Dot Consent: Fill & Download for Free

I suppose it's the risk the patient's family is willing to take. I say this based on my own experience.So it was Dasain (biggest festival for us Hindus which we celebrate for 10 days, kinda like Christmas, in terms of importance). And it was the last day, the 10th day, the day of Tika. I was the only doctor in the hospital, as everyone else had gone home to celebrate Dasain.I got a call at around 10 AM for a case of Hematemesis (the patient was vomiting blood). I ran to the ER, leaving my half-eaten breakfast on the table. When I got there, my patient was a 95-year-old lady with a history of Dilated Cardiomyopathy (her heart chambers had dilated beyond repair and they didn't contract properly to push blood into circulation), Old Myocardial Infarction (heart attack in the past) with Diabetes. Oh, the number of medications she was on! It must have been about ten of them.As I probed deeper, I found out she hadn't passed stool or flatus in 2 days and she had been vomiting foul-smelling vomitus since that morning. The vomitus looked like coffee grounds. As I examined her abdomen, it was really firm and the normal bowel sounds we normally hear were very sluggish. I did a digital rectal examination, and the rectum was empty of feces.As per the picture I told the patient's family that she had two emergencies, a surgical one (looked like bowel obstruction) and a medical one, since she was vomiting blood. There was nothing we could do in our setting as we had neither a practising Internist nor a surgeon in our district. They were baffled. They asked me about her chances, if anyone would operate on her as she was a patient with heart disease. I answered honestly and said that there was a chance this would be it for her.She was in considerable amount of pain, and the patient's family requested us to do whatever we could in that situation. I sent for the labs we could locally and an abdominal X-ray, standing up and lying down. Her white cell counts were through the roof. She couldn't get up to do abdominal X-rays but the X-rays lying down showed signs of Small Intestinal Obstruction.I kept the patient nil per oral (no food/fluid by mouth), inserted a nasogastric tube free drain for decompression of the bowel. I kept her on IV fluids, antibiotics and painkillers. This old lady didn't improve, and even complained of more pain. There was nothing else I could do, and I told them so.After some time, they couldn't bear it any longer and asked for referral. I referred them to Kathmandu.After a month or so I was going for my evening walk when I met the son of my patient. I asked him if his mother was all right. He said that he took his mother to one of the best but one of the most expensive hospitals in Kathmandu. She had appendicitis which had undergone changes to become an Appendicular Lump which had caused her bowel to become obstructed and since she was of such old age, it was difficult to perform surgery. But without surgery the obstruction was not going to be resolved.The man signed a document called DOT consent (Death On Table, signed when there is a high chance of the patient dying during surgery) after which surgery was done. She was kept in ICU for 2 weeks and discharged after one more week.How awesome is that! I mean, a woman of such extreme old age with such co-morbidities, heart disease, diabetes — she got under the knife and made it out alive!I still find it hard to believe. She is 95 and still kicking! Such a badass.

“Backronyms” (in the false etymology sense) are fun. These are when you create a fake acronym for a word that isn’t an acronym itself, as a way of either “explaining” its origin or being funny. A famous example is the joke that “Bing” stands for “Because It’s Not Google”.Sometimes backronyms will be so common that people end up seriously believing them. One such case is the common myth that “news” stands for “North-East-West-South”, on the grounds that the news covers everything happening in all directions. (It’s actually just the plural of “new”, similarly to French nouvelles.)It may seem ridiculous that anyone could believe the “news” backronym, but some are even more pervasive than that. SOS is the best instance of this: it does not stand for “Save Our Ship” or “Save Our Souls”. It was chosen as the “mayday” code because “SOS” in Morse code is the extremely simple dot-dot-dot dash-dash-dash dot-dot-dot.The idea that it meant “Save Our Ship/Souls” came afterwards, probably as a mnemonic.Two other very common ones involve some of English’s most common swear words, “shit” and “fuck”.Stolen jointly from Snopes and Etymonline, I present the myth as it commonly appeared in frequently-forwarded email form:Fabulous bit of historical knowledge: Ever wonder where the word shit comes from … well here it isCertain types of manure used to be transported (as everything was back then) by ship … well in dry form it weighs a lot less, but once water (at sea) hit it, it not only became heavier, but the process of fermentation began again, and one of the by products is methane gas . . . and as the stuff was stored below decks in bundles you can see what could (and did) happen, methane began to build up below decks and the first time someone came below at night with a lantern . . .BOOOOM! Several ships were destroyed in this manner before it was discovered what was happening. After that the bundles of manure where always stamped with the term S.H.I.T on them which meant to the sailors to “Ship High In Transit”. In other words high enough off the lower decks so that any water that came into the hold would not touch this volatile cargo and start the production of methane.Bet you didn’t know that one.This is, well, this is bullshit.“Shit” is one of the most raw, Anglo-Saxon words English has to offer. It was the default word for defecation for a long time, appearing in Old English in the form scite, from the earlier Proto-Germanic *skītaz, ultimately from Proto-Indo-European *sker (“divide”), which, as I mentioned in my answer here, is also where we get the word “science” from.Now on to “fuck”. The two backronyms usually listed are “Fornication Under Consent of the King” and “For Unlawful Carnal Knowledge”. The story accompanying the former tells of a time when couples wishing to procreate had to ask for their king’s permission, as this was in the Middle Ages in a time when resources were scarce. The fewer mouths to feed, the better.Upon receiving permission, couples trying for children had to hang a sign bearing “Fornication Under Consent of the King”, or simply “FUCK”, on their door. It, as you might imagine, evolved from there.Except it didn’t. ’Tis an oft-told tale, but it’s folk etymology. Likewise, the story regarding “For Unlawful Carnal Knowledge” - i.e., that adulterers had to walk around wearing a sign carrying those initials - may only be true in a universe other than ours.The actual etymology of “fuck” is a fantastic search, if you get the chance to look into it. There are cognates in other Germanic languages, such as Norwegian fukka (“to copulate”) and Dutch fokken (“to breed”).Interestingly enough, this list doesn’t include German ficken, with the same meaning as the English word, as the word’s Middle High German ancestor, ficken, meant “to rub together”, before taking a run on the euphemism treadmill and ending up with its modern definition.Ficken itself may be from Proto-Indo-European *pewḱ-, meaning “stick” or “stab”; it’s possible “fuck” and its relatives do also ultimately share this ancestor. Another PIE root put forward is *pug-, meaning “strike”, source of Latin pugnus and English fist.For more on this, I’d suggest starting with Etymonline’s article on the word.Finally, as a word of advice, be wary of etymologies that link words to acronyms. Words such as “posh”, “swag”, or “Adidas” are often given backronyms as origins - see each word’s link for more.Though I would like to note two words that are from acronyms:Scuba: Self-Contained Underwater Breathing ApparatusLaser: Light Amplification by Stimulated Emission of RadiationThanks for asking!

Yes.I had an appointment with an allergy specialist. I arrived and was rushed into a room where they started drawing dots on me without any explanation of why. When the needles came out, I spoke up. The nurse immediately got the doctor who told me I was wasting his time. I just picked up my purse and left.Now I know what they were doing, allergy testing, but then I was a twenty something without a clue as to what was going on. It was 15 years before I’d go to another allergist.I’m a nurse now, and I make sure my patients understand what is happening at all times. Besides simple courtesy it’s actually required. “Informed consent”.