Table 4.

Patient and Family Descriptions of Troublesome Preoperative Interactions

	Illustrative Quotes
Patients and family members described preoperative interactions that led to mistrust of the surgeon	Family Member: “And, we’re setting you up, we’ll have lab, and you’ll be doing your first chemo the end of this week”. It was just, and she was out of the room gone. My daughter looks at me and, so then when we went in for the actual chemo I said to the nurse, I said, “may I have a copy of the PET scan please?” And that’s when I found out all of the other places it [the cancer] is. So, a doctor has not even explained that to us. I was not real happy.
	Patient: I felt, he was telling me, “forget about the tissue valve, it’s gonna be mechanical and to back up what I’m saying Dr. [XXX] is gonna come in and tell you the same thing. He was implying it would be foolish to not get the mechanical valve... He [clinician] was basically telling me I didn’t know what I was talking about because I wanted a tissue valve. I think he was trying to help us make a good decision, but it didn’t come across that way.
	Family Member: And, there, and again, there was NO preparation for what was gonna go through with this [post-op] chemo and radiation either. Don’t gloss over it. And again, you know hindsight, at the time I was furious, how can you just schedule this thing you don’t know, what’s the, what’s in him and that was my biggest thing why put somebody through it? If it was in his liver if it was in his lungs, let him have some quality of life not quantity.