Anger After Surgery: A Most Understandable Result
Have you ever had the urge to throw a clock across the room just to watch it shatter, but lacked the physical strength and breath to do so? Because of your inability to speak, due to pain-eliminating drugs and being tied to a small army of clear plastic tubes, there is literally nothing one can do but wait for it to be over and pray that the situation you’re in (recovering from a cardiac surgery)… ends in your favor. While you lay there, unable to move, you’re being watched by mask-wearing people with smiling eyes and family members telling you to smile despite the pain in order to comfort themselves, not you in what could be your final moments? All you want to do is shriek in rage, but you physically cannot. To many, this experience is the stuff of nightmares. However, this infuriating and terrifying situation is often the reality of those who face cardiovascular disease (CVD) surgery. I have had this experience… and so have many who have had heart surgery.
And yet, despite all of this, we are expected to smile. To many, it is assumed and even prescribed that a person who has just gone through surgery, especially one with a cardiovascular element, should be nothing but grateful for having survived the experience. It is almost cliché and expected… however, I believe this is harmful and that it is normal and even healthy to experience anger after a surgery for a number of reasons.
In my experience, growing up with CVD, I had four open heart surgeries and honestly, I don’t remember the exact number of lesser but nevertheless scarring procedures. However, I was told that I had to smile through it all. That I had to be a “good girl” and to thank everyone who hurt me, be it the nurses with needles or the surgeons with scalpels. This was for me to be easy to control, and honestly, this game plan did give me the best chance for survival because, as it was explained to me one of the times I broke down crying. I was told to smile and be nice because the nurses would let me die if I didn’t. They have better things to do than help sick kids, especially if they’re ungrateful.
As one can imagine, this put a permanent mask on my face whenever I was in the doctor’s office or hospital. I said thank you to everyone who stuck me with a needle, administered medicine, or used a scalpel. Furthermore, I learned not to discuss this aspect or any other part of my illness with others, especially the ones that had had the audacity to venture beyond the prescribed, “I’m just so happy to be alive!” script. This is because whenever I did, they always somehow didn’t hear me or immediately changed the subject. If I brought it up, they said I didn’t speak loudly enough, and if I pushed back, it circled back to the inevitable, “You should be grateful and happy! Look at how much trouble you are!” starting point. Given the long road I have personally experienced with genuine medical trauma, I am deeply familiar with this particular side effect of medical practice, among many others.
Perhaps some people do accommodate better than others. Maybe it is a side effect of the lifelong struggle to stay alive that has left this impact on me that digs deeper and deeper with each operation and procedure. Maybe it is just a matter of personal experience… which is entirely possible. However, upon delving into research on this topic, I found that this is not the case; rather, this phenomenon is widely studied and often featured in academic journals.
One journal article, Experiences Of Undergoing Cardiac Surgery Among Older People Diagnosed With Postoperative Delirium: One Year Follow-Up by Claesson Lingehall et al., describes a slew of symptoms of patients after surgeries, which include anger, among a list of others. The results described how patients reported “feeling drained of vitality, having a body under attack, losing strength, and being close to death” (Claesson Lingehall et al., 2015). Many “thought they had no choice but to put up with what was going on now, that their bodies were ‘useless’” (Claesson Lingehall et al., 2015). One seventy-three-year-old female patient even stated, “I fervently hoped I would die. I think it was unfair of God not to let it happen. I could not even eat” (Claesson Lingehall et al., 2015). I do not add this to be distressing, but to recognize the reality and direness of the harrowing situation that many people with CVD face, regardless of their age. The irony is that there is a presumed weakness that comes with CVD and the assumed ‘burden’ that people with the condition often are associated with. However, this is not as much a comment on broader society because people with CVD often feel it within themselves more than anyone else ever could. It inspires unnecessary and brutal levels of shame. In this way, it is not uncommon for “patients [to] perceive their inability to meet their own basic needs as a failure” (Claesson Lingehall et al., 2015) and described terrifying experiences, like one seventy-one-year-old male testified that, “… I couldn’t get any air. I couldn’t make a sound. I couldn’t breathe. I thought to myself, now I know what it feels like to be a perch stranded on dry land” (Claesson Lingehall et al., 2015). These experiences are terrifying, frustrating, and anger-inspiring for those who experience them.
The article continues specifically describing how “participants described how their hospitalization could change into a nightmare with strong emotional feelings of frustration, anger, pronounced fear, anxiety, and loneliness” (Claesson Lingehall et al., 2015). Now, when they refer to ‘nightmare,’ they allude to a terrible, vivid dream of a life-threatening nature. This is often how the subconscious permeates the conscious mind, so when facing life-threatening situations involving one’s health, sleep often does little to alleviate those fears and, instead, enhances them.
