To think a surgeon should ask permission before drawing on your body

[Purringkittenmama]

A while ago, I was referred to a breast surgeon for a lump to be investigated. Is it in any way OK, after being prodded for a few seconds, for him to turn to the (lovely) nurse with him, and say 'Do you have a pen?' before turning back to me and drawing on the area. Without asking me, warning me he was going to do this, anything. For the ultrasound people I think (although they seemed a bit taken aback to see that he'd marked it). AIBU to still feel angry/upset/ violated by this?

I certainly do not think that HCPs should treat people with complete disrespect. I am just trying to explain how it feels from the other side and that it is likely no disrespect was intended.
I have said that I would encourage you to give feedback so that the person can change their behaviour.
I expect they would be surprised and concerned to have upset you and would think about it the next time.

I would not have a clue that this is normal procedure and can easily imagine it would feel horrid. Why on earth didn't the surgeon explain what he was going to do. I'm sorry, but I'm sick of 'experts' thinking that they can do what they want with a person who comes for treatment, from midwives to gynaecologists. People feel vulnerable showing personal parts of their body to total strangers. Explaining what you're doing and why is simple politeness!

It's hard to explain but you have your examination routine and once you are in the zone of that if you are distracted you can miss stuff. I have also had the experience myself of a patient's comment suddenly making me see myself 'from the outside' (whilst examining his genitals) and it suddenly made me feel acutely embarrassed although there was no reason to at all.
Your routine should encompass putting people at their ease and explaining if you need to concentrate for a while ideally of course.

I recently had ultrasound at the breast clinic and whilst I did not like the experience, the consultant radiographer was business-like, professional, explained what he was doing was perfectly polite. And no biro was involved either. Manners cost nothing.

I also remember going to one of the less housetrained members of my GP partnership about 20 years ago with a worrying scab by my eyebrow that wouldn't go away and bled every time I brushed it which was several times a day.

He quickly diagnosed it as a seborrheic keratosis and referred me to dermatologist for specialised diagnosis.

I was a bit worried and asked: 'What's that then?'

He said: 'Why do you need to know?'

I said I was just curious like that. He grudgingly gave a sparse explanation.

He was dead right in his diagnosis and he was also right to refer me to a specialist just in case.

Would it have hurt him to say: 'I am pretty sure you have a benign skin lesion caused by sun exposure and though I don't think you're going to die, it would be a good idea to stay out of the sun in future.'?

Instead I thought I was going to die of malignant melanoma for six weeks.

Thanks for that. Cunt.

By the time I saw the dermatologist the scab had dropped off and healed. He did his tests but said: 'I'll write to you but I'm pretty much sure that's benign. Just try to be more careful in the sun in future.'

Yes, I can see your point of view mamadoc. Actually, I think your's must be a horrendous job to do. I wouldn't enjoy it. And let's hope that most involved are genuinely trying to help others.
I can see why some think IABU. I think perhaps it was that this surgeon's general attitude was just rubbish during the whole consultation, before, during and after the examination. Maybe that is why I am venting my spleen. Maybe I just need to take some deep breaths.
But whatever, I still do think it is only polite to ask before drawing on someone's intimate bits. Just a quick 'I need to mark the area for ultrasound if that's OK.'

Is some degree of physical contact not expected in a breast examination, then?? He was examining the extent of a tissue mass; he could hardly have phoned it in...

I think it's perfectly normal to draw on patients and have been drawn on myself, but I do think the doctor should just say before they do it. It's probably so normal for them that they don't stop to think but maybe they just need to be reminded.

When a doctor had to draw on my DD aged about 7, he made the mark into a smiley face. She tried to avoid it being washed off for weeks

This thread reminds me of the first time I had a procedure on my spine when the surgeon marked it 'L4/5^' The next day while helping me into the shower my DH said 'why have you got ASS written near your butt?'

He's human, he may have remembered to ask/inform 5, 6, 7,12 patients that day he was going to draw on them then just forgot to ask you.

I think this is very very trivial however given your current circumstances I can understand you seeing this as a much bigger deal than it is.

Move on from it OP it is not something you should be upset about.

I hope all goes well for you

Just a quick 'I need to mark the area for ultrasound if that's OK.'

That seems entirely reasonable to me. I have no idea why a doctor would have to be 'in the zone' and unable to explain what she was doing.

If that's what a doctor needed to be able to do conduct an examination, then I'd have to accept that. Not least because I'd be taken by surprise.

And after that experience I would insist on another practitioner.

Crystal The issue isn't disagreeing with the OP. It isn't even being unable to sympathise with her position/ feelings.

The issue is others sharing their experiences in an attempt to minimise the OP's distress.

