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Education  |   August 2018
Subjective Objective: A Researcher’s Narrative on Human Relationships
Author Notes
  • From the Departments of Educational Administration and Anesthesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada. Jennifer.OBrien@usask.ca
  • Accepted for publication February 5, 2018.
    Accepted for publication February 5, 2018.×
Article Information
Education / Mind to Mind / Infectious Disease / Pain Medicine / Pediatric Anesthesia
Education   |   August 2018
Subjective Objective: A Researcher’s Narrative on Human Relationships
Anesthesiology 8 2018, Vol.129, 368-370. doi:10.1097/ALN.0000000000002168
Anesthesiology 8 2018, Vol.129, 368-370. doi:10.1097/ALN.0000000000002168
“Will she have her clothes on?” asked the suspicious mother standing before me.
I reassured the woman, rather uncomfortably, that her daughter would be fully clothed when I videotaped her emergence from general anesthesia in the recovery room. Dental procedures do not require patients to disrobe.
As a Research Assistant, my job is to recruit people to participate in research studies. I am responsible for gaining parental consent to videotape hysterical children as they awake from dental surgery. Instantly untrustworthy, I approach nervous parents to inform them that some children wake up from anesthesia in a state of delirium—thrashing, crying, and screaming as if they are having a nightmare.
Patients are often from remote indigenous communities, may not speak English, and often look uncomfortable when faced with my white coat. I feel like an intruder; I feel like parents should be suspicious. They are at their most vulnerable, placing their child in the hands of the medical system over which they have no control.
Later, in the recovery room, I rest my forearm on my swelling belly and point the video camera to frame the bloody face in the tussled bed sheets. Hair disheveled, eyes wary and crusted with dry tears, I have a strong urge to reach out from behind the camera and hug this child. I touch my pregnant belly with my free hand and sympathize with the mother’s helpless anxiety, as she remains in the waiting room for the nurse to call her in to her daughter.
Is this research project really going to improve care for these children? Or could we better soothe the girl by being less institutional, less cold, and more compassionate?
Being separated from her mother, surrounded by cold instruments and unfamiliar faces, and awakening to frozen face and an IV must be traumatizing to the bloody toddler on the stretcher before me. If nothing else, this project has strengthened my resolve to protect my future child from waking to the high-pitched beeping of the recovery room monitors.
*****
It is somewhat easier to recruit adult patients for research. If they agree to participate, I ask patients to rate their pain on a scale from 0 to10, where zero is “no pain” and 10 is “the worst pain imaginable.” I have developed a knack for approaching patients with an air of levity at this grave time in their lives.
However, uncomfortable moments still occur. I grieved for the woman in tears on postoperative day 1. I entered her semi-private hospital room to find her weeping over news that her surgery was unsuccessful and her breast cancer will continue to spread. How could I ask her to rate her physical pain at a time when emotional pain was far more significant? Should I feel guilt over my fleeting thought that a qualitative inquiry would have yielded far richer data in that situation?
*****
After purchasing our first home near an inner-city hospital, I recruited a young man with chronic renal failure. I watched him struggle with postoperative pain while the healthcare staff struggled with what they saw as a narcotic-seeking patient. His repeated requests for painkillers were difficult for me to deter, although the decision was luckily not mine to make. In me, he was seeking an advocate. From them, he was seeking narcotics. These are the ongoing struggles to reconcile my inner researcher with my inner humanity.
*****
People are generally pleasant and willing to help out. Once, a lean, grey-haired man in his mid-fifties agreed to participate in the study I was pitching. His severe-looking wife did not utter a word during the informed consent process, and I felt quite intimidated. I later discovered that she was a nurse on the postoperative ward. She must have been terrified that her husband’s bowel cancer would not be contained with the surgery. I speculated that she knew too much about the recovery process for this type of surgery.
When I saw this patient in the Recovery Room to ask him to rate his pain, he remembered my name in the postoperative haze of general anesthesia and smiled warmly. In his hospital room the next morning, he asked me if I had any children and I proudly told him about my nearly two-year-old daughter. He had children of his own, nearly my age. A week later when I phoned him at home, there was no answer. With a feeling of unease, I learned from hospital information that he had not been discharged and was still on the ward. Arriving in his room, I discovered a gaunt man in hospital pyjamas. He looked as if he had not showered in days. His hair was flattened and sticking up in the back, the result of too much pillow-time. This man had seen better days.
Smiling weakly, he asked after my daughter. He reminisced about his own kids’ childhoods like a man who had spent the past week reckoning with life and death.
“You should have more while you still can,” he advised. “They bring so much joy.”
Agreeing with him, his words echoed through the empty space in my womb that had been full of promise only days ago. Should I tell this man, this patient, that I had miscarried my second child this week?
*****
Recruiting research participants is one aspect of research that combines subjective and objective positions. As scientists, we strive for objectivity to our data so that we might produce the best evidence. As humans, we ask whether there is a shortcut to the best patient care, and that shortcut may be relating human-to-human. By their very nature these studies objectify patient responses to treatment. They also objectify the patient as a means to an end, and the transient relationships through recruitment and data collection.
The relationships described in this narrative leave reverberations that are felt after both participants leave the acute care hospital setting. At critical moments in my life, objective research subjects have made lasting subjective impact.