Ep 40-Who Owns The Body: The One Who Cuts Or The One Who Bleeds?

A knife that could take a leg in thirty seconds, a theater packed with spectators, and a patient who never got a say—our journey begins with Robert Liston, the unrivaled speed surgeon of the nineteenth century. From there we follow the messy, gripping path from pain-as-proof to consent-as-right, revealing how anesthesia muted screams without restoring voice, and how courts, scandals, and patient advocates forced medicine to listen.

If this conversation challenged your thinking, share it with someone facing a medical decision, subscribe for more deep dives, and leave a review to help others find the show. Then tell us: what would you want disclosed before any operation?
References

1. Liston, Robert. Practical Surgery. London: Longman, Orme, Brown, Green, and Longmans, 1837.
2. Lister, Joseph. “On the Antiseptic Principle in the Practice of Surgery.” The Lancet 90, no. 2299 (1867): 353–356.
3. Dickens, Charles. Household Words. Vol. 1, 1850. (Contains Dickens’s descriptions of Victorian surgical observation).
4. Wakley, Thomas. The Lancet, 1823–1850 editorial campaigns against surgical exploitation and hospital abuses.
5. Morton, W. T. G., and J. C. Warren. “First Public Demonstration of Ether Anesthesia.” Boston Medical and Surgical Journal 35 (1846): 309–317.
6. Percival, Thomas. Medical Ethics; or, A Code of Institutes and Precepts, Adapted to the Professional Conduct of Physicians and Surgeons. Manchester: S. Russell, 1803.
7. Historical and Academic Texts
8. Porter, Roy. The Greatest Benefit to Mankind: A Medical History of Humanity. New York: W.W. Norton, 1997.
9. Loudon, Irvine. Medical Care and the General Practitioner 1750–1850. Oxford: Clarendon Press, 1986.
10. Stanley, Liz. The Industrial Revolution and the Body: Labor, Injury, and Anatomy. London: Routledge, 2001.
11. Pernick, Martin S. A Calculus of Suffering: Pain, Professionalism, and Anesthesia in Nineteenth-Century America. New York: Columbia University Press, 1985.
12. Duffin, Jacalyn. History of Medicine: A Scandalously Short Introduction. Toronto: University of Toronto Press, 2010.
13. Reiser, Stanley J

Chapters

• 0:00 Cold Open And Northwoods Catch‑Up
• 3:52 Production Errors And Clean Re‑Release
• 5:44 Sponsor: Tona Activewear
• 7:33 Enter Robert Liston And The Age Of Speed
• 12:02 Spectacle, Suffering, And Missing Consent
• 17:02 Ether Arrives And A New Ethical Crisis
• 22:42 Power, Paternalism, And The Voiceless
• 28:52 Law Wakes Up: Schloendorff To Canterbury
• 36:22 Consent As Ritual Versus Reality
• 42:12 Chart Note: Robots, AI, And Shared Decisions
• 47:02 Modern Ortho’s Fault Lines And Conflicts
• 54:32 Hosts Reflect On Pain, Speed, And Ethics
• 58:22 Sponsor: Cheeky Night Guards
• 1:01:12 Medical Miss: The Orthopedic Odyssey
• 1:10:02 Wrap‑Up, Teasers, And Listener CTA

Transcript

SPEAKER_00: 0:52

Hello. How are you doing? Doing good in the neighborhood.

SPEAKER_02: 0:57

How are you? Good. Definitely. Nice to see you. Yeah. Glad that glad we have a little interweb so we can FaceTime and see each other's mugs while we talk.

SPEAKER_01: 1:10

And your phone must be getting more used to where the cell phone towers are because the last time we had a group FaceTime date, you kind of were just pixely and frozen most of the time, but we could hear you talking. But right now we've got a clear signal. So this is good.

SPEAKER_02: 1:30

I don't know. Sometimes I prefer the pixels, you know, just kind of get the they get the wrinkles out. Oh my gosh. Oh, so. How's the Northwoods? I mean, they're wooden. They're, you know, if you we're about, I don't know. Honestly, only four or five degrees colder than you, but the winds, the winds tear through here with no mercy. And so that makes it feel a lot colder. But the sun was out today and there were geese and eagles just soaring over my house. And I'm like, oh my god, that's a that's an eagle, you know. Yeah, no bears, no bees.

SPEAKER_01: 2:09

Good, good, good. Because ladybugs still don't know what to do if they came to the doorstep. So good we have a had a sighting.

SPEAKER_02: 2:18

People just keep telling me, well, you got a spray on them. I'm like, okay, well, all I have is the sound machine. So I'm gonna have to get some spray and get my Lysol out. Does Amazon go there? There you go, you're disinfected. Take that. 99.1% bacteria free. Off you go, bear. You're welcome. Happy hibernation.

SPEAKER_01: 2:39

You're so clean.

SPEAKER_02: 2:42

Oh my goodness. So well, we have some correction section, like major, major. So first time I released episode 39, part two of your episode about Beverly Alt, the cow that killed. It was actually a re-release of episode 38, part one. So then I pulled it and I re-released it. And somehow all the edits that I had done on that episode were gone. And so there was a lot of mishmash of us talking on top of each other. So I re-edited it and it will be re-released in a few days' time, probably at the same time as this episode, which is episode 40.

SPEAKER_01: 3:30

I was listening to that one, and I was like, honestly, it was hard to listen to because we were just talking over each other. But I was like, we don't talk over each other like this in real life. Like, how chaotic would that be? But when the tracks are laid over each other, it's just squabbling.

SPEAKER_02: 3:51

Oh it's horrible. It's horrible. So we even got, I think we got a bunch of downloads, 40, 50 downloads, of people who didn't complain. And I'm like, God bless your little cotton socks. I don't know why you wouldn't complain because that was awful. So let's try it again. You get a much cleaner audio this time around. And again, I'm still figuring out what the internet will and won't do here, and obviously wouldn't save my edits. So I think we're gonna be a Friday release pod because that's when I go back to civilization. So somehow it will let me record and I can edit stuff. But when it comes to uploading, that apparently takes the power of civilization.

SPEAKER_01: 4:35

So the entire Northwoods is like, what happened? The only signal we had is gone.

SPEAKER_00: 4:41

And you're like, this isn't even strong enough to upload.

SPEAKER_02: 4:46

I can download, but it can't up. I can't upity up. So so there you have it. Anything else you want to discuss?

SPEAKER_00: 5:00

I don't think so.

