALYSIS (SCARY), but mostly, we discussed the natural deafness that would fill my right ear.

“Now, you’re prepared,” he began, “to have no hearing left on your right side.”

I responded, “Well, I thought there was a chance some of my natural hearing would remain… I’ve heard it can happen.”

The emotionless expression remained on the surgeon’s face and he told me that while some recipients report having residual hearing, I should not expect to keep mine.  Funny how I panicked over the extremely rare threat of facial paralysis and yet I had been so assured that I would defy the odds regarding residual hearing.  I realized that my thinking up to that point had been jaded by these expectations that my surgery would somehow be exceptional—that I would wake up with my 20% natural hearing untouched, though every other recipient I’ve met had lost most or all of theirs.  I hadn’t truly believed that my right ear’s hearing would go away, never to return, until that moment.

Before the surgeon and I parted, I asked him if I would be seeing the audiologist.  He told me it wasn’t necessary during the pre-op unless I needed to talk to her for a specific reason.  It was then I realized that another expectation for my surgery was not going to happen.

It hit me like a ton of bricks.  The pre-op appointment is with the surgeon, discussing the incision, the pain medication… basically all that the surgery involves.  Why did I think the post-op would be any different? 
On the way out, I asked the nurse the question I already knew the answer to.
“So when I come to the post-op appointment, I won’t be getting activated that day?”

“Oh no,” she laughed.  “You have to heal first!  You won’t be getting activated until maybe, three weeks after the surgery.  But don’t worry—you’ll be hearing by summer!”

In a period of thirty minutes, I  truly realized I would  be deaf on one side, and also that the weeks following the surgery would be much different than I initially anticipated. Driving out of the parking lot, my mind was racing.  I had been prepared for 6 days un-activated, but three whole weeks or more?  How would I get through my daughter’s birthday  party?  I was so looking forward to hearing in church during my son’s first communion, and now I wouldn’t hear anything!  How would I tutor?  Baseball games, dance lessons… how was I going to do this?

It is thirteen highway exits from Albany to my husband’s office building, and I called him to see if he could meet me in the parking lot.  When the passenger door of my car opened and I looked in his eyes, I knew he understood why I unexpectedly drove there at 11 AM.  I was scared.  So much, that I wasn’t thinking clearly and even began doubting my decision.

 "What if he hits a nerve," I wailed, mascara running down my cheeks, "And I have facial paralysis... you promise you'll love me even if I have a droopy face?"

 "That's not going to happen, but if it did Pam, yes, I'll still love you."

We went on this way for awhile, me providing a terrible what-if scenario and then Jeff responding that it wasn’t going to happen.  My stress was all the more escalated because of my disappointment regarding post-surgery, and my emotions were running wild.  The tears had grown out of control, and any rational thinking was now replaced with uber-dramatic dialogue.

“I just wish I had more time to connect with the doctor,” I cried to Jeff.  “I should have reached for his hand.  I just wanted him to cradle me and tell me I would be okay.”  (Yes, I actually said this.)

It was that moment that Jeff looked me straight in the eye and said, “I don’t want you to take this the wrong way.   But you’re NOT THAT SPECIAL.”

Well, that shut me up.  I hope I’m not presenting Jeff in a negative light, because the tough love he gave me was EXACTLY what I needed to hear, and I remain grateful for the reality check.  In so many areas of my life, I dream up these exceptional, romanticized scenarios that in no way would be realistic unless my life was a movie or Broadway musical production.  Because of these overblown expectations- with my family, with my career, with myself- I constantly set myself up for disappointment.  And I was doing it again, creating ridiculous expectations for the surgeon to shield me from all that is bad in the world.  Jeff’s words made me realize I was dealing with a surgeon, not Superman, not my best friend, not a counselor.  He was a surgeon, and he was doing his job. 

