– It is time this nonsense stops!!!

Dear Editor,
I SAW a letter in the Stabroek News titled, ‘I consented to a vascular bypass at the back of the knee and woke up to a whole leg amputated’. First and foremost, I do sympathise with this patient. I can only imagine the physical and psychological pain he must be experiencing.

I went into the medical field for similar reasons. Many go into the medical field for the prestige and to be wealthy. While I am no vascular surgeon, if what this patient has written is true, and, frankly, I have no reason to doubt him, then it raises serious concerns. The first concern has to do with patient-informed consent. Any patient that is due for a surgery should be informed of the risks involved. The risks are then weighed with the benefits. If the risks far outweigh the benefits and the patient’s life is not at risk, then the patient is advised against the surgery. The fact that while the patient was unconscious on the table, the surgeon was running around to the relatives to get consent to amputate his leg would suggest that he was not adequately informed. Secondly, the relatives cannot give consent to such a procedure. It is only the patient who can do so, providing he has mental capacity, or the doctor, in the case of an emergency, has to act in the best interest of the patient.
This patient apparently had an aneurysm. This is simply a swollen blood vessel with thin fragile walls. Trying to correct that can result in the blood vessel bursting. This is similar to an over-inflated balloon. A little prick and it will burst. If that aneurysm burst during surgery, then the patient is likely to bleed to death. The only option is to lose the limb rather than losing the life. This should have been communicated to the patient.

In my opinion, if this risk was not communicated to the patient, then that was negligence on the part of the surgeon. It should not be a verbal consent; it should be a written and signed consent. The patient should also be given written information, in layman’s language, on the surgery proposed, the risk and the benefits. The fact is that most patients do not always remember what they are told, hence the need for written information.

I have been writing for years about what is happening in Guyana. I wrote about an ‘interventional cardiologist’ who is exploiting the poor. Mr. Donald Ramotar wrote about the said ‘cardiologist’. That cardiologist and Glenn Lall are best of friends. Someone in the higher echelons of society spoke to the Editor of Kaieteur News, Adam Harris, and was told that Glenn Lall passed a decree that none of my letters should be published. My factual letter on what this doctor was doing was removed from the Kaieteur News’ website. Subsequently, the so-called ‘interventional cardiologist’s life-saving exploits were publicised in the Kaieteur News.

The fact is that the Medical Council is weak. Those very doctors who are exploiting poor patients are part of the Medical Council. How can doctors investigate doctors? I have written on multiple occasions that the Medical Council needs revamping. I was the lone voice. Now, others are speaking out. They have attacked and have written to my boss in the UK, but I will not stop. I encourage patients to speak out and sue the clothes off their backs. To that patient whose leg was amputated, I say, no amount of money can replace what you have lost. Sue the hospital. Sue the doctor. It is time this nonsense stops! Patients are not cash cows! We are here to help and not exploit patients.

Regards,
Dr. Mark Devonish MBBS MSc MRCP(UK) FRCP(Edin)
Consultant Acute Medicine
Nottingham University Hospital, UK.