Pelvic exam during general anesthesia ??

[Elisabeth Kate]

There are preclinical students arguing on both sides, folks.

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[Geekchick921]

Jesus, this thread exploded.

Pregnantat51, I'm sorry about what happened to you. It's appalling. However, I agree with what others said that your experience isn't what's being argued for/against in the rest of the thread, by and large. No one is defending that.

As far as exams under anesthesia go, I did them, but only on my Ob/Gyn rotation when I was on Gyn and Gyn-Onc and only when there was an abnormal finding to be appreciated (cystocele, retroverted uterus, adnexal mass, huge fibroids, etc.). I always introduced myself to the patient first in pre-op. "Hi, Ms SoandSo? My name's Geekchick921... I'm one of the medical students working with Dr. Whatshername. I just wanted to introduce myself. I'm going to be helping Dr. Whatshername in the OR with your procedure today and helping take care of your afterwards." Then I'd usually make a little bit of small talk. Most people didn't ask me more specifically what I'd be helping with (and I wasn't sure what I'd be asked to do anyway) and were okay with that introduction.

Unfortunately, I never got to do a cervical check on L&D. If someone was still intact and already had an epi I would have attempted it if they were okay with it but otherwise it was painful because they were still unmedicated or they were ruptured and another hand didn't need to be up there and possibly introduce infection. I did, however, get to deliver about half a dozen babies and stay in the room for several more births. I introduced myself similarly to how I described above and if they asked me if I was going to be in the room I said I'd like to be, if it was okay with them, and how much I did was up to them and their doctor. Nearly every one was receptive to that. Birth experiences are a soapbox issue for me (thanks to the births of my own children) so I often stayed in the room with the mom while they pushed and offered more support, sometimes for hours, as long as I wasn't needed elsewhere. I had a few new moms take my hand at the end and thank me, that it meant so much to them that I was there, etc. (usually while I stayed with them as they sent dad to take pictures of the baby in the warmer). I think there was only one person that didn't want a student in the room and she was very crunchy, wanted as few interventions as possible, etc. I probably would have been one of the most supportive people for that experience there if she had let me in the room. *Shrug*

 

[fab4fan]

The sexualization of the pelvic exam by medical students here astonishes me. I feel like I'm in Pre Allo.

I keep getting the mental image of the pt. sedated and in stirrups, and a conga line of med students, interns, residents, and the attending doing a pelvic on the patient.

 

[DermViser]

I keep getting the mental image of the pt. sedated and in stirrups, and a conga line of med students, interns, residents, and the attending doing a pelvic on the patient.

I think this is rarely the case to have that many do a pelvic right before a surgery. Usually it's one med student, one intern/resident, and one attending. Even then, all of them may not do it (i.e. an attending who has done this surgery a bazillion times).

 

[fab4fan]

I think this is rarely the case to have that many do a pelvic right before a surgery. Usually it's one med student, one intern/resident, and one attending. Even then, all of them may not do it (i.e. an attending who has done this surgery a bazillion times).

I was joking.

 

[DermViser]

I was joking.

Sorry! I should know you know better. The other SDNers on the other hand make me wonder...

 

[Anastomoses]

You realize that providing incentives is extremely unethical because then we would only practice on poor people, right? That's like bioethics 101.

I don't exactly understand how it's unethical given medical research offers loads of money to participants for "risky" medications and trials. The suggestion is that those needing free/hugely discounted medical care should offer the small benefit of helping students learn...hospitals aren't charities. At any rate, I leave it up to the masses whether they find this unethical or not. This particular issue doesn't interest me enough. Just brainstorming on how to solve the lack of hands-on experience students would ideally get.

You don't understand communism.

I have a pretty sharp grasp of communism. At its very heart and soul is the philosophy that benefit for the community trumps benefit of the individual. But this is not the place to educate you about communism.

 

[Anastomoses]

Actually, it's more like half of DO students pursue an ACGME residency and not all of them take the USMLE.



