Ep 40-Who Owns The Body: The One Who Cuts Or The One Who Bleeds?

Episode Transcript
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SPEAKER_00 (00:09):
Hello.
How are you doing?
Doing good in the neighborhood.

SPEAKER_02 (00:14):
How are you?
Good.
Definitely.
Nice to see you.
Yeah.
Glad that glad we have a littleinterweb so we can FaceTime and
see each other's mugs while wetalk.

SPEAKER_01 (00:28):
And your phone must be getting more used to where
the cell phone towers arebecause the last time we had a
group FaceTime date, you kind ofwere just pixely and frozen most
of the time, but we could hearyou talking.
But right now we've got a clearsignal.
So this is good.

SPEAKER_02 (00:47):
I don't know.
Sometimes I prefer the pixels,you know, just kind of get the
they get the wrinkles out.
Oh my gosh.
Oh, so.
How's the Northwoods?
I mean, they're wooden.
They're, you know, if you we'reabout, I don't know.
Honestly, only four or fivedegrees colder than you, but the

(01:09):
winds, the winds tear throughhere with no mercy.
And so that makes it feel a lotcolder.
But the sun was out today andthere were geese and eagles just
soaring over my house.
And I'm like, oh my god, that'sa that's an eagle, you know.
Yeah, no bears, no bees.

SPEAKER_01 (01:27):
Good, good, good.
Because ladybugs still don'tknow what to do if they came to
the doorstep.
So good we have a had asighting.

SPEAKER_02 (01:35):
People just keep telling me, well, you got a
spray on them.
I'm like, okay, well, all I haveis the sound machine.
So I'm gonna have to get somespray and get my Lysol out.
Does Amazon go there?
There you go, you'redisinfected.
Take that.
99.1% bacteria free.
Off you go, bear.
You're welcome.
Happy hibernation.

SPEAKER_01 (01:56):
You're so clean.

SPEAKER_02 (01:59):
Oh my goodness.
So well, we have some correctionsection, like major, major.
So first time I released episode39, part two of your episode
about Beverly Alt, the cow thatkilled.

(02:21):
It was actually a re-release ofepisode 38, part one.
So then I pulled it and Ire-released it.
And somehow all the edits that Ihad done on that episode were
gone.
And so there was a lot ofmishmash of us talking on top of
each other.
So I re-edited it and it will bere-released in a few days' time,

(02:43):
probably at the same time asthis episode, which is episode
40.

SPEAKER_01 (02:48):
I was listening to that one, and I was like,
honestly, it was hard to listento because we were just talking
over each other.
But I was like, we don't talkover each other like this in
real life.
Like, how chaotic would that be?
But when the tracks are laidover each other, it's just
squabbling.

SPEAKER_02 (03:08):
Oh it's horrible.
It's horrible.
So we even got, I think we got abunch of downloads, 40, 50
downloads, of people who didn'tcomplain.
And I'm like, God bless yourlittle cotton socks.
I don't know why you wouldn'tcomplain because that was awful.
So let's try it again.
You get a much cleaner audiothis time around.

(03:29):
And again, I'm still figuringout what the internet will and
won't do here, and obviouslywouldn't save my edits.
So I think we're gonna be aFriday release pod because
that's when I go back tocivilization.
So somehow it will let me recordand I can edit stuff.
But when it comes to uploading,that apparently takes the power

(03:51):
of civilization.

SPEAKER_01 (03:52):
So the entire Northwoods is like, what
happened?
The only signal we had is gone.

SPEAKER_00 (03:59):
And you're like, this isn't even strong enough to
upload.

SPEAKER_02 (04:04):
I can download, but it can't up.
I can't upity up.
So so there you have it.
Anything else you want todiscuss?

SPEAKER_00 (04:18):
I don't think so.

SPEAKER_02 (04:19):
All right.
Well, today we are discussing atopic that was brought up by one
of our sponsors.
Thank you, Chillion, aboutRobert Liston and surgical, the
origins of surgical consent.
So I don't really have anydisclaimers or trigger warnings.
I mean, other than it's kind ofgory, some of it.

(04:41):
And I will tell you that any ofthe information we talk about
today, those resources will becited in our show notes.
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Now on to our case.
In the early 19th century, theword surgery carried a weight of
dread.
To enter an operating theaterwas to walk willingly towards

(06:16):
agony.
There were no anesthetics, noantiseptics, no surgical gloves,
and little hope of survival.
Yet crowds came to watch.
It was a spectacle, an educationand entertainment.
One name drew bigger audiencesthan any other.

(06:41):
And he embodied thecontradictions of his age.
He was brilliant, brutal,compassionate, and cruel.
He was tall, broad-shouldered,impatient, and known to bark at
medical students who hesitatednear the table.
When a nurse or assistantfumbled with an instrument, his
voice could rattle the balcony.
Time me, gentlemen.

(07:02):
Liston's reputation rested onone skill: speed.
In an era before anesthesia,speed meant mercy.
A patient might faint or die ofshock before the knife reached
bone, so a surgeon's ability tocut quickly could save lives.
He was rumored to remove a legin less than 30 seconds, and he

(07:24):
relished, he relished provingit.
His operating room became knownas the theater of velocity.
Accounts from his studentsdescribe a blur of motion, the
glint of steel, the saws, rasp,the smell of blood, and hot iron
as assistants cauterizedvessels.
The audience leaned forward,some swooning, some applauding.

(07:46):
And when it was over, Listonwould glance at his watch and
announce the time.
Proud, detached, convinced thathe delivered efficiency in place
of empathy.
But efficiency isn't consent.
The patient, strapped to thetable and held by assistants,
rarely understood what was aboutto happen.

(08:08):
Many were poor laborers whosecrushed limbs were the product
of the Industrial Revolution'snew machines.
Others were soldiers, prisoners,or charity cases.
They signed no forms, they askedno questions, and they were
given no explanation.
The surgeon decided and thepatient endured.
Liston's fame grew from thisimbalance.

(08:30):
He was both a savior and ashowman, a man who mastered pain
without ever feeling it himself.
Yet behind his success lay grimarithmetic.
For every limb he saved, anotherwas lost to infection.
The word Listarian forantiseptic practice would not
exist until decades later whenJoseph Lister transformed

(08:52):
surgery.
Until then, Liston's theaterreeked of decay.
The famous story, perhapsapocryphal, of Liston's 300%
mortality operation rate,captures the chaos of that
world.
He was amputating a leg before apacked house.
Moving too fast, he severed notonly the patient's limb, but two

(09:14):
fingers of his assistant.
As he swung the knife free, heslashed the coat of a spectator
who collapsed on the spot,convinced that he'd been gutted.
The patient and assistant bothdied of gangrene, and the
spectator died of fright.
Listen, unshaken, continued hiswork.

