Bladder surgery is very different an automotive repair shops

Today I was greeted with one of the most distinct lacks of understanding that I have ever been met with in the pre operative area.

The lady that had been signed up for a cystectomy sincerely believed that she would get her bladder back within the year. That we would "shine it up" and it would be perfect and ready for her to have it again.
When it was explained that this in fact was not possible. She, understandably, was quite disappointed. I then had to take the time to explain that she would in fact have a bag for life, quite the revelation 30 minutes before being taking back to the operating room.

This in my mind brings to light the repeated phenomenon of what we say and what patients hear.  I am constantly reminded that there is often no correlation with what is said and patient understanding. I have told people that they did not have any type of cancer and they have walked away thinking that they had 6 months to live because the only word they heard was cancer. I have told others that they had horrible disease and that we were unable to operate and they have interpreted that as they were cured.

Ineffective communication, be it in the communicator or communicatee is very frustrating and a daunting hurdle to overcome. So far I have only one possible answer. At the conclusion of each clinic visit, bedside round, or preoperative questioning, I have the people repeat back to me what I said in their own words. This is little more than a reality show without the cameras.

This just in: Cancer might inhibit artistic ability

Today on gravity rounds (my favorite because you start at the highest floor of the hospital where you have patients and spiral down to the lowest floor, thus being closest to the exit when you are done), we were seeing one of our last people a very pleasant gentleman whose primary diagnosis was invasive bladder cancer with the complicating factor of having been treated for prostate cancer in the past. The day before we had taken him to the operating room removed both of the above offending organs and given him an abdominal wall urinary diversion.

He wasn't in his room, but was meandering about (gold star for that. People often don't realize but they have to get up and move after surgery. Oddly enough don't seem to want to with a humungous incision running the length of the abdomen, go figure). As we approached he exclaimed that he had been looking for us because he had something very important to share.

He then went one to tell us that since we had removed his bladder and prostate (approximately 24 hours before), he had discovered that he could now play guitar (having never done so before) and even better he could play lynard skynard's freebird perfectly (apparently a long standing dream of his) while my attending incredulously looked on (everyone knows the smile that starts sincerely but then continues to widen towards disbelief).

There might be a scientific explanation for this, however it is likely summed up by the fact that we prescribe pretty amazing IV medication postoperatively.