You forget that some allopathic schools don't send all their students the same hospital either. In fact, some send their students to "community hospitals" as well and sometimes, those allo students work side-by-side with DO students in 3rd and 4th year.



It's not the case at the majority (if not all) of osteopathic medical schools. In the interest of not derailing this thread any further, PM me or start a new thread if you want to discuss this further. I just couldn't let your erroneous statements stand without a rebuttal.

Resist. He will take you on a rollercoaster ride if you let him.

He threw in something about DO schools and added some outrageous extrapolations - begging the question. And then more extrapolations as to how those of us arguing for patient rights > clinical learning means we think things are icky and wish to do the minimum on rotations. And I can't keep up with his disconnected premises and conclusions. Anyone else, you can at least follow how and why they disagree with you.

@NickNaylor - I'm not premed.

 

[IlDestriero]

I will give a personal example as to how this is relevant.

I have absolutely zero interest in doing OB/GYN. Nothing would make me happier than never examining a vagina again in my life. As a future psychiatrist, I clearly fall in the "90% of students who have no interest in OB/GYN.

And yet, I will be doing a minimum of 3 months of general medicine during my intern year. I imagine I will be doing at least one pelvic exam on a real live patient during that time, if not more. How am I serving the patient well if I have never had the opportunity to practice these skills? What happens when it's ultimately me that's responsible (to an arguable degree) for making sure the patient is receiving adequate care? I'll be sure to tell the OB/GYN resident I consult, "sorry guys, this patient is complaining of abdominal pain and has a history of ovarian pathology but unfortunately my medical school failed to give me the skills necessary to do a proper pelvic exam. Can you please come examine this patient for me?"

I don't think anyone fails to recognize patient rights on this issue. But at the same time, I'm going to be a goddamn doctor and I need to competent in these exams if only to perform my duties as an intern. My school has an obligation to give me a basic level of training to adequately perform in that role. It's not because I'm a medical student and I deserve it. It's because there will soon be a time when the buck stops with me and I will be expected to do these things.

With the exception of Elizabeth, I think it's interesting that those arguing the opposite point in an exceptionally vocal way are still preclinical students if I remember correctly. I probably would've thought the same way. But at some point a few months ago, I had an epiphany and realized, "holy ****, someone is going to entrust me fully with their medical care, and doing a substandard job could negatively affect them... forever." Perhaps once you have this realization your opinion will change, or maybe not, I dunno. But it's something worth considering that, as Derm said, I don't think some of you are really "getting." Or in reading your posts it doesn't come across that way.


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You get it Nick, the others... not so much.
If you are at a teaching hospital, having a gyn procedure, and exam under anesthesia is on the consent, WTF do you think is getting examined?
And the people examining you are the people directly involved in your care. People aren't lining up do do exams on anesthetized people. The anesthesiologist isn't going to glove up. I might palpate neck masses, etc. as they may have a significant impact on my management, now and with future patients. One never stops learning.
BTW, the idea of giving free care to patients who allow trainees to participate in their care is laughable. Patients come from all over the globe to my specialty hospital because we are innovators. We regularly do uncommon procedures and provide services that few other hospitals provide. That breadth and depth of experience is significant and absolutely affects outcomes. You aren't getting that for nothing.

 

[maxxor]

@NickNaylor - I'm not premed.

But you are preclinical.

 

[Elisabeth Kate]

But you are preclinical.

So are several others on this thread.

 

[DermViser]

Resist. He will take you on a rollercoaster ride if you let him.

He threw in something about DO schools and added some outrageous extrapolations - begging the question. And then more extrapolations as to how those of us arguing for patient rights > clinical learning means we think things are icky and wish to do the minimum on rotations. And I can't keep up with his disconnected premises and conclusions. Anyone else, you can at least follow how and why they disagree with you.

@NickNaylor - I'm not premed.

@NickNaylor said preclinical, not premed. And they're extrapolations only for your cerebral cortex.