(09:35):
To modern ears, his tale soundsabsurd, almost comic, but it
speaks to a truth.
Surgery then was not medicine aswe know it, it was controlled
violence, and violence performedwithout permission becomes
something closer to assault.
The 1830s and 40s were an ageobsessed with control.
Surgeons controlled the theater,physicians controlled diagnosis,

(09:59):
hospitals controlled the bodiesof the poor, and patients had
little recourse.
The concept of autonomy, that aperson has a right to make
decisions about their own body,had not yet entered medical
vocabulary.
The body was property, to berepaired or discarded according
to professional judgment.

(10:19):
For Liston, that hierarchy wasunquestioned.
He saw himself as a craftsman,not a philosopher.
His notebooks show meticulousattention to ligatures and
incisions, but no reflection onconsent.
When he performed one of thefirst operations under ether
anesthesia in Europe in 1846, hepraised its utility, not its

(10:39):
humanity.
Pain, to him, was a technicalobstacle, not a moral one.
Still, even among his peers,whispers circulated about the
brutality of surgical culture.
The novelist Charles Dickensattended an amputation in 1847

and later wrote of the horror: quote, I saw the quivering (10:56):
undefined
flesh, the sweat, the white faceof the surgeon, and I thought
the patient had gone mad, endquote.
Dickens' disgust reflected agrowing public unease.
Medicine's authority was vast,and its arrogance was
increasingly visible.
As hospitals expanded andmedical schools multiplied,

(11:18):
surgery moved from private homesinto institutions.
The operating theater became astage for professional
legitimacy.
Yet, in codifying theirauthority, surgeons erased the
patient's voice altogether.
Silence had become part of theritual.
In that silence lay the orangesof every future consent form,
because before there could beinformed consent, there had to

(11:40):
be recognition that somethingwas missing, that the patient's
will had been excised as cleanlyas a limb.
And the 19th century was notkind to the voiceless.
In the world of medicine, to bepoor, female, or uneducated was
to surrender bodily controlbefore you even entered the
hospital.

(12:01):
Surgeons like Robert Liston,bold and self-assured, stood at
the pinnacle of the system.
Their word carried not justmedical weight but moral
certainty.
To challenge them was to riskridicule, denial of care, or
worse, the accusation that one'ssuffering was self-inflicted.
In Britain's great cities,hospitals drew the working poor

(12:24):
in droves.
The Industrial Revolution wasgrinding bones as quickly as it
was forging progress.
Broken limbs from factoryaccidents, mangled hands cutting
textile looms, and crushed feetfrom iron foundries filled the
wards.
Many arrived desperate, halfconscious, begging only to live.

(12:44):
Consent, if it existed at all,was presumed through their
presence.
You came here to be saved, thesurgeon might say.
Now let us do our work.
The logic was simple andself-serving.
Survival justified intrusion,need justified obedience.
It was a system designed toprotect authority, not autonomy.

(13:05):
In teaching hospitals, patientsbecame learning material.
Surgeons demonstrated newtechniques on their bodies,
often before rows of studentswho took notes while blood ran
onto the floor.
The patient's face was rarelyvisible to the audience.
It was covered or turned aside,as if anonymity made the act
more acceptable.
Those who survived sometimesspoke of it afterwards.

(13:28):
The horror of being cut openwhile consciousness flickered,
the humiliation of beingobserved like an animal under a
knife.
For women, the situation waseven worse.
In an era when proprietydictated that even the mention
of a woman's body was indecent,medical examination was a
paradox.
Modesty demanded silence, andsilence enabled exploitation.

(13:52):
Gynacological procedures wereperformed without explanation or
anesthesia, justified by thesame paternalism that defined
all medicine.
It's for your own good.
Across the Atlantic, theAmerican South offered its own
horrifying version of surgicalprogress without consent.
The surgeon J.

(14:12):
Marion Sims, later hailed as thefather of modern gynecology,
conducted repeated experimentalsurgeries on enslaved black
women between 1845 and 1849.
They had no anesthesia, no rightto refuse, and no voice in the
records that immortalized hisname.
Sims claimed his work was inpursuit of medical advancement.

(14:36):
History records it as one of theclearest violations of human
dignity in medicine's past.
Liston and Sims never met, butthey practiced under the same
philosophical sky, one where thesuffering of some could be
rationalized as the education ofothers.
Orthopedic surgery, too, oftenrelied on captive or
impoverished patients.

(14:57):
Military hospitals, prisons,almshouses, those became
laboratories for improvement,quote unquote.
The absence of consent was notseen as cruelty, it was seen as
a necessity.
Surgeons argued that commonpeople lacked the education to
make medical decisions.
The patient knows not what isbest, wrote an Edinburgh

(15:18):
physician in 1839.
He is the subject of hisdisease, not the master of it.
End quote.
Even the language of surgeryreflected ownership.
Surgeons took limbs, claimedcases, saved patients, as if

(15:40):
they were possessions, andpatients internalized the
hierarchy.
Gratitude became expected torisk being labeled noncompliant,
ungrateful, or hysterical, andthose labels would persist into
the 20th century, mutating butnever disappearing.
In Lisnon's Day, surgery wasconsidered a masculine art, a

(16:01):
test of nerve and strength asmuch as knowledge.
Surgeons prided themselves oncourage, not compassion.
The patients' cries were proofof vitality.
The surgeon's speed was proof ofskill.
Pain was not to be avoided butendured.
Endurance was a measure ofcharacter.
And those who broke down, thosewho begged for mercy, were

(16:22):
mocked.
Accounts survive of studentslaughing as patients screamed,
of surgeons telling them to holdstill or die.
These stories are difficult toread today because they reveal
the thin line between medicineand sadism when empathy is
removed from the equation.
But not all surgeons were blindto the moral vacuum around them.

(16:43):
Some, particularly in themid-century reform movements,
began to question whether speedand spectacle were virtues or
vices.
The Quaker physician ThomasWickley, founder of The Lancet,
railed against the corruptionand cruelty he witnessed in
London's hospitals.
His publication exposedunnecessary operations,
untrained assistance, and theprioritization of showmanship

(17:06):
over safety.
The poor, he wrote, are made thesubjects of experiments, which,
had they the money, would neverbe attempted upon them.
That phrase, subjects ofexperiments, captured the
essence of the problem.
Consent could not exist in arelationship built on power
disparity.
When a patient's survivaldepends on obedience, freedom is

(17:28):
an illusion.
Orthopedic surgery, by itsnature, magnified the imbalance.
The procedures weren't invasiveand permanent.
To lose a limb or have it resetmeant losing not just flesh but
livelihood.
A botched amputation could meandeath from infection or poverty
from disability, and yetpatients rarely knew their

(17:49):
options.
The word alternative was foreignto surgical vocabulary.
The doctor decided and thepatient complied.
In rural Britain, so-called bonesetters were self-taught healers
who manipulated fractureswithout formal training.
They continued to serve theworking class and were scorned
by professionals like Liston,but trusted by locals.

(18:13):
They explained their methods inplain language and often
listened to their patients'fears.
To orthodox surgeons, thatapproach was unscientific.
To patients, though, it washumane.
The clash between formal surgeryand folk medicine revealed more
than a divide in technique.
It was a divide in trust.
And trust, once broken, leavesscars deeper than any incision.