Over the weekend, my household was busy with baseball practices, birthday parties, grocery shopping, house and yard work… though surgery was approaching, life was not stopping.  As I thought about my family’s schedules following the surgery, life would carry on at its steady pace.  We had places to be, and things to do, and I began to recognize that if I was uncomfortable handling certain tasks after surgery, I would have to relinquish my control.  I would have to ask for help.  In most cases, Jeff assumes any of my responsibilities when I’m unable to do so; he never complains,  he’s always helpful, and still, there is something about leaving him in charge that makes me extremely anxious.  Jeff does not prioritize neatness the way I do, and he certainly does not carry the urgency that I do when it comes to a tackling a to-do list.  Jeff gets things done, but in his own time, and sometimes it’s a very loooooong time, and he never, ever expects perfection.  Did I also mention he’s a pretty happy person?

As my post-surgery to-do list grew more daunting, my anxiety rose and sure enough, I snapped over a very small thing (my son’s choice of shoes), and I ended up crying and talking gibberish with the inability to stop, for a solid thirty minutes.  During this spell, I consulted with my mother-in-law and like her son, she gave me straightforward advice: LET IT GO.  If I asked others to help, I needed to let go of MY expectations and just LET THEM HELP.  Once again, I was reminded that it is okay to be vulnerable.  It’s okay to ask for assistance.  I was also reminded that assistance is rarely perfect, and that while I was working on accepting me and all my imperfections, there are many times I need to accept the the imperfect world around me.  Expecting perfection has never led to happiness, after all.

I remain a work-in-progress, and I am trying to live in the present without burying my thoughts in worries and overambitious expectations for the future. I continue to live and learn, and I have grown tremendously since sharing my story with you.  Mostly, I have learned how vital it is to have the support of family, friends, and even strangers during fearful times.  I thank everyone who has opened their hearts to me; I am strengthened by your fellowship.

I heard an interesting quote over the weekend quite fitting to my experience: “Those who are broken are blessed.”  For so long I have felt broken, but I can finally say I feel free, ready to heal, and eager to embrace the new blessings that will enter my life.  I'm not sure what it will be like to hear certain sounds; for once in my life, I have no expectations.  I'm excited to be surprised.


  1. Good luck Pam with the surgery. You’re inspirational. Your writing shows strength and bravery with exposing the intimate parts of your life. Thank you for sharing the journey with us . . we are always here for you, whenever and however you need us. We will be praying tomorrow :)
    We love you!

  2. I will be thinking of you tomorrow Pam! You are truly an inspiration to all. When you are all healed and rarin' to go, you should write an entire book about your life and journey with your hearing impairment. Just promise me that I get a personally signed copy!! Sending lots of hugs your way!
    Nathalie Hillman

  3. Your writing is amazing and so on the money. Your comments on the surgeon epitomized how I have felt about ENTs for as long as I can remember. I too wanted that support and reassurance - but I can tell you what you want is a master technician - someone who can get the job done and do it well. You will likely see him 1 or maybe 2 times to remove the sutures and check the incision. My surgeon barely recognizes me and he has operated twice - no conversation, nothing.

    My new BEST FRIEND is my audiologist - she and I really have a partnership which is crucial for your CI success. She is responsive, inciteful, creative (taking my feedback and actually making it sound better even when I know what I say does not make complete sense).

    Tonight I attended my 9th grade son's academic award night at high school, he got two awards which was great - better yet I heard his name called and understood what he was getting it for - it was in a high school gym and I was over 100 feet back. Amazing...

  4. I was so touched by your blog and understand the complexity of having to lose something to gain a positive outcome. Jeff is your rock to keep you strong and focused. He by telling you... "your not that special" (just at the right moment) put things in perspective for you to find the strength within you to move foreward in your journey. I pray God will enable the Dr.to perform this surgery better than he has ever done so that you can embrace the words of sound... Jeff, Colin and Claire's voices.

  5. Hi Pam, My prayers will be with you and your family as you go through this difficult time. I went to high school in Fort Edward with your husbands Aunt Susan Smith Fisher. It is truly amazing what modern medicine can do. Your husband and kids will be there for you as well as all those you Love and Who Love you. You are very brave....God Bless You and Bring you the joy of Hearing all he has created.Best Wishes, Ron Carter-Fish, Myrtle Beach, South Carolina