I've written before about how patients say the darndest things. But have you ever given much thought to how ludicrous the demands of perioperative care must seem to a patient? On top of all the built-in discomforts and disorientations of the surgical experience, we also ask patients to do the impossible and put up with the intolerable.

• "Block and move." Anesthesia has come a long way in the past couple of decades. We block targeted areas, limbs and systems with precision. It's amazing to see surgery done with just a little sedative and narcotic. Sometimes we're so amazed, we forget what's been blocked and expect the patient to immediately cooperate in moving from one surface to another. It must be pretty difficult when you still can't feel part of your body.
• NPO. The day of your scheduled surgery is off-putting enough. Plus, your mouth is as dry as sand. Sand with a cough. I don't know anyone who starts the day without at least a glass of water, a mug of coffee or some other liquid refreshment. As nurses, we've got to educate patients on why NPO is necessary. But also, have pity. I'll admit, it's irritating when they keep asking if they can have something to drink. I've wanted to reply, "If you do, you'll die!" But I don't. I just smile and keep asking them the same questions 3 other staff members have just asked.
• Our attitude toward obesity. Obesity is a real problem. Taking care of a patient with a body mass index between 18 and 25 now seems like the exception instead of the norm. Just because we have to move them (and see them without their clothes), who are we to judge? Not too long ago I was standing over a large patient getting an arthroscopy. I was thinking, "Well, no wonder your knee hurts. Lose some weight and it might feel better!" Then my knee brace made the scratchy sound of Velcro coming loose and my face went red. Who's the pot calling the kettle black now, Porky?
• Starting an IV. It's frustrating trying to start an IV when patients have no veins — I always joke, "Did you leave your veins at home? Did they decide to sleep in?" — but remember that the older, colder patients on the sharp end of the needle don't have what they used to. This is something that anyone with an acute memory and a cute body will eventually have to come to grips with themselves. I admire veins on people I see at the grocery store. "Wow, look," I think. "And that's without a tourniquet!" I want to reach out and press them with my index finger. OK, so a lot of younger men have great veins. But I am simply admiring youth.
• Q & A. We are constantly asking patients questions while they are going to sleep. Or when we've given them something "to help them relax." Or when we're taking an oral temperature. Or when anesthesia has placed a mask on their face and directed them to take some big, deep breaths. (What's that you said? I couldn't hear you, your voice is muffled.) This interrogation doesn't really play fair. It's like asking for a urine sample when they haven't been allowed anything to drink for 8 hours.

While surgery is routine stuff for us, it's anything but routine for the patients and families going through it. It shouldn't take a role reversal to wake us up to the fact that quality care isn't just about efficiency, but keep in mind that it could be us lying on a stretcher, thirsty, with no veins, feeling fat in a not-so-flattering backless gown. Cut your patients some slack.