SPEAKER_02: 5:02

All right. Well, today we are discussing a topic that was brought up by one of our sponsors. Thank you, Chillion, about Robert Liston and surgical, the origins of surgical consent. So I don't really have any disclaimers or trigger warnings. I mean, other than it's kind of gory, some of it. And I will tell you that any of the information we talk about today, those resources will be cited in our show notes. But before we begin, I want to talk about Tona Activeware. I want to talk about Tona Activeware, founded by a former Lululemon designer and a competitive athlete. This company creates premium leggings designed specifically for women who train hard. And I just want to interject here. I also couch a potato hard. So I feel like I'm gonna give me in this group. These leggings are made with moisture, wicking fabric and four-way stretch technology that offer comfort, flexibility, and a flawless fit. Customers praise them for staying in place, feeling like a second skin, and enhancing their shape. With 100% fit and happiness guarantee, Tona promotes its leggings as the ultimate combination of style and performance. These will be the last black leggings you'll ever need. Visit www.tonaactive t-o-n a active.com for 16% off your order with our exclusive code STAYSUSPIUS. S-T-A-Y-S-U-S-P-I-C-I-O-U-S. Now on to our case. In the early 19th century, the word surgery carried a weight of dread. To enter an operating theater was to walk willingly towards agony. There were no anesthetics, no antiseptics, no surgical gloves, and little hope of survival. Yet crowds came to watch. It was a spectacle, an education and entertainment. One name drew bigger audiences than any other. And he embodied the contradictions of his age. He was brilliant, brutal, compassionate, and cruel. He was tall, broad-shouldered, impatient, and known to bark at medical students who hesitated near the table. When a nurse or assistant fumbled with an instrument, his voice could rattle the balcony. Time me, gentlemen. Liston's reputation rested on one skill: speed. In an era before anesthesia, speed meant mercy. A patient might faint or die of shock before the knife reached bone, so a surgeon's ability to cut quickly could save lives. He was rumored to remove a leg in less than 30 seconds, and he relished, he relished proving it. His operating room became known as the theater of velocity. Accounts from his students describe a blur of motion, the glint of steel, the saws, rasp, the smell of blood, and hot iron as assistants cauterized vessels. The audience leaned forward, some swooning, some applauding. And when it was over, Liston would glance at his watch and announce the time. Proud, detached, convinced that he delivered efficiency in place of empathy. But efficiency isn't consent. The patient, strapped to the table and held by assistants, rarely understood what was about to happen. Many were poor laborers whose crushed limbs were the product of the Industrial Revolution's new machines. Others were soldiers, prisoners, or charity cases. They signed no forms, they asked no questions, and they were given no explanation. The surgeon decided and the patient endured. Liston's fame grew from this imbalance. He was both a savior and a showman, a man who mastered pain without ever feeling it himself. Yet behind his success lay grim arithmetic. For every limb he saved, another was lost to infection. The word Listarian for antiseptic practice would not exist until decades later when Joseph Lister transformed surgery. Until then, Liston's theater reeked of decay. The famous story, perhaps apocryphal, of Liston's 300% mortality operation rate, captures the chaos of that world. He was amputating a leg before a packed house. Moving too fast, he severed not only the patient's limb, but two fingers of his assistant. As he swung the knife free, he slashed the coat of a spectator who collapsed on the spot, convinced that he'd been gutted. The patient and assistant both died of gangrene, and the spectator died of fright. Listen, unshaken, continued his work. To modern ears, his tale sounds absurd, almost comic, but it speaks to a truth. Surgery then was not medicine as we know it, it was controlled violence, and violence performed without permission becomes something closer to assault. The 1830s and 40s were an age obsessed with control. Surgeons controlled the theater, physicians controlled diagnosis, hospitals controlled the bodies of the poor, and patients had little recourse. The concept of autonomy, that a person has a right to make decisions about their own body, had not yet entered medical vocabulary. The body was property, to be repaired or discarded according to professional judgment. For Liston, that hierarchy was unquestioned. He saw himself as a craftsman, not a philosopher. His notebooks show meticulous attention to ligatures and incisions, but no reflection on consent. When he performed one of the first operations under ether anesthesia in Europe in 1846, he praised its utility, not its humanity. Pain, to him, was a technical obstacle, not a moral one. Still, even among his peers, whispers circulated about the brutality of surgical culture. The novelist Charles Dickens attended an amputation in 1847 and later wrote of the horror: quote, I saw the quivering flesh, the sweat, the white face of the surgeon, and I thought the patient had gone mad, end quote. Dickens' disgust reflected a growing public unease. Medicine's authority was vast, and its arrogance was increasingly visible. As hospitals expanded and medical schools multiplied, surgery moved from private homes into institutions. The operating theater became a stage for professional legitimacy. Yet, in codifying their authority, surgeons erased the patient's voice altogether. Silence had become part of the ritual. In that silence lay the oranges of every future consent form, because before there could be informed consent, there had to be recognition that something was missing, that the patient's will had been excised as cleanly as a limb. And the 19th century was not kind to the voiceless. In the world of medicine, to be poor, female, or uneducated was to surrender bodily control before you even entered the hospital. Surgeons like Robert Liston, bold and self-assured, stood at the pinnacle of the system. Their word carried not just medical weight but moral certainty. To challenge them was to risk ridicule, denial of care, or worse, the accusation that one's suffering was self-inflicted. In Britain's great cities, hospitals drew the working poor in droves. The Industrial Revolution was grinding bones as quickly as it was forging progress. Broken limbs from factory accidents, mangled hands cutting textile looms, and crushed feet from iron foundries filled the wards. Many arrived desperate, half conscious, begging only to live. Consent, if it existed at all, was presumed through their presence. You came here to be saved, the surgeon might say. Now let us do our work. The logic was simple and self-serving. Survival justified intrusion, need justified obedience. It was a system designed to protect authority, not autonomy. In teaching hospitals, patients became learning material. Surgeons demonstrated new techniques on their bodies, often before rows of students who took notes while blood ran onto the floor. The patient's face was rarely visible to the audience. It was covered or turned aside, as if anonymity made the act more acceptable. Those who survived sometimes spoke of it afterwards. The horror of being cut open while consciousness flickered, the humiliation of being observed like an animal under a knife. For women, the situation was even worse. In an era when propriety dictated that even the mention of a woman's body was indecent, medical examination was a paradox. Modesty demanded silence, and silence enabled exploitation. Gynacological procedures were