Without Consent. Prahran 1976. Short Story.

Our story today with the title “Without Consent” is set in Prahran Melbourne in 1976. It is simply a shocking tale that should never be told. It should be hidden away because our medical student, Alice, is so ashamed of being a part of it. As an author, that is precisely why it should be told and heard by others. This story shines a light on barbaric normalised practices in medicine of old so hopefully they will not be repeated again. Listen to the very end to hear this important tale. 

Thanks for listening. Go to my YouTube channel @drdianerlesleywebster to hear more stories or read them in my latest novel “Four ways to die at Riverside Towers” available from Amazon and Kindle. Until next time, have a great day today and everyday. #shortstory #drdianelesleywebster #fourwaystodieatriversidetowers #thegoodguideforlife #simplestepsforhappiness #theartoflivingagoodlife #wellnessresilience

Transcript

Without consent. Prahran, April 1976

Our fourth-year group is composed of eight medical students. We are standing at the entrance to one of the surgical wards at the Alfred Hospital, Melbourne, looking awkward and waiting for our Surgical Consultant, Dr Tony Bassart to meet us for our weekly clinical teaching session.

 Dr Bassart arrived at a cracking pace and strode into the ward signalling for us to follow him. There was never a greeting ushered from Dr Bassart’s mouth; just a hand signal to move forward and follow him. We all followed him like a mother duck followed by her eight ducklings and approached the first bed in the six-bed ward.

 Dr Bassart did not say anything to the elderly lady lying in Bed 1. He immediately drew the curtains around the lady’s bed and then promptly turned his back on her and spoke to our group. 

“Today you are all going to learn how to do a PR examination”, Dr Bassart stated. “How many of you have done a rectal assessment before?”

No one raised their hand. 

“The only way to learn, is to do it and you need to do it on as many patients as you can; so, you can get a feel for it,” he continued very seriously.

We were all listening intently now. We had been based at Monash University, Clayton, for the last three years learning all the basic sciences of being a doctor. They were our preclinical years. Now we were in the last three years of our six-year degree course. These were our clinical years where we were based at Melbourne hospitals and clinics to learn all the essential elements of physical examination of a patient, investigation and management of their condition.

 We all knew that the PR, or per rectum examination, was an essential part of the general abdominal assessment. We would all be grilled on it before the end of our fourth year. We were expected to have done at least ten or more such examinations on actual patients; to know what to feel for and what the purpose was for such a personal, intimate and embarrassing examination of the patient. We were all asking ourselves, “How do we ever get practice at this sort of thing and how would a patient ever give consent for a mere medical student to do it?”

 I realised I had missed some of Dr Bassart’s words while I had been thinking about this.

“Each of you put on a disposable glove and put a little silicone jelly on your index finger then feel inside the patient for masses. You have to be systematic, feeling the anterior wall of the rectum first to the symphysis pubis, the pubic bone. Then feel laterally both sides and then posteriorly. In the female, you will take note of the vagina and uterus, anteriorly and superiorly. In the male, you will feel the prostate anteriorly and note its characteristics and size. Are we clear?”

I noticed he didn’t ask if there were any questions, just, are we clear? Of course, not one of the students said anything. We all felt intimidated by Dr Bassart’s manner. He was also a towering figure of a man, which didn’t help. 

“Alright, just start off then,” he said sternly. Only then, did he turn to the patient, Mrs Reid, and say, almost in passing,

“I’ve got a few medical students here today and they just want to examine your back passage.” 

 So that statement was Dr Bassart’s method for obtaining consent, I thought. I could see Dr Bassart’s name on the head of Mrs Reid’s bed, so obviously she was a surgical patient, who had been admitted under his unit of the hospital.

 The first two students proceeded through their exam. Now it was my turn. I did as I was told, and performed a systematic PR but I noticed how uncomfortable the patient seemed to be feeling. Surely Dr Bassart was not expecting this lady to have a rectal examination performed on her by eight medical students in turn?

 But Dr Bassart, just kept hand signalling to my fellow students to go forward and perform the exam. After five students had done their PR, I could see the lady lying on her side quietly sobbing. Surely, we will all stop now, I thought. Surely, we are not going to continue? Dr Bassart said nothing, and signalled to the last hesitant few students to go forward and perform the examination in turn.

 When we had finished, Dr Bassart approached the patient and simply said to her, 

“That’s all over now. Wasn’t too bad, was it? I’ll be back to see you tomorrow. Nurse will give me a run down on how you’re going.”

 He then pulled up the bed clothes around the patient and opened the curtains from around her bed. He signalled to our group to follow him and as we left the ward, I looked back at Mrs Reid who was on her side in the fetal position still sobbing quietly in her bed.

 What had I just been a part of? Why didn’t any of the students, including myself, raise an objection? I had been one of the perpetrators. I felt deeply embarrassed and ashamed of myself. Once we got into the clinical tutorial room Dr Bassart went to the white board and headed it ‘PR’ in big letters. He gave us a ten-minute tutorial on the procedure and what we would need to know for our exams and then he was questioning us on what our findings were with Mrs Reid.

 There was never a mention of the abusive act we had all just perpetrated on this dear elderly lady, in hospital, without her consent.