(18:36):
The early Victorian era also sawthe rise of medical paternalism
as an explicit ideology.
Doctors began writing about themoral duty to act in a patient's
best interest even against theirwill.
The term benevolent deceptionentered medical ethics.
The idea that withholdinginformation could protect a
patient from distress.

(18:57):
If a patient feared surgery, thedoctor might lie, assuring them
it was only minor.
If the diagnosis was fatal, thedoctor might conceal it to spare
grief.
The line between compassion andcontrol blurred completely.
And so the foundations of moderninformed consent, communication,
understanding, voluntariness,were not only absent but

(19:20):
actively resisted.
The culture of medicine rewardeddecisiveness and punished
hesitation.
The phrase, do no harm, wasinterpreted narrowly.
Harm meant physical injury, notmoral violation.
So cutting without consent wasnot considered unethical, it was
considered efficient.
In this world, the surgeon's egofilled the space where dialogue

(19:40):
should have been.
And Robert Liston embodied thatconfidence perfectly.
He was known for his temper.
He was quick to anger andquicker still to act.
A student once had hesitatedduring an operation, and Liston
snapped, If you can't hold him,I will.
He seized the patient himself,completed the amputation in half
a minute, and left the roomwithout a word.

(20:02):
To his colleagues, it wasanother demonstration of his
legendary efficiency.
To us, it reads, dominationdisguised as skill.
But Liston was not a monster.
He was a man of his time, drivenby the belief that speed saved
lives.
In a brutal world of infectionand agony, he might have been
right, but the moralarchitecture of his practice,

(20:24):
the absence of patient agency,set the stage for a century of
ethical reckoning.
By mid-century, reformers werebeginning to imagine a different
model of medicine, one in whichpatients could question or even
refuse.
But change came slowly and oftenonly after catastrophe.
The silence of patients wouldeventually be broken not by

(20:46):
surgeons, but by victims andtheir advocates.
Lawsuits, scandals, and publicoutrage would do what moral
appeals could not do, forcemedicine to listen.
But before that revolution couldbegin, another transformation
reshaped surgery entirely wasthe discovery of anesthesia.
Anesthesia promised to removepain, but it also introduced a

(21:09):
new problem.
When patients can no longerspeak, who would speak for them?
The age of ether would silencethe screams, but it wouldn't
restore the patients' voices.
On October 16, 1846, in theoperating theater of the
Massachusetts General Hospital,a dentist named William Morton

(21:30):
administered sulfuric ether to apatient about to have a neck
tumor removed.
The surgeon, John CollinsWarren, made his incision.
And for the first time inrecorded history, the patient
did not scream.
When it was over, Warren turnedto the stunned audience and
said, Gentlemen, this is nohumbug.

(21:55):
Within months, words of thismiracle, painless surgery,
spread across the Atlantic.
By December, Robert Listonhimself was preparing to test it
in London.
He was no sentimentalist, but herecognized the potential because
pain had been the surgeon'seternal enemy.
So to conquer it was to approachGodhood.
Liston's patient was a young manwith a diseased leg.

(22:17):
The operating theater was full,as always.
Morton's technique had beendescribed in newspapers, and the
air buzzed with expectation.
Liston, skeptical but intrigued,ordered the ether apparatus
readied.
The patient inhaled, and thecrowd fell silent.
When Liston made the firstincision, the man did not move.

(22:39):
There was no cry, no convulsion,just stillness.
Liston completed the amputationin his usual half-minute and
turned to the audience with agrin.
Gentlemen, he said, this YankeeDodge beats meserism hollow.
I don't even know what thatmeans.

SPEAKER_01 (22:59):
I was gonna say I don't know what that means, but
sure.

SPEAKER_02 (23:02):
It was the triumph of science and the beginning of
a new ethical crisis.
Because anesthesia changedeverything.
Pain, once the definingexperience of surgery, vanished,
but so too did the patient'sability to communicate.
Under ether or chloroform, theywere completely passive and
unconscious, voiceless anddefenseless.
Surgeons already accustomed tocontrol now had total dominion.

(23:25):
They could do whatever theywished, unseen and unquestioned.
At first, this power wasintoxicating.
Operations that were onceimpossible due to pain, like
deep abdominal surgery, lungbone reconstructions, complex
amputations were suddenlyfeasible.
The surgeon's reach expanded,but so did the potential for

(23:46):
abuse.
No one asked patients if theyunderstood what anesthesia
entailed.
No one could explain the risksbecause the risks were barely
known.
Ether could suffocate,chloroform could kill instantly,
but excitement over discoverydrowned out caution.
In the press, reports ofpainless miracles fueled public
demand.

(24:06):
Few questioned whether patientshad truly consented to these
experiments.
In hospitals, across Britain andAmerica, surgeons began testing
new anesthetic agents on anyoneavailable, often the poor,
soldiers, or prisoners, and whenthus when deaths occurred, they
were dismissed as unfortunatenecessities of progress.

(24:27):
The notion that a patient mighthave a right to refuse was
almost absurd.
Liston's successful etheroperation was amongst his last.
He died in 1847, likely from aruptured aneurysm at age 53.
But he lived long enough towitness surgery's transformation
from brute endurance tocontrolled unconsciousness.

(24:48):
Ironically, the new age that hehelped usher in would deepen
medicine's moral contradictions.
Before anesthesia, the cries ofpatients were a constant
reminder of their humanity.
Surgeons could not ignoresuffering when it filled the
room.
Now, silence reigned, and withit a dangerous illusion that
because pain had been conquered,consent had been achieved.

(25:11):
But the truth was the opposite.
Patients had become subjects ina new kind of experiment, one
that blurred the boundariesbetween compassion and control.
In the early years, doctorsdebated whether or not they
should use anesthesia, when andon whom, and some argued that
pain had moral value, that toremove it was to tamper with

(25:32):
divine purpose.
Others believed only respectablepatients deserved it.
The poor and the condemned mightnot.
These debates were rarely aboutwhat the patient wanted.
They were about the physician'sauthority.
And yet, beneath the progress,dissenting voices began to stir.
Clergymen, journalists, and afew physicians questioned

(25:52):
whether unconscious patientscould ever give true consent.
Was it ethical, they asked, toperform additional procedures
while a patient layanesthetized?
Ones that they hadn't agreed tobefore?
The temptation was strong.
Once the patient was under, whynot fix a few other problems
while you were down there?
Sure, why not?

(26:12):
By the 1850s, such opportunisticoperations were common.
A surgeon might begin with asimple tumor removal and decide
mid-procedure to explore deeper.
Consent was viewed as a flexibleconcept.
The patient's body, anesthetizedand silent, was considered an
open field.
This problem wasn't confinedjust to orthopedics, but it was

(26:33):
especially evident there.
Orthopedic patients oftenrequired repeat surgeries, bone
resets, or amputations, andsurgeons prided themselves on
decisive action.
A delay could mean infection,hesitation could mean death.
In that high pressureenvironment, asking for
permission seemed like a luxury.