performed without explanation or anesthesia, justified by the same paternalism that defined all medicine. It's for your own good. Across the Atlantic, the American South offered its own horrifying version of surgical progress without consent. The surgeon J. Marion Sims, later hailed as the father of modern gynecology, conducted repeated experimental surgeries on enslaved black women between 1845 and 1849. They had no anesthesia, no right to refuse, and no voice in the records that immortalized his name. Sims claimed his work was in pursuit of medical advancement. History records it as one of the clearest violations of human dignity in medicine's past. Liston and Sims never met, but they practiced under the same philosophical sky, one where the suffering of some could be rationalized as the education of others. Orthopedic surgery, too, often relied on captive or impoverished patients. Military hospitals, prisons, almshouses, those became laboratories for improvement, quote unquote. The absence of consent was not seen as cruelty, it was seen as a necessity. Surgeons argued that common people lacked the education to make medical decisions. The patient knows not what is best, wrote an Edinburgh physician in 1839. He is the subject of his disease, not the master of it. End quote. Even the language of surgery reflected ownership. Surgeons took limbs, claimed cases, saved patients, as if they were possessions, and patients internalized the hierarchy. Gratitude became expected to risk being labeled noncompliant, ungrateful, or hysterical, and those labels would persist into the 20th century, mutating but never disappearing. In Lisnon's Day, surgery was considered a masculine art, a test of nerve and strength as much as knowledge. Surgeons prided themselves on courage, not compassion. The patients' cries were proof of vitality. The surgeon's speed was proof of skill. Pain was not to be avoided but endured. Endurance was a measure of character. And those who broke down, those who begged for mercy, were mocked. Accounts survive of students laughing as patients screamed, of surgeons telling them to hold still or die. These stories are difficult to read today because they reveal the thin line between medicine and sadism when empathy is removed from the equation. But not all surgeons were blind to the moral vacuum around them. Some, particularly in the mid-century reform movements, began to question whether speed and spectacle were virtues or vices. The Quaker physician Thomas Wickley, founder of The Lancet, railed against the corruption and cruelty he witnessed in London's hospitals. His publication exposed unnecessary operations, untrained assistance, and the prioritization of showmanship over safety. The poor, he wrote, are made the subjects of experiments, which, had they the money, would never be attempted upon them. That phrase, subjects of experiments, captured the essence of the problem. Consent could not exist in a relationship built on power disparity. When a patient's survival depends on obedience, freedom is an illusion. Orthopedic surgery, by its nature, magnified the imbalance. The procedures weren't invasive and permanent. To lose a limb or have it reset meant losing not just flesh but livelihood. A botched amputation could mean death from infection or poverty from disability, and yet patients rarely knew their options. The word alternative was foreign to surgical vocabulary. The doctor decided and the patient complied. In rural Britain, so-called bone setters were self-taught healers who manipulated fractures without formal training. They continued to serve the working class and were scorned by professionals like Liston, but trusted by locals. They explained their methods in plain language and often listened to their patients' fears. To orthodox surgeons, that approach was unscientific. To patients, though, it was humane. The clash between formal surgery and folk medicine revealed more than a divide in technique. It was a divide in trust. And trust, once broken, leaves scars deeper than any incision. The early Victorian era also saw the rise of medical paternalism as an explicit ideology. Doctors began writing about the moral duty to act in a patient's best interest even against their will. The term benevolent deception entered medical ethics. The idea that withholding information could protect a patient from distress. If a patient feared surgery, the doctor might lie, assuring them it was only minor. If the diagnosis was fatal, the doctor might conceal it to spare grief. The line between compassion and control blurred completely. And so the foundations of modern informed consent, communication, understanding, voluntariness, were not only absent but actively resisted. The culture of medicine rewarded decisiveness and punished hesitation. The phrase, do no harm, was interpreted narrowly. Harm meant physical injury, not moral violation. So cutting without consent was not considered unethical, it was considered efficient. In this world, the surgeon's ego filled the space where dialogue should have been. And Robert Liston embodied that confidence perfectly. He was known for his temper. He was quick to anger and quicker still to act. A student once had hesitated during an operation, and Liston snapped, If you can't hold him, I will. He seized the patient himself, completed the amputation in half a minute, and left the room without a word. To his colleagues, it was another demonstration of his legendary efficiency. To us, it reads, domination disguised as skill. But Liston was not a monster. He was a man of his time, driven by the belief that speed saved lives. In a brutal world of infection and agony, he might have been right, but the moral architecture of his practice, the absence of patient agency, set the stage for a century of ethical reckoning. By mid-century, reformers were beginning to imagine a different model of medicine, one in which patients could question or even refuse. But change came slowly and often only after catastrophe. The silence of patients would eventually be broken not by surgeons, but by victims and their advocates. Lawsuits, scandals, and public outrage would do what moral appeals could not do, force medicine to listen. But before that revolution could begin, another transformation reshaped surgery entirely was the discovery of anesthesia. Anesthesia promised to remove pain, but it also introduced a new problem. When patients can no longer speak, who would speak for them? The age of ether would silence the screams, but it wouldn't restore the patients' voices. On October 16, 1846, in the operating theater of the Massachusetts General Hospital, a dentist named William Morton administered sulfuric ether to a patient about to have a neck tumor removed. The surgeon, John Collins Warren, made his incision. And for the first time in recorded history, the patient did not scream. When it was over, Warren turned to the stunned audience and said, Gentlemen, this is no humbug. Within months, words of this miracle, painless surgery, spread across the Atlantic. By December, Robert Liston himself was preparing to test it in London. He was no sentimentalist, but he recognized the potential because pain had been the surgeon's eternal enemy. So to conquer it was to approach Godhood. Liston's patient was a young man with a diseased leg. The operating theater was full, as always. Morton's technique had been described in newspapers, and the air buzzed with expectation. Liston, skeptical but intrigued, ordered the ether apparatus readied. The patient inhaled, and the crowd fell silent. When Liston made the first incision, the man did not move. There was no cry, no convulsion, just stillness. Liston completed the amputation in his usual half-minute and turned to the audience with a grin. Gentlemen, he said, this Yankee Dodge beats meserism hollow. I don't even know what that means.