 

[maxxor]

So are several others on this thread.

That's entirely the point. People are speaking as if they have experience as the med student doing these exams.

People are largely getting fired up about things they don't have any firsthand experience with. It's all what they think the OR or clinical rotations are like.

 

[Elisabeth Kate]

That's entirely the point. People are speaking as if they have experience as the med student doing these exams.

People are largely getting fired up about things they don't have any firsthand experience with. It's all what they think the OR or clinical rotations are like.

This is true. I added that several others are pre-clinical as well as only the ones on one of the issue were singled out when, in fact, there are pre-clinical posters on both sides of the issue.

 

[Armadillos]

This thread is a train wreck and I feel like many people are projecting negative experiences involving sexuality onto the practice of medicine which is a bit strange.

(And this is coming from someone who is perfectly happy with patients electing for me not to be part of their treatment team, thats their choice and I'm very willing to respect it. But the majority of my patients seem to enjoy having me and other medstudents around so its been super rare that its an issue)

 

[Anastomoses]

And they're extrapolations only for your cerebral cortex.

I assure you that even to your cohorts, you're discombobulated.

This thread is a train wreck and I feel like many people are projecting negative experiences involving sexuality onto the practice of medicine which is a bit strange.

(And this is coming from someone who is perfectly happy with patients electing for me not to be part of their treatment team, thats their choice and I'm very willing to respect it. But the majority of my patients seem to enjoy having me and other medstudents around so its been super rare that its an issue)

That's exactly the point. Most will be fine with it; those who are not should be respected. Fail to see how this relates singularly to sexuality. Would it still be sexuality if we were talking about a rectal?

 

[Armadillos]

Im a bit confused by the question, but I do have to say rectal exams are like the most over hyped thing ever by medstudents. They take like 2 seconds and when a patient is lying in a hospital bed wearing a gown its really not a particularly compromising undertaking.

 

[WillburCobb]

...this thread and it's "private parts"...

 

[Barcu]

As a medical student, you do need to introduce yourself to the patient and tell them that you will be involved in their care. They are certainly allowed to make any objections at that point (for example, they can say, "I don't mind you being there but I would prefer if you didn't do a pelvic exam"). If the patient raises no objections, I do not think you need to sit there and list every potentially sensitive thing you might do in the OR and ask if it's ok. The patient signs a consent agreeing that the physician or his treatment team (which includes the medical student) can perform indicated interventions. If that includes a pelvic exam under anesthesia, then a medical student should be able to perform it, even if they did not get explicit permission from the patient beforehand.

 

[DarkHorizon]

During my OB rotation as a med student, I did many, many pelvic exams. Including some on women that appeared uncomfortable but allowed me anyway, mostly becuse this was at a large teaching hospital and most patients didn't speak English, so they couldn't verbalize if properly.

The most interesting experience was a pelvic exam under anesthesia on a 29 y/o Caucasian female who was having an ex laparoscopy for vague pelvic pain symptoms. I had rounded on her previously many times and in fact had done a pelvic exam on her when I admitted her. However, my attending wanted me to do one under anesthesia and had me put on gloves and told me to start and left the room while I stood with my fingers in her vagina. As soon as he left, two young female nurses who were circulators raised hell and practically yelled at me for doing the pelvic exam under anesthesia. They practically walked up and pushed me aside and covered up the patient while yelling at me. Their rationale was that they would never allow a young male to do a pelvic exam, and this woman wouldn't either if she was awake. I kind of felt real awkward and didn't want to insist because I thought that would be creepy so I stepped aside.

I never told my attending about it but I felt those nurses were out of their place to stop me, now that I'm a resident, I would place them in their place. Of course no reason to do pelvic exams in my specialty so I won't ever have to do that again.

 

[Anastomoses]

During my OB rotation as a med student, I did many, many pelvic exams. Including some on women that appeared uncomfortable but allowed me anyway, mostly becuse this was at a large teaching hospital and most patients didn't speak English, so they couldn't verbalize if properly.

