What is the reference to “Jumping around on a peg leg like a pirate”? In some instances, the physician might ignore the reference, viewing it simply as another of the patient’s emotional outbursts. In this case, Dr. Edelman follows it up, perhaps as a way of trying to make better contact with Jack’s world. What would you do if you did not know the meaning of the reference?
- Ignore it?
- Laugh, as it seems to be a joke?
- Confess your unawareness of the reference and ask for more information?
Although he is still ambivalent, Jack now seems willing to consider surgery. Does the conversation convey that he has given verbal consent? Should Dr. Edelman present him with the consent form, or would that unnerve this independent-minded person, leading him to refuse again? How much can family members or physicians try to influence a patient’s decision? What about Dr. Edelman’s decision to request a psychiatric consultation? What are the advantages or disadvantages of involving a psychiatric assessment?