SPEAKER_01: 23:41

I was gonna say I don't know what that means, but sure.

SPEAKER_02: 23:45

It was the triumph of science and the beginning of a new ethical crisis. Because anesthesia changed everything. Pain, once the defining experience of surgery, vanished, but so too did the patient's ability to communicate. Under ether or chloroform, they were completely passive and unconscious, voiceless and defenseless. Surgeons already accustomed to control now had total dominion. They could do whatever they wished, unseen and unquestioned. At first, this power was intoxicating. Operations that were once impossible due to pain, like deep abdominal surgery, lung bone reconstructions, complex amputations were suddenly feasible. The surgeon's reach expanded, but so did the potential for abuse. No one asked patients if they understood what anesthesia entailed. No one could explain the risks because the risks were barely known. Ether could suffocate, chloroform could kill instantly, but excitement over discovery drowned out caution. In the press, reports of painless miracles fueled public demand. Few questioned whether patients had truly consented to these experiments. In hospitals, across Britain and America, surgeons began testing new anesthetic agents on anyone available, often the poor, soldiers, or prisoners, and when thus when deaths occurred, they were dismissed as unfortunate necessities of progress. The notion that a patient might have a right to refuse was almost absurd. Liston's successful ether operation was amongst his last. He died in 1847, likely from a ruptured aneurysm at age 53. But he lived long enough to witness surgery's transformation from brute endurance to controlled unconsciousness. Ironically, the new age that he helped usher in would deepen medicine's moral contradictions. Before anesthesia, the cries of patients were a constant reminder of their humanity. Surgeons could not ignore suffering when it filled the room. Now, silence reigned, and with it a dangerous illusion that because pain had been conquered, consent had been achieved. But the truth was the opposite. Patients had become subjects in a new kind of experiment, one that blurred the boundaries between compassion and control. In the early years, doctors debated whether or not they should use anesthesia, when and on whom, and some argued that pain had moral value, that to remove it was to tamper with divine purpose. Others believed only respectable patients deserved it. The poor and the condemned might not. These debates were rarely about what the patient wanted. They were about the physician's authority. And yet, beneath the progress, dissenting voices began to stir. Clergymen, journalists, and a few physicians questioned whether unconscious patients could ever give true consent. Was it ethical, they asked, to perform additional procedures while a patient lay anesthetized? Ones that they hadn't agreed to before? The temptation was strong. Once the patient was under, why not fix a few other problems while you were down there? Sure, why not? By the 1850s, such opportunistic operations were common. A surgeon might begin with a simple tumor removal and decide mid-procedure to explore deeper. Consent was viewed as a flexible concept. The patient's body, anesthetized and silent, was considered an open field. This problem wasn't confined just to orthopedics, but it was especially evident there. Orthopedic patients often required repeat surgeries, bone resets, or amputations, and surgeons prided themselves on decisive action. A delay could mean infection, hesitation could mean death. In that high pressure environment, asking for permission seemed like a luxury. But something was changing outside the operating room, something that would eventually challenge medicine's paternalism, the rise of the individual as a moral and legal entity. The Industrial Revolution had not only reshaped labor, it had reshaped identity. Workers were organizing, women were demanding education, citizens were questioning monarchy and church. Autonomy, the idea that one could own one's choices, was entering public consciousness. And sooner or later, that idea would collide with the operating table. For now, however, the old order held firm. In hospitals, the surgeon was still sovereign, the patient was still a body to be acted upon. And anesthesia, for all its benefits, had deepened that inequality by removing the patient's final instrument of resistance, the ability to say stop. One anesthetist in 1853 described his role bluntly. I am to the surgeon what the keeper is to the lion tamer. I restrain the beast. He meant it metaphorically, but the metaphor was telling. The patient was still seen as something to be subdued and not to be understood. The introduction of antisepsis in the 1860s by Joseph Lister, who was no relation to Liston, though their names are forever linked, added another layer to the illusion of progress. Infection rates plummeted, surgery became safer, hospitals grew in prestige, but while the body was finally protected, the mind, the personhood of the patient, remained exposed. Throughout the second half of the 19th century, medicine's technological leaps outpaced its ethics. Hospitals became more bureaucratic, surgeons more specialized, and patients more numerous. The relationship that once existed between healer and sufferer was replaced by a system, efficient, impressive, and deeply impersonal. Orthopedic surgery exemplified this mechanism of care. The new tools, the saws, clamps, bone screws, transformed the body into a kind of machine, something to be repaired rather than healed. The language followed suit. Surgeons spoke of adjustments, reconstructions, fixations, and the patient disappeared into anatomy. A report from St. Bartholomew's Hospital in 1875 described patients as cases identified by injury rather than name. Case of compound fracture, male, age 32, case of hip disarticulation, successful. There was no mention of consent, no note of discussion. The record was clinical, complete, and cold. By the late Victorian era, a few dissenters were beginning to articulate what would later be called medical ethics. They argued that progress required not only skill but conscience. The Scottish physician Thomas Percival, whose medical ethics, 1803, was one of the first attempts to codify professional behavior and emphasize respect and communication. But his influence went. Amid the surgical revolution. Only toward the century's end did his ideas gain traction as scandals forced public scrutiny. One such scandal erupted in 1889 when a woman in Edinburgh discovered that her husband's body had been used for dissection without permission after his death in hospital. Outrage spread through the newspapers, reigniting fears of body snatching, the notorious practice of stealing corpses for medical study. Though the Anatomy Act of 1832 had legalized the use of unclaimed bodies, the public remained uneasy. Consent, it seems, still stopped at the hospital gates. As the century turned, a few visionary doctors began to sense the approaching reckoning. They saw that the authority they cherished could not last forever. Science was advancing too quickly, and society was questioning too loudly, and law was beginning to take notice. The seeds of legal accountability were already sprouting. In the 1890s, a handful of civil cases in Britain and the United States tested the idea that unwanted medical intervention could be considered assault. The courts were inconsistent, often deferring to physicians, but each case chipped away at the notion that medical expertise conferred moral immunity. When the 20th century dawned, surgery had entered the modern age, sterile, anesthetized, and professionalized. The horrors of Listen's bloody theater were relics of the past. But the spirit of unquestioned authority remained alive and well. Surgeons no longer needed to be fast, they needed to be decisive. The scalpel was cleaner, but the hierarchy was unchanged. Patients were still rarely told everything and still expected to trust completely, still treated as vessels for medical success. It would take not just scientific innovation but social upheaval, the rise of patient rights, feminism, and legal activism to finally challenge that hierarchy. But before those battles could be fought, one more step had to occur: the transformation of consent from moral courtesy into legal mandate. And that transformation began, dear Ellie Katz, in a courtroom. By the turn of the 20th century, surgery had conquered pain, infection, and but not power. Hospitals are modern, surgeons wore clean coats, operations that were once unimaginable, like joint replacements, spinal fusions, internal fixations, were now becoming possible, and yet the moral equation remained familiar. Doctors decided and patients complied. The idea that a patient had the right to understand, question, or refuse treatment was still radical. Medicine was guided not by autonomy but paternalism, the belief that the doctor knew best, even against the patient's will. The Hippocratic oath, once a call to conscience, had become a shield against scrutiny, and like all shields, it sometimes hid more than it protected. But