I love a good ritual

August 18, 2008

A house officer attempts to persuade a diabetic 83 year old man with a gangrenous toe to sign an informed consent for surgery to remove the offending digit. This old man has spent the last two days talking animatedly to his drip-stand about the weather, Brisbane public transport, and the state of the train carriage they’re both sitting in on their way to work. The house officer makes some initial attempt at an explanation of the surgery and its associated risks (“We need to cut off your toe so that we don’t have to cut your leg off later. You’ll be asleep, so you won’t know anything about it”) and then endeavours to get the man to sign the paper.

“You need to sign it here, Mr Smith… No, here… You need to sign it… Mr Smith ? Mr Smith, can you hear me ?… You need to sign the paper to say you understand what’s going on… Look, here’s a pen… Careful now… No, the paper’s here, Mr Smith – here, that’s right, on the table… No, the table… Can you hold the pen, Mr Smith?… Let’s see if you can hold the pen… That’s it… Can you hold the pen?… You need to hold the pen so you can sign the consent…”

The informed consent. The “I know what reality is, that drip-stand is a drip-stand, I’m in hospital, I have a black toe, I know what you’re planning to do to me and I fully understand all of the associated risks because you have completely explained them to me, and I’m perfectly capable of holding a pen and signing my own name, thank you very much” consent.

The signature was obtained, somehow – either by Mr Smith having a lucky hit with the flailing pen, or by the house officer manoeuvring the relevant space on the paper underneath the quailing nib and then doing a Spectrograph impression – and Mr Smith had his surgery, and lost his toe, and then lost his life a few days later after contracting classic post-surgical old-person-with-only-cinders-of-a-mind-and-no-muscle-tone pneumonia.

I love a good ritual, don’t you ?

One Response to “I love a good ritual”

  1. […] gets ready to honour country’s athletes – Jamaica Observer Saved by laxkid275 on Thu 23-10-2008 I love a good ritual Saved by gecko1999 on Wed 22-10-2008 Safety concerns for back to school Saved by U2Love on Fri […]

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