Surgical consents are interesting.

One of the phrases in the surgical consent says that if the surgeon sees something weird, they are allowed to biopsy it. Also, if you are knocked out with anesthesia, that if the surgeon finds something really different from what they expected, they are allowed to deal with it.

Wait, what? Why?

Well. Here are two examples.

When I am stuck on bedrest 24 weeks pregnant, my mother calls. "What are the symptoms of appendicitis?" she says.

"GO TO THE ER, MOM. DON'T MESS AROUND." My mom is tough. Good at ignoring pain.

So she goes to the ER. This is in 1997, so our small rural hospital doesn't have a CT scanner.

They don't think it is appendicitis. They send her home.

She goes back a couple of days later. The surgeon says, yeah, well, let's take that bugger out. It's probably ok, but hell.

So she goes to the OR. Time passes slowly.

Grundoon and I panic at the same moment. We call each other and both get a busy signal. She is at our parents. I am in Colorado. She calls again. "WHAT IS TAKING SO LONG?!!?" she says, "IT'S BEEN THREE HOURS."

Fungk. "Um. Maybe it's a perfortated diverticulum, not her appendix." But we both know... could be cancer. Fuck.

Then she calls me again, in another hour. "It's cancer. They don't know what. Ovarian or colon. It's really bad. All over. The surgeon is apologizing because he didn't have a PATCH for her DIAPHRAGM. IT'S ON HER DIAPHRAGM!!"

"FUCK." We are all freaking out, of course. My mom is in the ICU, drugged to the gills. And I am on bedrest, I can't go see her. Fuck, fuck, fuckity, fuck. The surgeon says advanced as it is, better ovarian than colon cancer. Neither is good.

See gundoon's Mother's Day for more of that story.

A second example. A fellow female resident at OHSU. Her husband goes in for an inguinal hernia repair. Routine, right? Except the surgeon sees some funny looking tissue. Looks weird, I'd better biopsy that.

The pathology comes back urachal cancer. You are thinking, what the hell is the urachus and you would be right. It is a channel between the bladder and umbilicus that is supposed to have disappeared by the time you were a 12 week fetus. No kidding: But sometimes it doesn't disappear and then very very rarely it can form cancer: He was the ninth case known in the world. That is fucked up, right? Go in for your hernia, come out with a super rare cancer that they don't bloody well know how to treat.

Anyhow, that's why that phrase is in the surgical consent.


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