Outpatient Mastectomy Surgery

My thanks to Ellen Goodman for “The Latest HMO Outrage: Drive-Thru Mastectomy” (Commentary, Nov. 18). Last week I became an uninformed victim of this inhumane practice at Kaiser-Permanente, Los Angeles.

I want to acquaint women with my firsthand experience of this degradation and urge my fellow HMO patients to contact their Washington legislators.

My mastectomy and lymph node removal took place at 7:30 a.m., Nov. 13. I was released at 2:30 p.m. that same day. I received notice, the day before surgery, from my doctor that mastectomy was an outpatient procedure at Kaiser and I’d be released the same day. Shocked by this news, I told my surgeon of my previous complications with anesthesia and the fact that I have a cervical spine condition, which adds an additional consideration for any surgery. The pleasant doctor assured me that I’d be admitted, for the night, if I experienced excessive pain or nausea. This was noted in my chart.

In the recovery room and the holding area, I felt like a wounded soldier in a hospital tent during the Civil War. I was surrounded by moaning patients and placed directly next to a screaming infant. When I finally found a voice, I shouted, “Get me out of here!” A nurse flitted by, shot me a disapproving glance, and commented, “Some folks just don’t know when to be grateful.” This was the ultimate humiliation.

While in a groggy, postoperative daze, swimming in pain and nausea, I was given some perfunctory instructions on how to empty the two bloody drains attached to my body. I was told to dress myself and go home. My doctor’s written chart instructions for a room assignment, if I developed acute nausea or pain, were ignored by the nursing staff. Obviously, the reassurance had been given to placate me at the time of my discussion with the doctor but everyone knew an overnight stay was against Kaiser hospital rules. Everyone knew, except me. I had no time to mourn the loss of my breast or regain a sense of composure.

This experience was especially shocking because four years previously, I had undergone a hysterectomy and received excellent treatment and a four-night stay at the very same Kaiser facility.

We women can allow ourselves to be discounted or we can demand more from the HMOs. No civilized country in the world has mastectomy as an outpatient procedure.

VICTORIA BERCK

Los Angeles

* In Goodman’s excellent column, every word of which I endorse wholeheartedly, she quotes Cindy Pearson of the National Women’s Health Network as implying that women receive second-class medical treatment just because of their sex, by asking, “What part of a man’s body would they amputate in same-day surgery?” I can answer that one from experience: the testicle(s).

When I had my testicle removed for testicular cancer it was admittedly not as serious a surgery as radical mastectomy, but it did involve general anesthesia, surgery and the loss of a body part to which I was deeply attached. And it was only covered as outpatient surgery by my HMO, male though I be (still).

MICHEL MASSON

Santa Barbara