the world outside medicine was changing faster than the profession could contain. Industrialization had created not only machines but laws. Workers were suing employers, women were demanding suffrage, citizens were discovering the power of rights, and sooner or later that language would find its way into the hospital. And that spark came from a single woman, Mary Schlomendorff. In 1908, Schlohendorf was a 40-year-old woman admitted to a New York hospital with stomach pain. Doctors discovered a tumor and recommended surgery. She refused. She agreed to an examination under anesthesia. She explicitly stated that she did not consent to any operation. The doctors nodded and operated anyway. When she awoke, her tumor was gone, along with her trust in medicine. She sued the hospital alleging assault. The court's decision, delivered in 1914 by Justice Benjamin Cardozo, became one of the most quoted passages in medical law. Quote, every human being of adult ears and sound mind has a right to determine what shall be done with his own body, end quote. And with those words, the modern concept of informed consent was born. The case of Schlorendorff versus Society of New York Hospital established a principle that seems obvious today, but was revolutionary at the time, that unwanted medical treatment constitutes a form of battery. Yet the ruling came with a caveat. The hospital itself was not held liable, only the doctors. This was a reflection of the era's legal conservatism. But even so, Cardozo's statement echoed far beyond the courtroom. It forced medicine to confront an uncomfortable truth, that a well-intentioned act could still be a violation. For surgeons, this was a seismic shift. The operating room, long considered a sanctuary of authority, was now a potential site of legal peril. Consent could no longer be assumed, it had to be proven. Still, the transformation was slow. For decades after Schlowendorf, doctors continued to interpret consent loosely. A patient's signature on a general form or even a verbal yes was treated as carte blanche. Explanations were minimal and questions were discouraged. The imbalance of knowledge between physician and patient made true understanding nearly impossible. Orthopedic surgery, in particular, was fertile ground for conflict. The procedures were complex, the outcomes uncertain, and the risks, infection, paralysis, loss of mobility, were significant. Surgeons prided themselves on technical innovation, often pushing boundaries before ethics could catch up. One of the earliest legal challenges in orthopaedic medicine came in the 1930s when a surgeon performed a spinal fusion without the patient's informed agreement about its permanence. The patient, unable to bend afterwards, claimed she hadn't understood what the operation entailed. The court sided with a surgeon, declaring that the patient's ignorance was not his fault. The doctor, they said, had acted in good faith. Good faith. That phrase would dominate medical law for half a century. It implied that as long as a doctor believed he was helping, consent was secondary. It wasn't until the mid-20th century that this paternalistic notion was finally dismantled. The next turning point came from another patient whose story echoed Schlohendorf's. In 1957, in Salgo versus Leelone Stanford Junior Board of Trustees, a man underwent a diagnostic procedure that left him paralyzed. He sued, claiming that the physician failed to warn him of the risk. The California court agreed, coining a new phrase, informed consent. The court ruled that physicians have a duty to disclose any facts necessary for a patient to make an informed decision, not just that consent be obtained, but that be informed. The difference was monumental. It recognized the patient was not a passive subject, but that they were an active participant in their own care. Yet even this case left ambiguity. How much information was enough? Should the doctors list every risk or only those that are deemed material? The law struggled to define the line between reassurance and overwhelm. And that question would find its answer in 1972 in a case that changed medical ethics forever. Canterbury v. Spence. Jerry Canterbury was a 19-year-old clerk who underwent spinal surgery for back pain. His surgeon, Dr. William Spence, didn't warn him that paralysis was a possible risk. After the operation, Canterbury fell from his hospital bed and was left paralyzed from the waist down. He sued, arguing that he would not have consented to surgery had he known the risk. The court sided with Canterbury, but more importantly, it shifted the standard of disclosure from the physician's judgment to the patient's right. The ruling declared that what must be disclosed is not what the doctors think is relevant, but what a reasonable patient would want to know. This was a quiet revolution. For centuries, medical ethics had been guided by the doctor's conscience, and now it was guided by the patient's perspective. The ripple effects reached every corner of medicine, including orthopedics. Suddenly, surgeons were required to explain in plain language the potential risks, benefits, and alternatives to every procedure. A hip replacement wasn't just a technical operation, it was a contract, an agreement between equals. But equality on paper isn't equality in practice. Even as consent forms multiplied, true understanding lagged behind. Studies in the 1980s and 90s revealed that most patients remembered less than half of what the doctors told them before surgery. Anxiety, unfamiliar terminology, and the power dynamic of the consultation room all conspired to limit comprehension. And so the ritual of consent became just that: a ritual. The surgeon's authority, dressed now in the language of law, persisted. In orthopedics, this tension was particularly acute because of the irreversible nature of many procedures. A fusion cannot be undone. A prosthetic joint, once implanted, becomes part of the body's story forever. And when outcomes fail, patients turned again to the courts. The late 20th century saw a wave of lawsuits alleging inadequate consent in orthopedic cases. Patients claimed they hadn't been told about potential loss of motion, nerve injury, or the need for future revisions. Surgeons countered that full disclosure would only frighten patients into refusal. The old paternalism resurfaced, cloaked in concern. Judges, however, were less sympathetic than before. In one landmark 1980s case, a surgeon who performed a total knee replacement without explaining the likelihood of chronic pain was found liable. The court ruled that omitting probable complications was equivalent to deceit. The message was clear. Paternalism was no longer protection, it was negligence. As the legal landscape evolved, medical institutions began rewriting their policies. Hospitals introduced standardized consent forms, educational brochures, and mandatory cooling off periods before elective surgery. Medical schools incorporated ethics training into their curriculum, teaching young doctors that technical skill alone was not enough. And yet, for all the progress, the ghost of Liston's era lingered. Consent remained a performance, a few minutes of explanation before the patient signed, anesthetized, and was silent once more. The ethical questions grew even murkier with advances in technology. In orthopedic surgery, the rise of spinal implants, robotic assistance, and experimental prosthetics blurred the line between innovation and experimentation. Patients often consented to routine procedures that involved untested devices or techniques. The distinction between surgery and research became perilously thin. In 1998, an investigation into a series of failed spinal implants in the United States revealed that many patients had not been told their devices were part of an experimental program. They had signed standard surgical consents, unaware that their surgeries were also data points in a corporate study. The scandal reignited debate about whether true informed consent was even possible in an era of commercialized medicine. By the dawn of the 21st century, the phrase informed consent had become ubiquitous, a legal, ethical, and cultural touchstone. But the struggle between knowledge and authority persisted. Surgeons now disclosed more information than ever before, yet patients remained dependent on trust. The complexity of modern medicine meant that no lay person could fully grasp every risk. And so consent evolved once more from a document to a process. Hospitals began emphasizing shared decision making, a model that sought to restore dialogue. Instead of a one-way lecture, it was meant to be a conversation, in return, in some ways, to the lost humanity of medicine before the machines, before the speed. It was finally an acknowledgement that control over one's body can't exist without understanding. But the question remains: could a system built on centuries of hierarchy truly learn to listen? As the 21st century unfolded, the answer would depend on whether medicine could remember what Robert Liston, in all his speed and certainty, had never paused to ask. What does the patient want? And now it's time for a chart.