Personally, I have nightmares of a similar nature almost every night due to similar feelings of anxiety caused by my heart condition. But, while the participants in this study are of an elderly demographic, it follows that the nightmares of feelings of frustration and anger over one’s health failing are not limited to a certain age group.
Another article, The Effectiveness of Acceptance and Commitment-Based Therapy on Anger, Anxiety and Hostility for Heart Surgery Patient by (Kheyran-Alnesa, Mirzaian and Yar-Ali, 2018) points out how “in Iran, coronary artery bypass grafts are common and account for more than 50% to 60% of all cardiac surgeries. The necessity of doing this for the patient on the one hand and the compulsion to accept it on the other hand causes serious changes in his life and sometimes leads to unwanted and common problems in different stages of treatment and after treatment of these patients.” Perhaps regionally specific, this statistic is not too far-fetched from statistics on heart surgeries in general, and it recognizes the difficulty of accepting such a statistic, especially when it directly impacts your own life.
It is important to discuss the significance of anxiety that plays a role in the anger regarding such a potentially distressing situation. The article by Kheyran-Alnesa, Mirzaian and Yar-Ali points out how “one of the variables that threatens to improve the quality of life of patients undergoing heart surgery is ‘anxiety.’ Anxiety is an invisible form of energy that is mentally conceived by the person who experiences its effect”
(Kheyran-Alnesa, Mirzaian and Yar-Ali, 2018). However, this hostility “is associated with a number of phenomena such as aggression, anger, distress, irritability, suspicion, hatred, verbal and physical aggression, and a sense of distrust” (Kheyran-Alnesa, Mirzaian and Yar-Ali, 2018) and another factor is “anger is defined as an emotional state, which includes emotions that range in intensity from mild stimulation or anger to madness and rage” (Kheyran-Alnesa, Mirzaian and Yar-Ali, 2018). All three factors — anxiety, hostility, and anger — are interconnected with heart problems, according to this article because, “as can be observed, heart surgery, in addition to physical complications, has significantly reduced the individual and social function, the level of psychological and behavioral adjustment of these patients, which leads to hostility, anger and anxiety” (Kheyran-Alnesa, Mirzaian and Yar-Ali, 2018). This creates a completely understandable cyclical relationship between heart surgeries, anxiety, hostility and anger each feeding into another in a developed coping mechanism when facing a truly dire situation.
My point is that anger when facing or after heart surgery or any cardiac procedure is not rude or a personality flaw. It is an entirely understandable response in this particular circumstance. However, while one may experience anxiety, hostility, and even anger when facing or recovering from cardiac surgeries and procedures, one should be certain to remember one thing: they are not the only ones experiencing them. Others around you, friends and family, also experience these emotions when you are facing surgery. Granted, perhaps to a different, less-personal degree, but their experiences are still valid. So that’s why, if you can avoid it, do your best not to take your fears out on them in a manner of lashing out. Express it and discuss it, but certainly do your best not to cause any more harm than necessary. As such, if you do have these strong emotions surrounding your medical health, I personally recommend you discuss them with a trained therapist or confide in your friends. However, one must remember that friends may not always know how to respond — I know mine often didn't — but finding even one person who will genuinely listen is worth the attempt. They may be able to offer you comfort and solace during these difficult times.
What do you think? Did you find this helpful? Can you relate?
Do you have CVD or a chronic illness? Can you relate?
Comment below.
Tune in next Monday and Friday for more! I will be writing more now that I’m finally feeling better, so I’m getting a new, more frequent schedule.
Keep ticking, everybody!
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Reference List:
Claesson Lingehall, H., Smulter, N., Olofsson, B. and Lindahl, E. (2015). Experiences Of Undergoing Cardiac Surgery Among Older People Diagnosed With Postoperative Delirium: One Year Follow-Up. BMC Nursing, 14(1). doi:https://doi.org/10.1186/s12912-015-0069-7.
Kheyran-Alnesa, M., Mirzaian, B. and Yar-Ali, D. (2018). The Effectiveness of Acceptance and Commitment-Based Therapy on Anger, Anxiety and Hostility for Heart Surgery Patients. https://jbiochemtech.com/storage/models/article/YZYjuCKliShIcR6acQaeAh3X47xGozcoF1GPg7rTns4ZHzMfBF81ZUZ8k3Sy/the-effectiveness-of-acceptance-and-commitment-based-therapy-on-anger-anxiety-and-hostility-for-he.pdf.
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