(26:54):
But something was changingoutside the operating room,
something that would eventuallychallenge medicine's
paternalism, the rise of theindividual as a moral and legal
entity.
The Industrial Revolution hadnot only reshaped labor, it had
reshaped identity.
Workers were organizing, womenwere demanding education,

(27:14):
citizens were questioningmonarchy and church.
Autonomy, the idea that onecould own one's choices, was
entering public consciousness.
And sooner or later, that ideawould collide with the operating
table.
For now, however, the old orderheld firm.
In hospitals, the surgeon wasstill sovereign, the patient was

(27:36):
still a body to be acted upon.
And anesthesia, for all itsbenefits, had deepened that
inequality by removing thepatient's final instrument of
resistance, the ability to saystop.
One anesthetist in 1853described his role bluntly.
I am to the surgeon what thekeeper is to the lion tamer.

(27:56):
I restrain the beast.
He meant it metaphorically, butthe metaphor was telling.
The patient was still seen assomething to be subdued and not
to be understood.
The introduction of antisepsisin the 1860s by Joseph Lister,
who was no relation to Liston,though their names are forever
linked, added another layer tothe illusion of progress.

(28:19):
Infection rates plummeted,surgery became safer, hospitals
grew in prestige, but while thebody was finally protected, the
mind, the personhood of thepatient, remained exposed.
Throughout the second half ofthe 19th century, medicine's
technological leaps outpaced itsethics.
Hospitals became morebureaucratic, surgeons more

(28:40):
specialized, and patients morenumerous.
The relationship that onceexisted between healer and
sufferer was replaced by asystem, efficient, impressive,
and deeply impersonal.
Orthopedic surgery exemplifiedthis mechanism of care.
The new tools, the saws, clamps,bone screws, transformed the

(29:01):
body into a kind of machine,something to be repaired rather
than healed.
The language followed suit.
Surgeons spoke of adjustments,reconstructions, fixations, and
the patient disappeared intoanatomy.
A report from St.
Bartholomew's Hospital in 1875described patients as cases
identified by injury rather thanname.

(29:22):
Case of compound fracture, male,age 32, case of hip
disarticulation, successful.
There was no mention of consent,no note of discussion.
The record was clinical,complete, and cold.
By the late Victorian era, a fewdissenters were beginning to
articulate what would later becalled medical ethics.
They argued that progressrequired not only skill but

(29:44):
conscience.
The Scottish physician ThomasPercival, whose medical ethics,
1803, was one of the firstattempts to codify professional
behavior and emphasize respectand communication.
But his influence went.
Amid the surgical revolution.
Only toward the century's enddid his ideas gain traction as

(30:06):
scandals forced public scrutiny.
One such scandal erupted in 1889when a woman in Edinburgh
discovered that her husband'sbody had been used for
dissection without permissionafter his death in hospital.
Outrage spread through thenewspapers, reigniting fears of
body snatching, the notoriouspractice of stealing corpses for

(30:28):
medical study.
Though the Anatomy Act of 1832had legalized the use of
unclaimed bodies, the publicremained uneasy.
Consent, it seems, still stoppedat the hospital gates.
As the century turned, a fewvisionary doctors began to sense
the approaching reckoning.
They saw that the authority theycherished could not last

(30:48):
forever.
Science was advancing tooquickly, and society was
questioning too loudly, and lawwas beginning to take notice.
The seeds of legalaccountability were already
sprouting.
In the 1890s, a handful of civilcases in Britain and the United
States tested the idea thatunwanted medical intervention
could be considered assault.

(31:09):
The courts were inconsistent,often deferring to physicians,
but each case chipped away atthe notion that medical
expertise conferred moralimmunity.
When the 20th century dawned,surgery had entered the modern
age, sterile, anesthetized, andprofessionalized.
The horrors of Listen's bloodytheater were relics of the past.
But the spirit of unquestionedauthority remained alive and

(31:32):
well.
Surgeons no longer needed to befast, they needed to be
decisive.
The scalpel was cleaner, but thehierarchy was unchanged.
Patients were still rarely toldeverything and still expected to
trust completely, still treatedas vessels for medical success.
It would take not justscientific innovation but social
upheaval, the rise of patientrights, feminism, and legal

(31:55):
activism to finally challengethat hierarchy.
But before those battles couldbe fought, one more step had to

occur (32:01):
the transformation of consent from moral courtesy into
legal mandate.
And that transformation began,dear Ellie Katz, in a courtroom.
By the turn of the 20th century,surgery had conquered pain,
infection, and but not power.
Hospitals are modern, surgeonswore clean coats, operations
that were once unimaginable,like joint replacements, spinal

(32:24):
fusions, internal fixations,were now becoming possible, and
yet the moral equation remainedfamiliar.
Doctors decided and patientscomplied.
The idea that a patient had theright to understand, question,
or refuse treatment was stillradical.
Medicine was guided not byautonomy but paternalism, the
belief that the doctor knewbest, even against the patient's

(32:47):
will.
The Hippocratic oath, once acall to conscience, had become a
shield against scrutiny, andlike all shields, it sometimes
hid more than it protected.
But the world outside medicinewas changing faster than the
profession could contain.
Industrialization had creatednot only machines but laws.
Workers were suing employers,women were demanding suffrage,

(33:09):
citizens were discovering thepower of rights, and sooner or
later that language would findits way into the hospital.
And that spark came from asingle woman, Mary
Schlomendorff.
In 1908, Schlohendorf was a40-year-old woman admitted to a
New York hospital with stomachpain.
Doctors discovered a tumor andrecommended surgery.

(33:31):
She refused.
She agreed to an examinationunder anesthesia.
She explicitly stated that shedid not consent to any
operation.
The doctors nodded and operatedanyway.
When she awoke, her tumor wasgone, along with her trust in
medicine.
She sued the hospital allegingassault.
The court's decision, deliveredin 1914 by Justice Benjamin

(33:56):
Cardozo, became one of the mostquoted passages in medical law.
Quote, every human being ofadult ears and sound mind has a
right to determine what shall bedone with his own body, end
quote.
And with those words, the modernconcept of informed consent was
born.
The case of Schlorendorff versusSociety of New York Hospital

(34:19):
established a principle thatseems obvious today, but was
revolutionary at the time, thatunwanted medical treatment
constitutes a form of battery.
Yet the ruling came with acaveat.
The hospital itself was not heldliable, only the doctors.
This was a reflection of theera's legal conservatism.
But even so, Cardozo's statementechoed far beyond the courtroom.

(34:41):
It forced medicine to confrontan uncomfortable truth, that a
well-intentioned act could stillbe a violation.
For surgeons, this was a seismicshift.
The operating room, longconsidered a sanctuary of
authority, was now a potentialsite of legal peril.
Consent could no longer beassumed, it had to be proven.

