SIR,- My indignation at Mrs. Catling's article en- titled 'Hospitals
versus Patients' is not so much over SIR,- My indignation at Mrs. Catling's article en- titled 'Hospitals versus Patients' is not so much over the criticism that she levelled at the hospital as that directed at her medical treatment. Before publishing her opinions of how she thinks her case should have been handled, would it not have been a wise policy to consult something in the way of technical advice?
There is nothing whatever in the article to suggest that Mrs. Catling's case was handled in anything except a proper fashion. The fact that an operation fcr appendicitis, in which the diagnosis was in doubt, was not carried out for seven hours after her admission to the hospital is not reprehensible. If Mrs. Catling wishes to be in the care of a surgeon who plunges a knife into her belly without proper investigation and due thought, then she must be prepared to take the consequences. And they may he dire. And in case she considers that there should have been no doubt I would refer her to Professor Ian Aird's synopsis on the subject : he lists twenty diagnoses that should pass through a surgeon's mind when he regards the 'acute abdomen'; in four- teen of which surgery is not indicated, and would be detrimental to the patient's recovery.
Mrs. Catling's objections to being examined by two surgeons arc singularly idiotic. In appendicitis of all things a second opinion, no matter how young and inexperienced that opinion may be, is invaluable. And a third opinion is always useful, if it happens to be standing in Casualty with nothing to do. Surgical diagnosis is an art. 'Intuition still plays its part, and always will do. A consultant may some- times be as wrong as the house surgeon is right.
The final chapter of this pathetic history is per- haps the most lamentable. To give general antesthe- Si-1 at a patient's insistence for a procedure which does not really warrant it is unforgivable. If Mrs. Catling cares to contact me I will give her some figures on the mortality of anaesthesia. She will probably consider them to be negligible; but we don't. You have only to see the peaceful and pathe- tic face of a young man of twenty-three who died under anaesthesia administered for a procedure that didn't really need it, and you never give 'general anaesthesia again, unless you have to.
I confess that when I read of the 'semi-transparent bugs with lots of little legs' my first thought was incipient delirium tremens. But if they really were there then the hospital's attitude certainly does sound apathetic.--Yours faithfully.
20 Royal Avenue, Chelsea, SW3
IL M. II. PIOCOCK
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