The Scene, The pre-operative anaesthesia assessment visit. The Patient. A man in his 50s, for intermediate orthopaedic surgery.  He is obese (BMI 36), has hypertension and epilepsy controlled on drugs, smokes 10-15/day (allegedly)  and has bad teeth.   He also has a partner/wife with him who interjects all the time. The Scenario. I tell the man how I intend to anaesthetise him (GA, TCI, LA for post op, analgesia).   I also say that I will do my best to avoid damage to his teeth, in the course of maintaining his airway. The wife cuts in, "Then we'll sue you!" I glare. "Ha-ha! Only joking!  We're a bit nervous" I say that I am not joking, I take my job very seriously, and that I hope that they will too.  I give a short lecture on the risks of anaesthesia with special reference to the airway.   I conclude my visit, having obtained the man's verbal consent (all that we do in the UK). He arrives in theatre, calm, and his anaesthetic and operation go smoothly. But In theatre and later on the ward, the staff all ask me, "What DID you say to that woman?!?"    Apparently, she stormed out just after I had gone, very clearly very angry. Reflection. She had already irritated me by her constant prodding and correcting of her husbands replies to my questions.    I have been threatened before with being sued for tooth damage.  Then and now, I warn the patient and document it, but no one likes being sued. She may have been worried, for her husband, and I should have made allowance. The patient was not straightforward, and I wasn't expecting to enjoy his case. so another reason for being snappy. But was I unprofessional?  Should I have ignored her remark as being irrelevant to the patient's care? John
Posted by John D