(35:03):
Still, the transformation wasslow.
For decades after Schlowendorf,doctors continued to interpret
consent loosely.
A patient's signature on ageneral form or even a verbal
yes was treated as carteblanche.
Explanations were minimal andquestions were discouraged.
The imbalance of knowledgebetween physician and patient
made true understanding nearlyimpossible.

(35:24):
Orthopedic surgery, inparticular, was fertile ground
for conflict.
The procedures were complex, theoutcomes uncertain, and the
risks, infection, paralysis,loss of mobility, were
significant.
Surgeons prided themselves ontechnical innovation, often
pushing boundaries before ethicscould catch up.
One of the earliest legalchallenges in orthopaedic

(35:46):
medicine came in the 1930s whena surgeon performed a spinal
fusion without the patient'sinformed agreement about its
permanence.
The patient, unable to bendafterwards, claimed she hadn't
understood what the operationentailed.
The court sided with a surgeon,declaring that the patient's
ignorance was not his fault.
The doctor, they said, had actedin good faith.

(36:08):
Good faith.
That phrase would dominatemedical law for half a century.
It implied that as long as adoctor believed he was helping,
consent was secondary.
It wasn't until the mid-20thcentury that this paternalistic
notion was finally dismantled.
The next turning point came fromanother patient whose story
echoed Schlohendorf's.

(36:28):
In 1957, in Salgo versus LeeloneStanford Junior Board of
Trustees, a man underwent adiagnostic procedure that left
him paralyzed.
He sued, claiming that thephysician failed to warn him of
the risk.
The California court agreed,coining a new phrase, informed
consent.
The court ruled that physicianshave a duty to disclose any

(36:50):
facts necessary for a patient tomake an informed decision, not
just that consent be obtained,but that be informed.
The difference was monumental.
It recognized the patient wasnot a passive subject, but that
they were an active participantin their own care.
Yet even this case leftambiguity.

(37:10):
How much information was enough?
Should the doctors list everyrisk or only those that are
deemed material?
The law struggled to define theline between reassurance and
overwhelm.
And that question would find itsanswer in 1972 in a case that
changed medical ethics forever.
Canterbury v.

(37:30):
Spence.
Jerry Canterbury was a19-year-old clerk who underwent
spinal surgery for back pain.
His surgeon, Dr.
William Spence, didn't warn himthat paralysis was a possible
risk.
After the operation, Canterburyfell from his hospital bed and
was left paralyzed from thewaist down.
He sued, arguing that he wouldnot have consented to surgery

(37:53):
had he known the risk.
The court sided with Canterbury,but more importantly, it shifted
the standard of disclosure fromthe physician's judgment to the
patient's right.
The ruling declared that whatmust be disclosed is not what
the doctors think is relevant,but what a reasonable patient
would want to know.
This was a quiet revolution.

(38:13):
For centuries, medical ethicshad been guided by the doctor's
conscience, and now it wasguided by the patient's
perspective.
The ripple effects reached everycorner of medicine, including
orthopedics.
Suddenly, surgeons were requiredto explain in plain language the
potential risks, benefits, andalternatives to every procedure.
A hip replacement wasn't just atechnical operation, it was a

(38:34):
contract, an agreement betweenequals.
But equality on paper isn'tequality in practice.
Even as consent formsmultiplied, true understanding
lagged behind.
Studies in the 1980s and 90srevealed that most patients
remembered less than half ofwhat the doctors told them
before surgery.
Anxiety, unfamiliar terminology,and the power dynamic of the

(38:56):
consultation room all conspiredto limit comprehension.
And so the ritual of consentbecame just that: a ritual.
The surgeon's authority, dressednow in the language of law,
persisted.
In orthopedics, this tension wasparticularly acute because of

(39:17):
the irreversible nature of manyprocedures.
A fusion cannot be undone.
A prosthetic joint, onceimplanted, becomes part of the
body's story forever.
And when outcomes fail, patientsturned again to the courts.
The late 20th century saw a waveof lawsuits alleging inadequate
consent in orthopedic cases.
Patients claimed they hadn'tbeen told about potential loss

(39:39):
of motion, nerve injury, or theneed for future revisions.
Surgeons countered that fulldisclosure would only frighten
patients into refusal.
The old paternalism resurfaced,cloaked in concern.
Judges, however, were lesssympathetic than before.
In one landmark 1980s case, asurgeon who performed a total
knee replacement withoutexplaining the likelihood of

(40:01):
chronic pain was found liable.
The court ruled that omittingprobable complications was
equivalent to deceit.
The message was clear.
Paternalism was no longerprotection, it was negligence.
As the legal landscape evolved,medical institutions began
rewriting their policies.
Hospitals introducedstandardized consent forms,

(40:22):
educational brochures, andmandatory cooling off periods
before elective surgery.
Medical schools incorporatedethics training into their
curriculum, teaching youngdoctors that technical skill
alone was not enough.
And yet, for all the progress,the ghost of Liston's era
lingered.
Consent remained a performance,a few minutes of explanation

(40:42):
before the patient signed,anesthetized, and was silent
once more.
The ethical questions grew evenmurkier with advances in
technology.
In orthopedic surgery, the riseof spinal implants, robotic
assistance, and experimentalprosthetics blurred the line
between innovation andexperimentation.

(41:03):
Patients often consented toroutine procedures that involved
untested devices or techniques.
The distinction between surgeryand research became perilously
thin.
In 1998, an investigation into aseries of failed spinal implants
in the United States revealedthat many patients had not been
told their devices were part ofan experimental program.

(41:24):
They had signed standardsurgical consents, unaware that
their surgeries were also datapoints in a corporate study.
The scandal reignited debateabout whether true informed
consent was even possible in anera of commercialized medicine.
By the dawn of the 21st century,the phrase informed consent had
become ubiquitous, a legal,ethical, and cultural

(41:47):
touchstone.
But the struggle betweenknowledge and authority
persisted.
Surgeons now disclosed moreinformation than ever before,
yet patients remained dependenton trust.
The complexity of modernmedicine meant that no lay
person could fully grasp everyrisk.
And so consent evolved once morefrom a document to a process.

(42:08):
Hospitals began emphasizingshared decision making, a model
that sought to restore dialogue.
Instead of a one-way lecture, itwas meant to be a conversation,
in return, in some ways, to thelost humanity of medicine before
the machines, before the speed.
It was finally anacknowledgement that control
over one's body can't existwithout understanding.

But the question remains (42:32):
could a system built on centuries of
hierarchy truly learn to listen?
As the 21st century unfolded,the answer would depend on
whether medicine could rememberwhat Robert Liston, in all his
speed and certainty, had neverpaused to ask.
What does the patient want?

(42:53):
And now it's time for a chart.

SPEAKER_03 (43:04):
Ooh, get a girl.

