Article Image

Topsy-Turvy Cataract Surgery — A Stress Test for Guided Imagery Meditation

Op-Med is a collection of original articles contributed by Doximity members.

Over the course of my life, I’ve had four elective surgeries — all conducted under general anesthesia. When informed that I would be awake for cataract surgery, I became alarmed. I envisioned watching with one eye as the other was speared. I told the pre-op nurse that I was anxious. She recommended guided imagery meditation designed to reduce stress before surgery.

I’m a psychiatrist. I believe in the healing powers of meditation. I taught meditation to patients for nearly 50 years. But it never worked for me. Whenever I tried to meditate, I became bored. My mind wandered. I made to-do lists. I conjured up new concerns. On the few occasions I stopped thinking, I fell asleep. 

In desperation, I downloaded the meditation. The background music was beautiful. The woman’s voice was soothing. The imagery was lovely, and the messages felt meaningful. I was hooked. I was advised to play it as often as possible — the more you listen, the stronger the effect. 

No problem. Soon I was up to four times a day. I felt peaceful and relaxed. I’d always assumed that anticipating problems enabled me to solve them before they occurred. Now, instead of waking up with a stack of worries, I reached for my iPhone to play the meditation. I tried other guided imageries on the same website to see if they might have a similar effect. The infertility meditations were especially useful. Though I never had a desire to bear children, the affirmations were generic enough for anyone experiencing distress. “Worries are merely mental events” — what a concept! I’d always believed that worries protected me from danger.

On surgery day, it was still dark as my spouse, Dee (also a physician), drove into the hospital garage and pushed the button for a parking ticket. The machine was broken — no ticket and the gate wouldn’t budge. Cars pulled up behind us. I panicked at the prospect of being trapped. I had a fleeting image of flooring the accelerator and smashing through the gate. Then I remembered to take a deep breath. Destroying the front of our car did not fit with my program. I double masked, stepped out of the car, and walked from car to car to explain that everyone needed to back up to try another entrance. 

When we arrived at the ambulatory surgery building, the door was locked. We knocked on the glass to get the attention of the security guard. He said we were in the wrong place and sent us to the hospital. I showed my paperwork to the person in the information booth. She confirmed the surgical location, pointing out that the facility was so new that many were unfamiliar with it. She contacted the security guard to let us in. By then I was 20 minutes late.

My predicament reminded me that patients may seem overly stressed or show up late due to unforeseen circumstances. Health care professionals only control what happens within the hospital. We may be completely unaware of challenges patients face even on the day of admission. 

During prep, I was seated in a cushy, oversized recliner that doubled as an OR bed. The nurse gave me a folded gown and left while I undressed. The “gown” was irregularly shaped, surrounded by snaps, with no obvious formula to make it fit. I tried various configurations without success. Sheepishly covering my naked torso with the limp fabric, I opened the door to explain that I could not figure out how to assemble it. To my great relief, the nurse was no more successful than I. She draped it over my body and secured several snaps behind my neck to hold it in place. 

Two attendants began wheeling the recliner toward the door. Bam — the chair hit the door jamb. “Pull in your arms so the IV doesn’t catch,” said one. “I hope they measured these chairs,” muttered the other. I offered to walk. Not allowed. They called for assistance. Four aides wrestled with the chair until it squeezed through the door. 

In the OR, the surgeon asked the nurse to push “recline” so I would be lying flat. The control malfunctioned and the back of the chair proceeded to the floor. I grabbed the arms as I began sliding headfirst. I suddenly felt nauseous. The surgeon reached for the control and pressed various buttons until the chair became horizontal. 

I pushed replay on messages I recalled from the meditations. “You are perfectly, utterly safe. These are capable, competent people who will ensure your well-being.”

During the operation, everything seemed to be going well until I felt a sharp pain in my eye. Just as I was about to ask for more fentanyl, it subsided. The surgeon sounded frustrated. “This isn’t working,” he said. (What? What wasn’t working?) “I need you to get the wrench and tighten this screw.” (Wrench for the eye? Screw?) I saw movement near my eye. “Tighten here. Much better. Now it’s working.” (Whew?)  

A short time later, my chair and I were wheeled to the recovery room. Dee took me home, and I rested for the day. The next morning when I removed the eye covering, everything was bright and crisp. I could see leaves on trees and petals on flowers for the first time in decades. 

I asked the surgeon about the wrench and screw, anticipating an amusing coda to this story. He explained that the sterile probe used to pulverize the lens is changed for each patient. When the probe touched the lens, it didn’t work. The screw attaching the probe hadn’t been tightened. He removed the probe, asked for the wrench, got the screw tightened, reinserted the probe, and zapped my lens. (He didn’t say “zapped,” but that’s what I visualized.)   

I still listen to the meditations because their messages prevented all-out panic during the Laurel and Hardy-like prelude to the surgery, not to mention the problem with the screw. They reinforce my gratitude for 72 years of good health and excellent health care. I feel empowered when reminded that my ability to cope with any future challenge is entirely up to me. As far as I can see, I’m as prepared as I can be — for eye number two.

Have you ever experienced a perspective shift when it comes to meditation? Share your experience in the comments below.

Nanette Gartrell, MD is a retired psychiatrist who served on the faculties of Harvard Medical School and the University of California, San Francisco. She conducted groundbreaking research on sexual misconduct by physicians, and she is a leading international scholar on sexual minority parent families.   

Image by GoodStudio / Shutterstock   

All opinions published on Op-Med are the author’s and do not reflect the official position of Doximity or its editors. Op-Med is a safe space for free expression and diverse perspectives. For more information, or to submit your own opinion, please see our submission guidelines or email

More from Op-Med