My week seems to have been characterised by this – patients going for major surgery. One man had to go urgently for a laparotomy for an intra-abdominal mass, a carcinoid tumour. I was fortunate enough to be able to be there for the surgery, and say hello beforehand. There was no doubt that he was very pleased to see me there. However, when I asked him how he felt, he said “terrified”; I realised I had not done my job, or served his needs. It would have been so easy to find a few minutes beforehand and help him through the terror into a place of peace. After all, this is what I go on about – this is what I have trained myself for. A missed opportunity indeed. Who knows what hormones, amines were pouring around his system that may have interfered with his anaesthetic, with his recovery, with post-operative pain and its control? I’m sure there are studies on this somewhere.
This is an excerpt from Wikepedia, on serotonin: Serotonin is a neurotransmitter, and in the gut mediates gut movements … and the animal’s perception of resource availability. In advanced animals resources can also mean social dominance. In response to the perceived abundance or scarcity of resources the animal’s growth, reproduction or mood may be elevated or lowered. Studies have demonstrated that serotonin has strong associations with depression in regards to a negative environment. How much food an animal gets not only depends on the abundance of food, but also on the animal’s ability to compete with others. This is especially true for social animals, where the stronger individuals might steal food from the weaker. Thus, serotonin is not only involved in the perception of food availability, but also of social rank. Serotonin inhibits the fleeing reaction in subordinates, but enhances it in socially dominant or isolated individuals.
Food for thought here – to look at his perception of himself in terms of being able to provide, to compete, to dominate. Why would his body have the need to pour out this extra serotonin?