SPEAKER_03: 43:46

Ooh, get a girl.

SPEAKER_02: 43:48

Welcome to the Chart Note segment where we learn about what's happening in medicine and healthcare. If Robert Liston's era was defined by speed and silence, the newest generation of orthopedic surgery may be defined by precision and partnership. Across the US and Europe, hospitals are beginning to pilot patient interactive robotic systems for joint replacement and spine surgery. Unlike traditional robotics, which respond only to the surgeon's hand or program pathway, these systems incorporate real-time feedback from the patient's anatomy and even their own movement data recorded before surgery. One of the most promising examples is the Mako Smart Robotics platform, used for knee and hip replacements. Before surgery, patients walk on pressure-sensing mats that create a detailed motion map of how their joints function in daily life. That map guides the robot during the operation, allowing the surgeon to restore that person's unique alignment, not just textbook anatomy. It's a shift from the one size fits all to one body at a time. Meanwhile, researchers at the Cleveland Clinic are developing systems that integrate AI-assisted consent tools into surgical planning. These platforms use conversational AI to explain procedures, risks, and alternatives in plain language, confirming comprehension through interactive questions. Patients can review their choices later online, replay explanations, or share them with the family before they sign. Early studies show a 30% increase in patients' recall of surgical risks and satisfaction with their decision. In other words, the technology is doing what the paperwork never could. It's making consent a true dialogue. Even more remarkable, several rehabilitation centers are trialing collaborative prosthetics. These are limb systems that adjust automatically to patient intention through neural feedback and microsensors. These aren't just tools but partners learning from the user's movement and comfort levels over time. The goal isn't just mobility, but agency. And taken together, these innovations suggest that the next frontier of orthopedics won't just be mechanical, it will be relational. The scalpel is becoming smarter, but so is the conversation around it. Two centuries ago, Robert Liston demanded his patients hold still. Today, medicine is learning to listen instead. Back to the case. By the early 21st century, orthopedic surgery had become a marvel of precision and engineering. There were titanium joints, computer-assisted defecation, 3D printed implants. These turned the body, which were once the surgeon's battlefield, into a canvas of possibility. Yet, beneath the sleep technology and glossy patient brochures, the same old fault line remained. The uneasy relationship between trust, knowledge, and power. Modern orthopedics is among the most common elective specialties. Millions undergo hip and knee replacements every year. Spinal fusion, fracture fixations, rotator cuff repairs all promise mobility and relief from pain, but each carries a risk, and risks are not always fully understood or clearly explained. Informed consent, once the rallying cry of ethical reform has become a paradox. On paper, it is absolute. In practice, it often falters under pressure. Surgeons, bound by law to disclose everything, face the reality that too much information can overwhelm patients. And patients, anxious and hopeful, will just hear what they want to hear. The consent conversation becomes a negotiation between clarity and comfort, between truth and reassurance. And within that negotiation, old habits find fertile ground. In 2011, a New England Journal of Medicine study revealed that nearly 40% of orthopedic patients could not recall the main risks of their surgery just a day after signing their consent forms. Some couldn't even remember which joint was being replaced. Others were unsure whether alternatives like physiotherapy had even been discussed. And the signatures were there, but the understanding was not. In 2007, a 54-year-old Florida woman underwent what she believed was a routine spinal decompression. Postoperatively, she discovered her surgeon had also implanted experimental rods that were not yet FDA approved. He defended it as a therapeutic privilege, the notion that full disclosure might have scared her into refusing a beneficial procedure. The court disagreed. The woman won a multimillion dollar settlement, reigniting debate over how much choice patients really have when they're unconscious. Therapeutic privilege sounds archaic, a relic of the paternalistic 19th century, but yet it persists. The idea that a doctor might withhold information for the patient's good still appears in malpractice suits, ethic reviews, and hospital policies. It's the modern echo of list uncertainty, rephrased in clinical language. In orthopedics, where interventions are often reversible, these tensions are magnified. Patients are told prosthetic joints that last 15 to 20 years, but they're rarely warned that some fail far sooner. Spinal fusions are marketed as solutions for back pain, although large studies show long-term outcomes often match conservative care. And once the screw and cages are in place, there's no going back. A 2012 British Medical Journal, Expose, revealed unnecessary orthopedic surgeries in private hospitals. Surgeons were recommending operations for patients who hadn't exhausted non-surgical options, sometimes motivated by financial incentives or surgical volume quotas. The report concluded that informed consent had become a formality rather than a safeguard. Patients weren't being lied to, they were being led. Industry influence began shaping the very tools of consent. Device manufacturers sponsored patient educational materials that highlighted benefits and softened complications. Brochures bore company logos, not hospital crests. And the relationship between surgeon, patient, and corporation blurred into something resembling marketing more than medicine. The rise of surgical entrepreneurship. Doctors holding shares in the devices at the implant added new ethical landmines. In 2013, the U.S. Department of Justice investigated dozens of orthopedic surgeons for failing to disclose financial ties to device makers. Some had received millions in consulting fees for promoting implants that were later found to have high failure rates. Patients consented to surgery, believing recommendations were medical, not financial. Hospitals tighten disclosure rules, but transparency remains uneven. Many patients assume informed consent includes financial conflicts, but it usually doesn't. The form explains the surgical risks, not the motivation. The most haunting violations are invisible, not wrong limb surgeries or severed nerves, but choices quietly taken away. In 2015, an Australian study of orthopedic trauma cases found that in 80% of emergencies, consent was obtained under distress, patients medicated, in pain, or disoriented. The authors concluded informed consent in acute orthopedics is more symbolic than substantive. The body is broken, the clock is ticking, and the surgeon holds all the time that remains. Yet modern orthopedics isn't devoid of conscience. Many surgeons are deeply aware of these problems and struggle to balance efficiency, empathy, and disclosure. Dr. Fiona Kelly, an orthopedic consultant in London, put it best. We talk about consent as if it's a legal event, but it's a relationship event. The forum isn't the consent, the conversation is. Some even record consent sessions to ensure transparency. These innovations aim to restore what surgery's technological triumphs have often obscured, the human voice. Still, the ghosts of paternalism linger. When fear or trust silences questions, when pressure masquerades as confidence, informed consent becomes theater once more. The instruments are cleaner, the language gentler, but the silence is the same. The persistence of these issues shows how deeply they're woven into medicine's DNA. The very qualities that make a good surgeon, decisiveness, certainty, control, can also threaten a patient's autonomy. A hesitant surgeon is frightening, a confident one is comforting, even when they're wrong. In that emotional calculus, consent is fragile. Orthopedic surgery magnifies this tension because its consequences are visible and permanent. Patients wake up to find their bodies altered, they're shorter, straighter, heavier, stiffer, and they must reconcile what they agree to, in theory, with what they now inhabit in reality. For some, that realization is empowering, and for others, it feels like betrayal. The ethical challenge for modern orthopedics is not merely to inform, but to translate, to bridge the gap between medical knowledge and human understanding. An assigned form can't do that. Only honest, time-rich conversation can. But time is the one resource medicine has made scarce. Liston prized speed because it meant survival, and today speed means efficiency. The motive has changed, but the effect is eerily familiar. And so history loops back on itself. The instruments gleam the room's homotechnology, but the oldest question in medicine remains unanswered. Who owns the body? The one who cuts or the one who bleeds?

