Strange she didn't notice

I can't figure this one out... unless everything was done under anaesthetic  and she woke up to the surprise. Seems to me, it's something you'd notice a little earlier. 

Self-Proclaimed Self-Proclaimer

I found this in a fit of shredding. It's from 1967, and why I have it, I don't know. But, I love the idea of SELF-PROCLAIMED atheist. What other kind is there? A Church-Accused atheist? A don't-ask-don't-tell atheist?