The most interesting experience was a pelvic exam under anesthesia on a 29 y/o Caucasian female who was having an ex laparoscopy for vague pelvic pain symptoms. I had rounded on her previously many times and in fact had done a pelvic exam on her when I admitted her. However, my attending wanted me to do one under anesthesia and had me put on gloves and told me to start and left the room while I stood with my fingers in her vagina. As soon as he left, two young female nurses who were circulators raised hell and practically yelled at me for doing the pelvic exam under anesthesia. They practically walked up and pushed me aside and covered up the patient while yelling at me. Their rationale was that they would never allow a young male to do a pelvic exam, and this woman wouldn't either if she was awake. I kind of felt real awkward and didn't want to insist because I thought that would be creepy so I stepped aside.

I never told my attending about it but I felt those nurses were out of their place to stop me, now that I'm a resident, I would place them in their place. Of course no reason to do pelvic exams in my specialty so I won't ever have to do that again.

What you're describing is a confusing situation. I would have totally made it clear that the attending told me to do the pelvic exam and they should behave. This, of course, has nothing to do with whether you should have been able to do one on the patient or not - but if you'd already done one on that same patient when she was conscious, it seems less likely she'd have objected. Weird weird weird.

But it also bunks @maxxor 's claim that once you're actually in clinic, all of the sudden your ideas change about whether clear consent is required or not.

 

[maxxor]

What you're describing is a confusing situation. I would have totally made it clear that the attending told me to do the pelvic exam and they should behave. This, of course, has nothing to do with whether you should have been able to do one on the patient or not - but if you'd already done one on that same patient when she was conscious, it seems less likely she'd have objected. Weird weird weird.

But it also bunks @maxxor 's claim that once you're actually in clinic, all of the sudden your ideas change about whether clear consent is required or not.

Paragraph 2 does not follow from paragraph 1, lady of the logical fallacies.

Secondly, you have misread my comments. I emphasize that this thread is full of people who keep commenting on situations they have not personally experience. For example, you also have not experienced OR circulator nurses first hand. As a male in a GYN OR, having two circulators jump on your back for doing something they don't like can directly affect your rotation grade, especially around something as sensitive as a pelvic exam. Your role as a medical student when criticized or told to do something is to say thank you, NOT defend yourself.

 

[Elisabeth Kate]

During my OB rotation as a med student, I did many, many pelvic exams. Including some on women that appeared uncomfortable but allowed me anyway, mostly becuse this was at a large teaching hospital and most patients didn't speak English, so they couldn't verbalize if properly

That says it all, doesn't it?

 

[Siggy]

I think there's another issue that comes up with this, vis-a-vis consent. That's attitude. Are you, the medical student, a part of the patient's medical team, or someone shadowing. If you get told to do a basic H&P on the patient in ED 7, do you sit there and say, "Good afternoon, my name is Siggy, I'm the ___ year medical student on your team, how can we help you out today?" [introduction, elicit chief complaint], or do you say "Good afternoon, my name is Siggy, I'm the ___ year medical student on your team, do you mind if I do an exam?"

One says that your supposed to be there and a member of the team. The other says that it's something extra. Similarly, when I went to do procedures during medical school (suturing, pelvics, etc), once I was comfortable with that procedure, once I cleared my plan with my resident or attending, I went and did it. If the patient objected (rarely happened), the first thing I did was attempt to alleviate their concern (Yep... I'm a medical student, but your skin avulsion on your knuckle is an easy suture, I've sutured much worse, and I'm going to be a doctor in 4 weeks...), and if I couldn't then I would get the attending.

When it came to deliveries and surgeries, same thing.

If you act like you aren't supposed to be there, or being there is extra and unnecessary, then I think the patient has a right to feel uncomfortable (especially for anything related to the genitalia). If the vibe you give off is that you're supposed to be there, like the 5-6 other people in the room, then I don't see very often that there will be an objection.