SPEAKER_01: 54:19

Very good coverage of this background of informed consent. And thank you, Jillian, for suggesting this. I did not have a background on this. And the way my entire body had the absolute shivers when I thought about medicine pre-anesthesia era, because obviously that was a long time.

SPEAKER_02: 54:40

But I mean, if you gotta do it with anesthesia, don't you want to be fast?

SPEAKER_01: 54:44

I only know the world with anesthesia and oh my gosh, having the amputation completed in 30 seconds. But I like when you were reading that, I was like, oh my god, I can't stand like you know, like a a paper cut hurts. Or like when you're cooking bacon and you get snapped with like the bacon grease flinging off, like how much that hurts. I'm just thinking about like someone whacking off a lemon 30 seconds. Ah my god.

SPEAKER_02: 55:11

On my so on my four-hour commute back to my week home, my week, the home I stayed during the week, I couldn't help it. I it was it was rural. I was hungry. There was a McDonald's. I pulled over. It took them seven minutes to make this McChicken. Oh my god. And I was like, oh my God, if it's gonna be crap food, at least make it fast. So they must have just pulled it out of like 160-degree fryer because as soon as I bit into that chicken patty, it it just blew like a whole burst of hot grease onto my face. I have a secondary burn on my face. I would have been a finer little price you pay for eating fast food, I guess. But yeah.

SPEAKER_00: 56:08

I would have been like, it wasn't even fast. I should have just waited. Now my face is burned.

SPEAKER_02: 56:15

Oh, I would have died from what did they say? Die from fear or fright or pain. I probably would have been like a witness to somebody having that done and died of shock. I I wouldn't have survived.

SPEAKER_01: 56:30

Yeah, I thought that was interesting. Like, and then how many people still died from or like he saved one limb, but then the other one.

SPEAKER_02: 56:38

Yeah, he had like a 300% mortality rate. So you were more likely to die than not, but at least he was fast about it. Oh gosh.

SPEAKER_01: 56:51

It made me think too. Adam recently had surgery. And when I talked to the surgeon after his procedure, he had said, you know, normally I would have wanted to do this additional procedure while in there, but I couldn't get informed consent. So obviously I didn't. So like he'll have to come. You have an ethical surgeon. And so yeah, what a timely conversation I just had last week about that. And then of course, you know, Adam's all loopy-doopy when he's waking up from anesthesia. And, you know, he's all how to go-da-da. I'm like, oh, you know, good, but you there you'll have another surgery in in a few months. And, you know, he's like, Well, why didn't he just do it? And I was like, Well, because you couldn't consent. And he's like, Oh, he should have just done it and I would have consented. It's like that's not how it works. But I do like the point of it's more about the conversation of what's going to happen and not just, okay, sign this form. We all know you're having surgery. Cause I agree, even like surgery aside, if we're counseling patients in clinic, their recall of what we actually discussed is typically low, right? It's just a lot of information, terms they're not used to. And so then when you're talking about surgery, those terms are even more complex. Yeah. And the anxiety and everything is higher. You're gonna have surgery.

SPEAKER_02: 58:27

So and I like that they're they've taught us like the teachback technique. Like you talk, you you know their eyes are rolling back, you're gonna give them written information to help bolster what you've said, but you're like, tell me what you heard me just say. You know, because a lot of times what they want to hear is what they're gonna pull out of what you're saying, and then they tell you back, and you're like, that's true, but also, you know, and you can just kind of reinforce. But yeah, you have to have time to do that and to develop that rapport, to have the time to counsel and teach back and explain. And let's face it, in today's healthcare world, there's not a whole lot of time. I'm just cutting back the time you spend with patients, yeah. And that's the time that actually guarantees compliance and better outcomes that's being cut. So that's my two cents there.

SPEAKER_01: 59:28

Boo. Um, well, anyway, you did great. Thank you so much. And again, thank you, Gillian. Great suggestion.

SPEAKER_02: 59:36

Speak El boy, she's singing. Speaking of my cheeky mama, we're gonna talk about our second sponsor, Cheeky. Cheeky offers affordable custom night guards delivered to your doorstep at a fraction of the cost charged by dentists. Their easy-to-use impression kit captures your bite from the comfort of your home, ensuring a dentist quality night guard tailored to your teeth. Cheeky night guards provide protection against teeth grinding by especially when you're reading stressful things or listening to stressful stuff like we're talking about. Don't grind your teeth. Get a Cheeky night guard. They'll absorb your grinding forces, they'll help prevent headaches, jaw pain, and chip teeth, and promote healthier gums and confident smiles. With free shipping and 100% money back guarantee, Cheeky is the perfect solution for teeth grinding or clenching. Try it, risk free, and join thousands who choose Cheeky to solve their grinding and clenching problems. Visit Cheeky, oops, sorry, visit getchey.com for 30% off your order with our exclusive code. And now it's time for our medical mission.

SPEAKER_01: 1:00:50

Medical miss. Okay, this week's story comes from I'm gonna guess I can say your name. Yeah. Um Mrs. Carol Templeton, age 73. Yes. From Austin, Texas.

SPEAKER_02: 1:01:11

Mrs. Carol Templeton.

SPEAKER_01: 1:01:14

Hi, Carol. And it's titled The Orthopedic Odyssey. And she writes, Doctor's House in Tanell. Oh, thank you. Wow. Feeling like a queen over here. I love you, ladies, and would love to have you over for tea.