Hesitant to post this as I appreciate it may come across as a bit abstract, but it's how I'm relating to the situation. I've experienced rape, but I wouldn't dream of bringing it up when someone was talking about the upset they've experienced during 'lesser' traumas. E.g. if someone said they had been verbally attacked or commonly assaulted, I wouldn't say 'well I've been raped, and if I had to be verbally attacked to avoid it, I would have been happy to do so.' Or 'I've been raped, so the upset you feel from your verbal attack is ridiculous.'

It isn't, or it shouldn't be, a competition between levels of upset/ distress. It should be possible to either agree or disagree with the OPs feelings, without bringing up examples of worse experiences to belittle their feelings.

Ketchup

I would see this as a normal part if the examination process.
And I'd be grateful he had taken the time and trouble to mark the area.

Before I was born (actually before I was even conceived) DM had a kidney removed. There was mixup somewhere along the line and she was horrified when she heard a nurse referring to the amputation that was about to take place. Luckily she was able to put them right and taken to a different operating theatre

Marking the area is done for your benefit.

YABcompletelyU
and yes, I've been there, had all the scans, and the lumpectomy.
I actually think it's a bit ridiculous the amount you do get asked by all manor of HCPs "Do you mind if I....". Oddly, no, I don't - that's what I've come for, just get on with it.

Far too little information here to make a judgment.

Did he draw something rude? What colour? Did he use a cheap pen (inexcusable) or an expensive one (stop whining you silly mumsnet person)? Did it make you look cheap? Did it make you look expensive? Enquiring minds need to know.

Op do you think that some of your feelings around your potential breast cancer were transferred onto the doctor?

Because that is what it sounds like to me.

"YANBU. It wouldn't hurt him to say: 'Miss/Ms/MrsPurring, I'm going to mark your breast with my pen to make absolutely sure the scan is done in the correct place.' Unfortunately some consultants are unable to speak Human to underlings, who include their patients.They should go into pathology if they can't be arsed to develop a decent bedside manner."^

^ This.

YANBU. One of the NHS 6Cs is communication, which means good communication with patients as well as collegues. When a health care professional is dealing with patients it is good practice to explain what they are going to do (before they do it), and explain why they are doing it, no matter how "minor" it is. It may be routine for them but the patient could be anxious and stressed, made worse by fear of the unknown. This is one reason why communication is recognised as very important within the NHS.

Soldier- Your poor DM. I hope she is still doing well now. Understand the whys of the situation- just think there are sensitive and insensitive ways of doing it.
Back- So assume it IS normal to be asked- at least in many HCPs eyes.
Sammasati- I think that's kind of the point- the people he is dealing with are in an incredibly vulnerable state. So surely a surgeon might try to show more sensitivity than usual. (Although other, more recent surgery I have had which was very minor, no risk of cancer etc., done under LA in five minutes on non-sensitive area (eyelid)- surgeon extremely considerate, DID ask if OK to mark area, explained what she was doing etc.)

Ethylred- sorry- meant to reply to you too- think it was just some old, leaky bic that the nurse had to hunt through her pocket for

When I had my cochlear implant done, the surgeon drew a big arrow pointing to the correct ear!! BUT he asked my permission first - it's only polite to let people know what you are going to do. I can see that perhaps it is not a big thing in the scheme of things when being tested for cancer, but courtesy should not be forgotten.

Reading this thread reminds me of why so many women feel guilty about feeling shame, upset, depression and loss of dignity / identity after traumatic procedures and exams. And why they so often feel they can't express or don't deserve to feel that way.

It's entirely reasonable to expect to be treated with dignity by medical professionals. All this 'be grateful and shut up as he was concentrating on saving your life' bollocks is exactly that. They don't entirely do it out of the goodness of their hearts. A patient is not a collection of body parts, or indeed one isolated part.

It sounds to me as if the being drawn on was just the culmination of purringkittenmama's experience of being treated in a very cavalier manner by someone who didn't see her as a person. Unfortunately there are some surgeons/medical professionals who do think like that. It's not a sign of professionalism and has little to do with their technical skills either. It's a failing not a good thing to be poor at communication.

I used to work in breast screening quality and so met a large number of breast surgeons. The ones that had the best results also most obviously cared about their patients. One for example always taped his consultations and gave his patients the recording as he had observed that when people are very stressed they find it difficult to hear and remember what they are told. Another asked his patients about their hobbies and activities so that he could take it into account when planning reconstructive surgery.

The ex-military reconstructive surgeon whose patients had to have pre and post consultation counseling was not held in high regard by his peers despite his technical skills. Bedside manners are important.

You poor dear, I've only just read your reply.

A leaky Bic that the nurse found in her pocket?? How utterly unhygienic, you should lie down and have a large brandy and soda. And tell your husband, don't bother leaving room for the soda.