 

[Anastomoses]

Paragraph 2 does not follow from paragraph 1, lady of the logical fallacies.

Secondly, you have misread my comments. I emphasize that this thread is full of people who keep commenting on situations they have not personally experience. For example, you also have not experienced OR circulator nurses first hand. As a male in a GYN OR, having two circulators jump on your back for doing something they don't like can directly affect your rotation grade, especially around something as sensitive as a pelvic exam. Your role as a medical student when criticized or told to do something is to say thank you, NOT defend yourself.

Yes. You have not been a patient with your anus or urethra probed, I imagine? I have certainly been in clinic touching patients, inserting foleys but not an official rotation.

I'm not sure exactly where the logical fallacy is. You implied that this lack of experience of being the medical student makes one unequipped to speak...from the patient's perspective? To speak on what exactly? Sorry, even when I'm the one dying to put my hand in a vagina to feel a pathology, it won't change what human entitlement should be. I get annoyed by some of the silly presumptions that you have to endure an experience to "know what it's like". Um...no. The nurses in the aforementioned story are presented with such patients every day and probably do foleys. They disagree that it's okay for a student to do a pelvic exam under anesthesia w/o consent, if we are to take his story to be true. @Elisabeth Kate has rotated and shares this view. You can't shut down patient rights discussions with patients, lawyers, or pre-clinical students by telling them they haven't clinically rotated. Sorry. Try again.

 

[Laryngophed]

I think the difference is that many of us believe this falls under the general "students and residents will be involved in your care" part of the consent, while some seem to think they need a specific heads up on pelvic exams for some reason. If you've spent any amount of time in an operating room, I think you'd realize why we think this is unnecessary. There are a hundred things that are done during a surgery that don't require your specific consent (some of them much more "humiliating" than a pelvic exam...there's not really much left to be shy about during a gyn/rectal/prostate surgery, let me put it that way). Having an extra person do an indicated pelvic exam before the start of a procedure which is going to address the very thing we are examining is a very benign thing in the grand scheme of the surgery. If you want the surgeon to put that in/discuss that separately, they might as well let you know that they'll be using 4-0 vicryl to close your skin incision, as that'll have much more of an effect on you than a pre-op pelvic exam.

That's a lie. Everyone knows you use 5-0 monocryl and make these students hand tie.

 

[JoBreeze]

Wait, covenant with the public? I have never heard of this and did not enter into such an agreement. It is absolutely disrespect to me and my body to practice any procedure on me without clear consent. That models are needed does not mean that patients should lose the right to refuse participating as a model.

At a Planned Parenthood office, a student nurse came into the exam room with the NP to observe my exam. I refused. The appointment is unpleasant enough without a stranger there looking at my body as if it were an anatomy book. How invasive. She couldn't even bother to ask, but simply showed up planning to breach my privacy for her benefit. It is for her benefit. She is the one who wished to become a nurse.

There seems to be a disconnect here that because medical students need to learn, patients have an obligation to cast aside modesty and autonomy and allow themselves to be used.

Ma'am, we live in a world that has disease, and this world needs to be guarded by people with expertise in physical examination. Who's going to do it? You? You, DrCharlemagne?! You, pdxhopeful!?!

I have neither the time nor the inclination to explain myself to woman who rises and sleeps under the blanket of the very care that I provide, and then questions the manner in which I learned to provide it. I would rather you'd just said thank you and went on your way; otherwise I suggest you pick up a pair of gloves and detect your own tumor.

I don't give a damn what you think you are entitled to.

 

[Kiwi713]

I guess I just don’t understand why you would choose to go into a profession so you can help people, and then do something that SO many women find not only invasive and humiliating, but abusive and traumatizing. Why take the chance of destroying your relationship with them when you can just ask and explain to them exactly what will happen? To act like you don’t know a women would be more upset about students lining up to insert fingers in their vagina while they are anesthetized than if you were just taking a look in, oh, say…her ears.. is ridiculous. It’s not the same. Studies show that a large amount of women give consent when asked, and it’s about respect. You can argue that there is nothing wrong with it, that by agreeing to have surgery there IS consent, but if you truly wanted to help people, you should be honest.


