When Care Has No Place In The System

Between Efficiency and Humanity: When Care Gets Lost in the Healthcare System

This is a personal story about a recent hospital stay.

Some time ago I was lying on an operating table, unable to move, my finger prepared for surgery. Medically speaking, it was not a major procedure. A partial, local anesthesia. Everything routine, everything safe, I was told beforehand. And yet my nervous system was in a state of profound vulnerability.

When a person cannot get up, can’t move away, and additionally can’t fully feel their body - moreover has to surrender control - the nervous system enters a state in which it becomes especially receptive to safety as well as to threat. In moments like these, it is not only medical competence that shapes our experience, but also the quality of regulation present in the room.

What I longed for in that moment was simple, human co-regulation. That someone (perhaps the anesthesiologist who checked on me repeatedly) would - for instance - place a hand on my shoulder. A brief, calm contact. A signal to my nervous system: You are not alone. Someone is here. You are safe.

Instead, I was offered media glasses so I could watch a film during the procedure. One can see it as a well-intended distraction. I tried it, but it did not feel regulating to me at all. The glasses intensified my sense of being trapped. My field of vision was restricted, my body already immobilized. What was meant to soothe created more constriction than safety.

In that moment, I realized that I needed to speak up clearly about what my nervous system needed. I asked the anesthesiologist to sit beside me, to stay near me. I told him that in films you often see medical staff placing a hand on a patient’s shoulder as a gesture of presence and reassurance. At the same time, I sensed that in real medical settings this might not be as common as one would think. In hindsight, I am quite shocked about the extra stress I had to undergo.

I became very explicit. My nervous system was already overwhelmed, and I began to cry because I felt so exposed and vulnerable. I explained that I needed this kind of contact in order to feel safe. Eventually, he did place his hand on my shoulder. Perhaps it felt unfamiliar or slightly uncomfortable for him at first. But for me, it made a big difference.

The moment his hand rested on my shoulder, something shifted. We began to talk more naturally, and I felt genuinely seen. My body was able to settle. The surgery, which lasted two and a half hours, became much easier to endure. Not because the procedure itself changed, but because my nervous system was no longer alone.

This experience reminded me once again how essential education and nervous-system-informed understanding would be in medical contexts. Knowing what will happen, how the body might feel, what sounds may occur, how long certain steps will take — all of this supports regulation. It provides orientation. And orientation is safety for the nervous system.

Yet within the medical world, regulation still seems not to have fully taken root. Functioning, efficiency, and technical precision remain at the forefront. The subtle interpersonal elements — eye contact, a calm voice, physical presence, genuine care — are rarely understood as essential parts of treatment. Having worked in hospitals myself, I even sense a decrease of empathy and simple human kindness now compared to some years ago. And yet, for many people, especially highly sensitive or traumatized nervous systems, they are crucial.

Co-regulation is not an “extra.” It is a biological necessity. Especially in moments when we are vulnerable, a regulated person at our side can make the difference between an experience the body stores as threat and one that can be integrated.

For me, this is a reminder of how important it is to speak about nervous systems beyond therapeutic spaces. In hospitals. In medical education. Everywhere people find themselves in vulnerable states.

Because healing does not happen through procedures alone. It also happens through relationship, through safety, and through the quiet knowing in the body: I am being held.