SPEAKER_02 (43:06):
Welcome to the Chart Note segment where we learn
about what's happening inmedicine and healthcare.
If Robert Liston's era wasdefined by speed and silence,
the newest generation oforthopedic surgery may be
defined by precision andpartnership.
Across the US and Europe,hospitals are beginning to pilot
patient interactive roboticsystems for joint replacement

(43:26):
and spine surgery.
Unlike traditional robotics,which respond only to the
surgeon's hand or programpathway, these systems
incorporate real-time feedbackfrom the patient's anatomy and
even their own movement datarecorded before surgery.
One of the most promisingexamples is the Mako Smart
Robotics platform, used for kneeand hip replacements.

(43:49):
Before surgery, patients walk onpressure-sensing mats that
create a detailed motion map ofhow their joints function in
daily life.
That map guides the robot duringthe operation, allowing the
surgeon to restore that person'sunique alignment, not just
textbook anatomy.
It's a shift from the one sizefits all to one body at a time.

(44:11):
Meanwhile, researchers at theCleveland Clinic are developing
systems that integrateAI-assisted consent tools into
surgical planning.
These platforms useconversational AI to explain
procedures, risks, andalternatives in plain language,
confirming comprehension throughinteractive questions.

(44:31):
Patients can review theirchoices later online, replay
explanations, or share them withthe family before they sign.
Early studies show a 30%increase in patients' recall of
surgical risks and satisfactionwith their decision.
In other words, the technologyis doing what the paperwork
never could.
It's making consent a truedialogue.

(44:54):
Even more remarkable, severalrehabilitation centers are
trialing collaborativeprosthetics.
These are limb systems thatadjust automatically to patient
intention through neuralfeedback and microsensors.
These aren't just tools butpartners learning from the
user's movement and comfortlevels over time.

(45:15):
The goal isn't just mobility,but agency.
And taken together, theseinnovations suggest that the
next frontier of orthopedicswon't just be mechanical, it
will be relational.
The scalpel is becoming smarter,but so is the conversation
around it.
Two centuries ago, Robert Listondemanded his patients hold

(45:37):
still.
Today, medicine is learning tolisten instead.
Back to the case.
By the early 21st century,orthopedic surgery had become a
marvel of precision andengineering.
There were titanium joints,computer-assisted defecation, 3D
printed implants.
These turned the body, whichwere once the surgeon's

(45:58):
battlefield, into a canvas ofpossibility.
Yet, beneath the sleeptechnology and glossy patient
brochures, the same old faultline remained.
The uneasy relationship betweentrust, knowledge, and power.
Modern orthopedics is among themost common elective
specialties.
Millions undergo hip and kneereplacements every year.

(46:18):
Spinal fusion, fracturefixations, rotator cuff repairs
all promise mobility and relieffrom pain, but each carries a
risk, and risks are not alwaysfully understood or clearly
explained.
Informed consent, once therallying cry of ethical reform
has become a paradox.
On paper, it is absolute.

(46:40):
In practice, it often faltersunder pressure.
Surgeons, bound by law todisclose everything, face the
reality that too muchinformation can overwhelm
patients.
And patients, anxious andhopeful, will just hear what
they want to hear.
The consent conversation becomesa negotiation between clarity
and comfort, between truth andreassurance.
And within that negotiation, oldhabits find fertile ground.

(47:05):
In 2011, a New England Journalof Medicine study revealed that
nearly 40% of orthopedicpatients could not recall the
main risks of their surgery justa day after signing their
consent forms.
Some couldn't even rememberwhich joint was being replaced.
Others were unsure whetheralternatives like physiotherapy
had even been discussed.

(47:26):
And the signatures were there,but the understanding was not.
In 2007, a 54-year-old Floridawoman underwent what she
believed was a routine spinaldecompression.
Postoperatively, she discoveredher surgeon had also implanted
experimental rods that were notyet FDA approved.
He defended it as a therapeuticprivilege, the notion that full

(47:49):
disclosure might have scared herinto refusing a beneficial
procedure.
The court disagreed.
The woman won a multimilliondollar settlement, reigniting
debate over how much choicepatients really have when
they're unconscious.
Therapeutic privilege soundsarchaic, a relic of the
paternalistic 19th century, butyet it persists.

(48:09):
The idea that a doctor mightwithhold information for the
patient's good still appears inmalpractice suits, ethic
reviews, and hospital policies.
It's the modern echo of listuncertainty, rephrased in
clinical language.
In orthopedics, whereinterventions are often
reversible, these tensions aremagnified.
Patients are told prostheticjoints that last 15 to 20 years,

(48:33):
but they're rarely warned thatsome fail far sooner.
Spinal fusions are marketed assolutions for back pain,
although large studies showlong-term outcomes often match
conservative care.
And once the screw and cages arein place, there's no going back.
A 2012 British Medical Journal,Expose, revealed unnecessary

(48:54):
orthopedic surgeries in privatehospitals.
Surgeons were recommendingoperations for patients who
hadn't exhausted non-surgicaloptions, sometimes motivated by
financial incentives or surgicalvolume quotas.
The report concluded thatinformed consent had become a
formality rather than asafeguard.
Patients weren't being lied to,they were being led.

(49:16):
Industry influence began shapingthe very tools of consent.
Device manufacturers sponsoredpatient educational materials
that highlighted benefits andsoftened complications.
Brochures bore company logos,not hospital crests.
And the relationship betweensurgeon, patient, and
corporation blurred intosomething resembling marketing
more than medicine.

(49:37):
The rise of surgicalentrepreneurship.
Doctors holding shares in thedevices at the implant added new
ethical landmines.
In 2013, the U.S.
Department of Justiceinvestigated dozens of
orthopedic surgeons for failingto disclose financial ties to
device makers.
Some had received millions inconsulting fees for promoting

(49:57):
implants that were later foundto have high failure rates.
Patients consented to surgery,believing recommendations were
medical, not financial.
Hospitals tighten disclosurerules, but transparency remains
uneven.
Many patients assume informedconsent includes financial
conflicts, but it usuallydoesn't.

(50:18):
The form explains the surgicalrisks, not the motivation.
The most haunting violations areinvisible, not wrong limb
surgeries or severed nerves, butchoices quietly taken away.
In 2015, an Australian study oforthopedic trauma cases found
that in 80% of emergencies,consent was obtained under
distress, patients medicated, inpain, or disoriented.

(50:40):
The authors concluded informedconsent in acute orthopedics is
more symbolic than substantive.
The body is broken, the clock isticking, and the surgeon holds
all the time that remains.
Yet modern orthopedics isn'tdevoid of conscience.
Many surgeons are deeply awareof these problems and struggle
to balance efficiency, empathy,and disclosure.
Dr.
Fiona Kelly, an orthopedicconsultant in London, put it

(51:04):
best.
We talk about consent as if it'sa legal event, but it's a
relationship event.
The forum isn't the consent, theconversation is.