I was 16 when I had an appendectomy –It was an emergency and my parents signed all the paperwork in a hurry. I was diagnosed with a ruptured appendix prior to surgery, obviously, and without the need for a pelvic exam. I now know after the experience that I acquire much more anesthesia than the average 100 lb girl. I woke up, in stirrups, AT SIXTEEN to a bunch of 20 something year old male med students probing my vagina. I panicked – it felt, I imagine, akin to gang rape. I did NOT know that was going to happen. It was humiliating and I was told I “would not remember a thing” and knocked back out as I squirmed to try and get away from them. It WAS traumatizing to me and I cannot BELIEVE that anyone in the med school would brush this off because it’s “for patient’s well being”- What good is helping someone physically if you destroy them emotionally? ALL YOU HAVE TO DO IS ASK! You have NO right to feel entitled to practice on someone without their consent.

 

[PL198]

yes gang rape, that's a really good comparison

 

[Kiwi713]

yes gang rape, that's a really good comparison

yes. when you wake up up a bunch of strangers probing you, unaware that was going to happen, as a 16 year girl you feel VERY violated

I realize as a med student, you don't see it as a sexual thing - but when you're a girl that young who's never been touched intimately by anyone?? - it's hard to see men just a few years older than you probing you as anything other than an invasion of privacy....

 

[Kiwi713]

and just to be clear, I am not saying it IS gang rape, I am saying that to a 16 year old the shame and embarrassment you feel is similar to what I imagine victims of sexual assault and rape feel like. I trusted those people.

 

[22031 Alum]

and just to be clear, I am not saying it IS gang rape, I am saying that to a 16 year old the shame and embarrassment you feel is similar to what I imagine victims of sexual assault and rape feel like. I trusted those people.

It's far less likely that it was some surgical pervert den, and more likely that it was a necessary procedure that was inadequately explained. An intern and PGY2 helping a student figure out how to put a Foley in is "a bunch of male 20 something's probing the vagina," but clearly, that's not malevolent. And I wouldn't expect a 16 year old girl who is in pain, scared, and already got anesthesia meds to realize that. Nor do I think it makes it any less traumatizing. I hope you and your family spoke with a hospital representative about that experience.

 

[Kiwi713]

It's far less likely that it was some surgical pervert den, and more likely that it was a necessary procedure that was inadequately explained. An intern and PGY2 helping a student figure out how to put a Foley in is "a bunch of male 20 something's probing the vagina," but clearly, that's not malevolent. And I wouldn't expect a 16 year old girl who is in pain, scared, and already got anesthesia meds to realize that. Nor do I think it makes it any less traumatizing. I hope you and your family spoke with a hospital representative about that experience.

Thank you for understanding. I was in no way trying to say that the intentions of the procedure were not needed, or were malicious. I was only saying that it is not okay to not explain that this was going to happen, and the shock and embarrassment of WAKING UP to that has no doubt had an effect on me...Unfortunately, I was too embarrassed to ever tell my parents, or anyone really.

 

[Psai]

I guess I just don’t understand why you would choose to go into a profession so you can help people, and then do something that SO many women find not only invasive and humiliating, but abusive and traumatizing. Why take the chance of destroying your relationship with them when you can just ask and explain to them exactly what will happen? To act like you don’t know a women would be more upset about students lining up to insert fingers in their vagina while they are anesthetized than if you were just taking a look in, oh, say…her ears.. is ridiculous. It’s not the same. Studies show that a large amount of women give consent when asked, and it’s about respect. You can argue that there is nothing wrong with it, that by agreeing to have surgery there IS consent, but if you truly wanted to help people, you should be honest.


