Intended for healthcare professionals

Fillers My most unfortunate mistake

Not always looking on the bright side of life

BMJ 2005; 330 doi: (Published 10 March 2005) Cite this as: BMJ 2005;330:584
  1. Ruth James, research fellow in vascular surgery (
  1. Nuffield Department of Surgery, John Radcliffe Hospital, Oxford

One of my first tasks as a new senior house officer in vascular surgery was to get a patient's consent for elective abdominal aortic aneurysm repair. He was a slim, active, very anxious 73 year old with a 5.6 cm asymptomatic aneurysm. He was intensely interested in the mechanics of the operation. I drew many diagrams and explained in detail the risks of surgery.

I told him there was a 5% risk of death, pausing to emphasise the gravity of the situation, and then solemnly described in painstaking detail the risks of embolisation—limb loss, paraplegia, bowel ischaemia, …

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