(51:31):
Some even record consentsessions to ensure transparency.
These innovations aim to restorewhat surgery's technological
triumphs have often obscured,the human voice.
Still, the ghosts of paternalismlinger.
When fear or trust silencesquestions, when pressure
masquerades as confidence,informed consent becomes theater

(51:54):
once more.
The instruments are cleaner, thelanguage gentler, but the
silence is the same.
The persistence of these issuesshows how deeply they're woven
into medicine's DNA.
The very qualities that make agood surgeon, decisiveness,
certainty, control, can alsothreaten a patient's autonomy.
A hesitant surgeon isfrightening, a confident one is

(52:15):
comforting, even when they'rewrong.
In that emotional calculus,consent is fragile.
Orthopedic surgery magnifiesthis tension because its
consequences are visible andpermanent.
Patients wake up to find theirbodies altered, they're shorter,
straighter, heavier, stiffer,and they must reconcile what
they agree to, in theory, withwhat they now inhabit in

(52:37):
reality.
For some, that realization isempowering, and for others, it
feels like betrayal.
The ethical challenge for modernorthopedics is not merely to
inform, but to translate, tobridge the gap between medical
knowledge and humanunderstanding.
An assigned form can't do that.
Only honest, time-richconversation can.

(52:59):
But time is the one resourcemedicine has made scarce.
Liston prized speed because itmeant survival, and today speed
means efficiency.
The motive has changed, but theeffect is eerily familiar.
And so history loops back onitself.
The instruments gleam the room'shomotechnology, but the oldest

(53:19):
question in medicine remainsunanswered.
Who owns the body?
The one who cuts or the one whobleeds?

SPEAKER_01 (53:36):
Very good coverage of this background of informed
consent.
And thank you, Jillian, forsuggesting this.
I did not have a background onthis.
And the way my entire body hadthe absolute shivers when I
thought about medicinepre-anesthesia era, because
obviously that was a long time.

SPEAKER_02 (53:58):
But I mean, if you gotta do it with anesthesia,
don't you want to be fast?

SPEAKER_01 (54:02):
I only know the world with anesthesia and oh my
gosh, having the amputationcompleted in 30 seconds.
But I like when you were readingthat, I was like, oh my god, I
can't stand like you know, likea a paper cut hurts.
Or like when you're cookingbacon and you get snapped with
like the bacon grease flingingoff, like how much that hurts.

(54:24):
I'm just thinking about likesomeone whacking off a lemon 30
seconds.
Ah my god.

SPEAKER_02 (54:29):
On my so on my four-hour commute back to my
week home, my week, the home Istayed during the week, I
couldn't help it.
I it was it was rural.
I was hungry.
There was a McDonald's.
I pulled over.
It took them seven minutes tomake this McChicken.

(54:50):
Oh my god.
And I was like, oh my God, ifit's gonna be crap food, at
least make it fast.
So they must have just pulled itout of like 160-degree fryer
because as soon as I bit intothat chicken patty, it it just
blew like a whole burst of hotgrease onto my face.
I have a secondary burn on myface.

(55:18):
I would have been a finer littleprice you pay for eating fast
food, I guess.
But yeah.

SPEAKER_00 (55:26):
I would have been like, it wasn't even fast.
I should have just waited.
Now my face is burned.

SPEAKER_02 (55:33):
Oh, I would have died from what did they say?
Die from fear or fright or pain.
I probably would have been likea witness to somebody having
that done and died of shock.
I I wouldn't have survived.

SPEAKER_01 (55:47):
Yeah, I thought that was interesting.
Like, and then how many peoplestill died from or like he saved
one limb, but then the otherone.

SPEAKER_02 (55:55):
Yeah, he had like a 300% mortality rate.
So you were more likely to diethan not, but at least he was
fast about it.
Oh gosh.

SPEAKER_01 (56:08):
It made me think too.
Adam recently had surgery.
And when I talked to the surgeonafter his procedure, he had
said, you know, normally I wouldhave wanted to do this
additional procedure while inthere, but I couldn't get
informed consent.
So obviously I didn't.
So like he'll have to come.

(56:29):
You have an ethical surgeon.
And so yeah, what a timelyconversation I just had last
week about that.
And then of course, you know,Adam's all loopy-doopy when he's
waking up from anesthesia.
And, you know, he's all how togo-da-da.
I'm like, oh, you know, good,but you there you'll have

(56:50):
another surgery in in a fewmonths.
And, you know, he's like, Well,why didn't he just do it?
And I was like, Well, becauseyou couldn't consent.
And he's like, Oh, he shouldhave just done it and I would
have consented.
It's like that's not how itworks.
But I do like the point of it'smore about the conversation of
what's going to happen and notjust, okay, sign this form.

(57:13):
We all know you're havingsurgery.
Cause I agree, even like surgeryaside, if we're counseling
patients in clinic, their recallof what we actually discussed is
typically low, right?
It's just a lot of information,terms they're not used to.
And so then when you're talkingabout surgery, those terms are

(57:35):
even more complex.
Yeah.
And the anxiety and everythingis higher.
You're gonna have surgery.

SPEAKER_02 (57:44):
So and I like that they're they've taught us like
the teachback technique.
Like you talk, you you knowtheir eyes are rolling back,
you're gonna give them writteninformation to help bolster what
you've said, but you're like,tell me what you heard me just
say.
You know, because a lot of timeswhat they want to hear is what

(58:06):
they're gonna pull out of whatyou're saying, and then they
tell you back, and you're like,that's true, but also, you know,
and you can just kind ofreinforce.
But yeah, you have to have timeto do that and to develop that
rapport, to have the time tocounsel and teach back and
explain.
And let's face it, in today'shealthcare world, there's not a

(58:29):
whole lot of time.
I'm just cutting back the timeyou spend with patients, yeah.
And that's the time thatactually guarantees compliance
and better outcomes that's beingcut.
So that's my two cents there.

SPEAKER_01 (58:45):
Boo.
Um, well, anyway, you did great.
Thank you so much.
And again, thank you, Gillian.
Great suggestion.

SPEAKER_02 (58:54):
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SPEAKER_01 (01:00:07):
Medical miss.
Okay, this week's story comesfrom I'm gonna guess I can say
your name.
Yeah.
Um Mrs.
Carol Templeton, age 73.
Yes.

(01:00:27):
From Austin, Texas.

SPEAKER_02 (01:00:29):
Mrs.
Carol Templeton.

SPEAKER_01 (01:00:32):
Hi, Carol.
And it's titled The OrthopedicOdyssey.
And she writes, Doctor's Housein Tanell.
Oh, thank you.
Wow.
Feeling like a queen over here.
I love you, ladies, and wouldlove to have you over for tea.

SPEAKER_00 (01:00:50):
Oh, it's so cute.
Please.
Oh my god.
I want to go to tea in Texas.