I was 16 when I had an appendectomy –It was an emergency and my parents signed all the paperwork in a hurry. I was diagnosed with a ruptured appendix prior to surgery, obviously, and without the need for a pelvic exam. I now know after the experience that I acquire much more anesthesia than the average 100 lb girl. I woke up, in stirrups, AT SIXTEEN to a bunch of 20 something year old male med students probing my vagina. I panicked – it felt, I imagine, akin to gang rape. I did NOT know that was going to happen. It was humiliating and I was told I “would not remember a thing” and knocked back out as I squirmed to try and get away from them. It WAS traumatizing to me and I cannot BELIEVE that anyone in the med school would brush this off because it’s “for patient’s well being”- What good is helping someone physically if you destroy them emotionally? ALL YOU HAVE TO DO IS ASK! You have NO right to feel entitled to practice on someone without their consent.

this post is such bull****. since when do you have a bunch of medical students in the or? we never have more than one, two max. we also don't go probing around in the vagina on the general surgery rotation except when the patient needs a foley. why would they have an or bed that is set up for stirrups in a general surgery case? also, no one's going to be probing the vagina when you're about to wake up from anesthesia. generally, people who are waking up are more concerned about the tube in their throat than anything else. troll 1/10

 

[PL198]

Thank you for understanding. I was in no way trying to say that the intentions of the procedure were not needed, or were malicious. I was only saying that it is not okay to not explain that this was going to happen, and the shock and embarrassment of WAKING UP to that has no doubt had an effect on me...Unfortunately, I was too embarrassed to ever tell my parents, or anyone really.

so you feel passionate enough about it to compare it to rape, but you're too embarrassed to prevent others from a similar fate. seems logical

 

[oldanddone]

Kiwi713 maybe knowing for yourself a bit more about what happened would help. Often times a hospital has a patient liaison person. You could talk to them about wanting to know more about what happened who was involved in your care etc. These things should typically be documented in your chart. As well since there is residual upset talking to a counselor would be very useful as well. This forum may not be the best place to get clarity on unanswered questions you may have about what was happening or closure you may want. Good luck and all the best.

 

[Siggy]

so you feel passionate enough about it to compare it to rape, but you're too embarrassed to prevent others from a similar fate. seems logical

Because the first thought that pops into my mind when I see a 16 year old is "logical" or "rational."

 

[Winged Scapula]

None of us were there and don't know what happened of what the above woman *perceived* happened. But I posit the following:

- it was Foley placement/removal she was experiencing (most likely)
- as noted above, it would be very unlikely, even in an academic medical center, to have more than 1-2 medical students per room especially for an appy
- many prefer to do laparoscopic cases with the patient in lithotomy position (ie in stirrups)
-NOTES or transvaginal appendectomy is an option (requires lithotomy)

 

[Psai]

None of us were there and don't know what happened of what the above woman *perceived* happened. But I posit the following:

- it was Foley placement/removal she was experiencing (most likely)
- as noted above, it would be very unlikely, even in an academic medical center, to have more than 1-2 medical students per room especially for an appy
- many prefer to do laparoscopic cases with the patient in lithotomy position (ie in stirrups)
-NOTES or transvaginal appendectomy is an option (requires lithotomy)

Didn't know that thanks. I'll be seeing a lot soon

 

[preDoGuy24]

None of us were there and don't know what happened of what the above woman *perceived* happened. But I posit the following:

- it was Foley placement/removal she was experiencing (most likely)
- as noted above, it would be very unlikely, even in an academic medical center, to have more than 1-2 medical students per room especially for an appy
- many prefer to do laparoscopic cases with the patient in lithotomy position (ie in stirrups)
-NOTES or transvaginal appendectomy is an option (requires lithotomy)

Always appreciate when an attending comes through the forum and drops some knowledge. Appreciate this clarification.


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[22031 Alum]

- many prefer to do laparoscopic cases with the patient in lithotomy position (ie in stirrups)

Of course, for me, laparoscopy=lithotomy, but I didn't want to comment on that for General Surgery. I think whatever happened was just amplified by anesthesia, pain, and not knowing what the heck was going on.