SPEAKER_00: 1:01:33

Oh, it's so cute. Please. Oh my god. I want to go to tea in Texas.

SPEAKER_01: 1:01:37

Boston, Texas, here we come. I want to know everything there is to know about true crime in healthcare, so thank you for bringing these issues to light. I'm writing to tell you about a story of mine. Hopefully, you'll find interesting. A few years ago, I slipped in my kitchen while reaching for the top shelf because apparently gravity doesn't care if you're making banana bread. I landed awkwardly and fractured my ankle. Oh my gosh. She's all the she writes this. No big deal, I'm a farm girl. Oh bless. Um, I'm sorry. The way my ankles just like curled for yours. I thought I'd be in a cast for a few weeks, maybe some physical therapy, and back to business. But what I didn't realize was that I was about to embark on a six-week comedy of orthopedic errors. Oh dear. Oh. It started in the emergency department. The doctor who came in to examine me was approximately 12 years old and sweating through his lab coat. That's so funny because I I've hit the age where like I see new staff or doctors or whoever, I'm just like, oh, you're so you look so young.

SPEAKER_03: 1:02:54

Like, oh my god, cute.

SPEAKER_01: 1:02:58

He introduced himself as Dr. Chen, the orthopedic resident on call. He was kind, gentle, and confident, which was reassuring until he picked up the x-rays and said, Huh, that's not the angle I expected. I naturally asked, What angle did you expect? And he replied, The one that would make this look less like a Picasso painting.

unknown: 1:03:22

Ha!

SPEAKER_01: 1:03:23

Oh no. Oh, okay. Um, we both laughed nervously, but the truth was the x-ray had been taken upside down. So for a solid five minutes, we were trying to figure out why my ankle appeared to bend in two directions at once. My ankles just curled for okay. The orientation issue was sorted out. Dr. Chen then said he would need a small plate and a few screws to stabilize the bone. He assured me it was routine, saying, You'll be waking you'll be walking again in no time. The surgery went smoothly, mostly. When I woke up, my leg was wrapped from knee to toe, and I immediately noticed a sharp pain, not where I had broken the bone, but several inches higher. Of course I asked the nurse if that was normal, and she said, Oh honey, everything's normal right after surgery. That's the anesthesia talking. But it wasn't the anesthesia talking, it was the IV line, inserted into the wrong leg, taped in place and forgotten. For two days my uninjured leg looked like it had been preparing for its own separate operation. Oh no. And on day three, the attending surgeon came by for morning rounds. He was cheerful, upbeat, and full of metaphors. You're healing beautifully, Mrs. T, like a house under renovation. Interesting. He left the room before I could ask which part of my house he went.

SPEAKER_02: 1:04:59

I like this lady.

SPEAKER_01: 1:05:02

Me too. Then came the physical therapy consult. The therapist arrived with a walker, a clipboard, and pronounced me as having, quote, the energy of someone who just had three espresso and a motivational seminar and love it. He told me we were going to practice walking. I politely reminded him that my chart said non-weight bearing. He flipped through the papers, frowned, and said, That's weird. It says partial weight bearing on the left. I stared at him. Left, my right ankle's broken. There was a long pause. Then he said, Oh, well that explains why your balance test went so poorly. By this point, I had decided to take control of my recovery, or at least my paperwork. I started double-checking every label, every prescription, every order that came my way. When the pharmacy sent up my discharge meds, I read the instructions carefully and found one labeled Take One Pill Every Four Hours for Pain. I turned the bottle around and saw the name Charles Templeton. That was my husband. Oh dear. He'd had his gallbladder removed two months earlier, and they had given me his leftover prescriptions by mistake. Girlfriend, where are you? And it like sounds like a house of horrors. By the time I finally made it home, I felt like I earned a minor degree in hospital administration. My ankle healed perfectly and I'm walking fine today, but I learned two valuable lessons. One, never underestimate your ability to advocate for yourself, even when you're wearing a backless gown and compression socks. And two, if anyone hands you a pill bottle, a walker, or an x-ray that looks like a modern art, ask questions. And she ended her letter with this line, which I think sums up the spirit of Doctoring the Truth perfectly. I forgive them. They meant well. But sometimes medicine just needs a second set of eyes. Preferably the patients. Oh, thank you, Carol, for sending in your story. My ankles are crying for yours. I'm glad you're all healed up.

SPEAKER_02: 1:07:20

In spite of everybody. Hopefully your husband got his pain meds.

SPEAKER_01: 1:07:25

Jeez, Louise. I hope you guys found a new medical home.

SPEAKER_02: 1:07:30

Oof. Well, what can our listeners expect to hear next week, Amanda? That's gonna be a surprise for all of us. Louis likes choking up.

SPEAKER_01: 1:07:41

Sorry, you'll have to cut that out. I sucked in too hard. Oh. It's gonna be a surprise for all of us because I don't know yet.

SPEAKER_02: 1:07:50

I will all be surprised, including yourself.

SPEAKER_01: 1:07:54

Yes. You know, I just like I've started to get into this thing where I like start to do research on one and then I'm like, this isn't interesting enough. And then I'll do another one. And so like I think I have three or four cases right now that have like three to five six pages done. Yeah.

SPEAKER_02: 1:08:10

And I'm like one.

SPEAKER_01: 1:08:12

Who am I to say that this isn't interesting enough? Also, yeah. I don't know. But I've been doing that lately, which is not good for our um time frame of having our homework done.

SPEAKER_02: 1:08:23

Oh, you got time, girl.

SPEAKER_01: 1:08:25

Yeah, we got a week. We good. We good. We made it through a lot of college. I'll be fine. I'll be fine. Crunch time's the most productive time.

SPEAKER_03: 1:08:38

Right?

SPEAKER_01: 1:08:38

So until then, y'all, don't miss a beat. Subscribe or follow Doctoring the Truth wherever you enjoy your podcasts for stories that shock, intrigue, and educate. Trust, after all, is a delicate thing. You can text us directly on our website at doctoringthetruth at buzzsprout.com. Email us your own story ideas and comments at Doctoringthe Truth at Gmail, and be sure to follow us on Instagram at Doctoring the Truth Podcast and on Facebook at Doctoring the Truth. We are on TikTok at Doctoring the Truth and Ed Odd Pod. Don't forget to download, rate, and review so we can be sure to bring you more content next week. Until then, stay safe and stay sauce. Stay suspicious. Stay suspicious. Guys. Stay suspicious. Make sure the right X-ray was taken. Bye. Bye. Make the markable in before they take it off. Careful for a seven minute cooked chicken patty. Stay suspicious of a long McDonald's order. Okay, three, two, one, stop.