SPEAKER_01 (01:00:55):
Boston, Texas, here we come.
I want to know everything thereis to know about true crime in
healthcare, so thank you forbringing these issues to light.
I'm writing to tell you about astory of mine.
Hopefully, you'll findinteresting.
A few years ago, I slipped in mykitchen while reaching for the
top shelf because apparentlygravity doesn't care if you're

(01:01:18):
making banana bread.
I landed awkwardly and fracturedmy ankle.
Oh my gosh.
She's all the she writes this.
No big deal, I'm a farm girl.
Oh bless.
Um, I'm sorry.
The way my ankles just likecurled for yours.
I thought I'd be in a cast for afew weeks, maybe some physical

(01:01:41):
therapy, and back to business.
But what I didn't realize wasthat I was about to embark on a
six-week comedy of orthopedicerrors.
Oh dear.
Oh.
It started in the emergencydepartment.
The doctor who came in toexamine me was approximately 12
years old and sweating throughhis lab coat.
That's so funny because I I'vehit the age where like I see new

(01:02:07):
staff or doctors or whoever, I'mjust like, oh, you're so you
look so young.

SPEAKER_03 (01:02:12):
Like, oh my god, cute.

SPEAKER_01 (01:02:15):
He introduced himself as Dr.
Chen, the orthopedic resident oncall.
He was kind, gentle, andconfident, which was reassuring
until he picked up the x-raysand said, Huh, that's not the
angle I expected.
I naturally asked, What angledid you expect?
And he replied, The one thatwould make this look less like a

(01:02:38):
Picasso painting.

unknown (01:02:40):
Ha!

SPEAKER_01 (01:02:40):
Oh no.
Oh, okay.
Um, we both laughed nervously,but the truth was the x-ray had
been taken upside down.
So for a solid five minutes, wewere trying to figure out why my
ankle appeared to bend in twodirections at once.
My ankles just curled for okay.

(01:03:03):
The orientation issue was sortedout.
Dr.
Chen then said he would need asmall plate and a few screws to
stabilize the bone.
He assured me it was routine,saying, You'll be waking you'll
be walking again in no time.
The surgery went smoothly,mostly.
When I woke up, my leg waswrapped from knee to toe, and I

(01:03:27):
immediately noticed a sharppain, not where I had broken the
bone, but several inches higher.
Of course I asked the nurse ifthat was normal, and she said,
Oh honey, everything's normalright after surgery.
That's the anesthesia talking.
But it wasn't the anesthesiatalking, it was the IV line,
inserted into the wrong leg,taped in place and forgotten.

(01:03:50):
For two days my uninjured leglooked like it had been
preparing for its own separateoperation.
Oh no.
And on day three, the attendingsurgeon came by for morning
rounds.
He was cheerful, upbeat, andfull of metaphors.
You're healing beautifully, Mrs.
T, like a house underrenovation.

(01:04:10):
Interesting.
He left the room before I couldask which part of my house he
went.

SPEAKER_02 (01:04:16):
I like this lady.

SPEAKER_01 (01:04:19):
Me too.
Then came the physical therapyconsult.
The therapist arrived with awalker, a clipboard, and
pronounced me as having, quote,the energy of someone who just
had three espresso and amotivational seminar and love
it.
He told me we were going topractice walking.
I politely reminded him that mychart said non-weight bearing.

(01:04:43):
He flipped through the papers,frowned, and said, That's weird.
It says partial weight bearingon the left.
I stared at him.
Left, my right ankle's broken.
There was a long pause.
Then he said, Oh, well thatexplains why your balance test
went so poorly.

(01:05:03):
By this point, I had decided totake control of my recovery, or
at least my paperwork.
I started double-checking everylabel, every prescription, every
order that came my way.
When the pharmacy sent up mydischarge meds, I read the
instructions carefully and foundone labeled Take One Pill Every
Four Hours for Pain.

(01:05:25):
I turned the bottle around andsaw the name Charles Templeton.
That was my husband.
Oh dear.
He'd had his gallbladder removedtwo months earlier, and they had
given me his leftoverprescriptions by mistake.
Girlfriend, where are you?
And it like sounds like a houseof horrors.
By the time I finally made ithome, I felt like I earned a

(01:05:49):
minor degree in hospitaladministration.
My ankle healed perfectly andI'm walking fine today, but I
learned two valuable lessons.
One, never underestimate yourability to advocate for
yourself, even when you'rewearing a backless gown and
compression socks.
And two, if anyone hands you apill bottle, a walker, or an
x-ray that looks like a modernart, ask questions.

(01:06:15):
And she ended her letter withthis line, which I think sums up
the spirit of Doctoring theTruth perfectly.
I forgive them.
They meant well.
But sometimes medicine justneeds a second set of eyes.
Preferably the patients.
Oh, thank you, Carol, forsending in your story.
My ankles are crying for yours.

(01:06:36):
I'm glad you're all healed up.

SPEAKER_02 (01:06:38):
In spite of everybody.
Hopefully your husband got hispain meds.

SPEAKER_01 (01:06:42):
Jeez, Louise.
I hope you guys found a newmedical home.

SPEAKER_02 (01:06:48):
Oof.
Well, what can our listenersexpect to hear next week,
Amanda?
That's gonna be a surprise forall of us.
Louis likes choking up.

SPEAKER_01 (01:06:59):
Sorry, you'll have to cut that out.
I sucked in too hard.
Oh.
It's gonna be a surprise for allof us because I don't know yet.

SPEAKER_02 (01:07:08):
I will all be surprised, including yourself.

SPEAKER_01 (01:07:11):
Yes.
You know, I just like I'vestarted to get into this thing
where I like start to doresearch on one and then I'm
like, this isn't interestingenough.
And then I'll do another one.
And so like I think I have threeor four cases right now that
have like three to five sixpages done.
Yeah.

SPEAKER_02 (01:07:28):
And I'm like one.

SPEAKER_01 (01:07:29):
Who am I to say that this isn't interesting enough?
Also, yeah.
I don't know.
But I've been doing that lately,which is not good for our um
time frame of having ourhomework done.

SPEAKER_02 (01:07:41):
Oh, you got time, girl.

SPEAKER_01 (01:07:43):
Yeah, we got a week.
We good.
We good.
We made it through a lot ofcollege.
I'll be fine.
I'll be fine.
Crunch time's the mostproductive time.

SPEAKER_03 (01:07:55):
Right?

SPEAKER_01 (01:07:56):
So until then, y'all, don't miss a beat.
Subscribe or follow Doctoringthe Truth wherever you enjoy
your podcasts for stories thatshock, intrigue, and educate.
Trust, after all, is a delicatething.
You can text us directly on ourwebsite at doctoringthetruth at
buzzsprout.com.
Email us your own story ideasand comments at Doctoringthe
Truth at Gmail, and be sure tofollow us on Instagram at

(01:08:19):
Doctoring the Truth Podcast andon Facebook at Doctoring the
Truth.
We are on TikTok at Doctoringthe Truth and Ed Odd Pod.
Don't forget to download, rate,and review so we can be sure to
bring you more content nextweek.
Until then, stay safe and staysauce.
Stay suspicious.

(01:08:39):
Stay suspicious.
Guys.
Stay suspicious.
Make sure the right X-ray wastaken.
Bye.
Bye.
Make the markable in before theytake it off.
Careful for a seven minutecooked chicken patty.
Stay suspicious of a longMcDonald's order.

(01:09:04):
Okay, three, two, one, stop.

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