 

[touchpause13]

yes gang rape, that's a really good comparison

Yeah it actually is.

Being penetrated by multiple people without your consent is pretty much the definition of gang rape.

I just think it's ****ty for someone to come forward and say they had an experience like that and be lambasted. Regardless of the intent of those involved, it was clearly traumatic for her, and I hope she has been able to process it.

 

[touchpause13]

so you feel passionate enough about it to compare it to rape, but you're too embarrassed to prevent others from a similar fate. seems logical

It's not like rape victims ever don't tell anyone about what happened to them or anything



Wait a minute....

 

[s5260205]

so you feel passionate enough about it to compare it to rape, but you're too embarrassed to prevent others from a similar fate. seems logical

Not to sidetrack this thread, but in countries like India, sexual assault is grossly under-reported exactly because of this mentality of victims. The social repercussions incurred by reporting sexual assault is sometimes so severe that victims are afraid of reporting them. Not to mention that in some Middle Eastern countries, victims are forced to marry the perpetrator, jailed, or lashed. Now where is the logic in that?

 

[touchpause13]

Not to sidetrack this thread, but in countries like India, sexual assault is grossly under-reported exactly because of this mentality of victims. The social repercussions incurred by reporting sexual assault is sometimes so severe that victims are afraid of reporting them. Not to mention that in some Middle Eastern countries, victims are forced to marry the perpetrator, jailed, or lashed. Now where is the logic in that?

Yup. It's just horrifying. Like the most extreme forms of victim blaming possible *shudder*

Not like it's all sunshine and rainbows for victims here, it's still grossly underreported and stigmatized

 

[bi polar bear]

Thank you all so much.

I have for years been explaining to my wife about the reality of the medical establishment...to no real avail. I have worked in hospitals and been an EMT working as a paramedic. My wife like so many women just generally trusts all doctors and medical facilities, believing they always have her best interest at heart.

This thread, with the narcissistic, arrogant, demeaning attitudes so readily exposed has finally opened her eyes. She has had a few surgeries and now understands why I asked her to formally write out that no under anesthesia exams will be performed unless necessary and only by the doctor she hired.

She gets it and is as disgusted as I am. In fact she said she is done with all asymptomatic visits...I am so very thankful to you all.

 

[Psai]

don't care if you don't trust the medical establishment. just don't ask us to clean up the mess you make

 

[PL198]

Thank you all so much.

I have for years been explaining to my wife about the reality of the medical establishment...to no real avail. I have worked in hospitals and been an EMT working as a paramedic. My wife like so many women just generally trusts all doctors and medical facilities, believing they always have her best interest at heart.

This thread, with the narcissistic, arrogant, demeaning attitudes so readily exposed has finally opened her eyes. She has had a few surgeries and now understands why I asked her to formally write out that no under anesthesia exams will be performed unless necessary and only by the doctor she hired.

She gets it and is as disgusted as I am. In fact she said she is done with all asymptomatic visits...I am so very thankful to you all.

do you really think they'd choose anesthetized patients to perform pointless exams on, when there are countless volunteers to do so? if they're doing an exam on an anesthetized patient, I'm pretty confident someone it would be necessary.

 

[22031 Alum]

Thank you all so much.

I have for years been explaining to my wife about the reality of the medical establishment...to no real avail. I have worked in hospitals and been an EMT working as a paramedic. My wife like so many women just generally trusts all doctors and medical facilities, believing they always have her best interest at heart.

This thread, with the narcissistic, arrogant, demeaning attitudes so readily exposed has finally opened her eyes. She has had a few surgeries and now understands why I asked her to formally write out that no under anesthesia exams will be performed unless necessary and only by the doctor she hired.

She gets it and is as disgusted as I am. In fact she said she is done with all asymptomatic visits...I am so very thankful to you all.

So she's done with wellness checks because of a forum thread? Cool.

 

[VisionaryTics]

This thread, from start to finish, is full of so much cray