Psychological Aspects of Preoperative and Postoperative Care

T HE psychological care of patients, in many respects, is the no-man's land of surgery. Everyone has a claim on it, but no one really owns it. In other areas, responsibility is well defined. Here it is not. Surgical management is clearly the surgeon's job, anesthesia belongs to the anesthesiologist, and the nurse has certain prescribed duties. But psychological care is widely divided so that everyone who comes in contact with the patient has a hand in it. Not only the surgeon, the anesthesiologist, and the nurse, but also social workers, ward aides, clergymen, relatives, and even other patients all have a variable but definite impact upon the patient's mental life. Because of the many sources of psychological influence, one thing is certain: the patient will have a lot of mixed-up ideas. He will be mixed up about his illness, his anatomy, his surgery, his anesthesia, and many other things besides. Although many people are involved in the patient's mental welfare, the main responsibility for it falls to the surgeon and the nurse, and ideally they will work together in deciding