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Operation! A Handbook for Surgical Patients by R. A. J. Youngson, David
& Charles, pp 160, £5.99 pbk

According to a survey quoted in Robin Youngson’s Operation! A Handbook
for Surgical Patients, 27 out of 100 patients questioned after their operation
didn’t know what organ had been operated upon; 44 didn’t know the nature
of their operation. Many patients admitted to hospital chose not to know
the details of their illness or treatment, abdicating total responsibility
for their wellbeing to the hospital staff. Operation is not intended for
this type of patient as the book aims to supply ‘expert information and
practical guidance to help you take control’.

In some respects the book is similar to a traveller’s guide-book that
describes the people and customs in a foreign environment, the hospital.
I particularly liked the chapter that describes the various types and grades
of hospital staff which the patient may encounter.

‘Have sympathy,’ Youngson writes, ‘if at times the houseman appears
zombie-like, dishevelled, inattentive, surly, rude or insensitive, it’s
probably because he’s been working flat out for 36 hours or more without
sleep.’ If anyone of that description approached me with a syringe, sympathy
wouldn’t be the dominant emotion.

Youngson also describes the role of the nursing staff, as professionals
who frequently know more about the health of the patients than any of the
doctors involved. Even laboratory staff, who work in the background, get
a rare acknowledgement.

I also enjoyed the chapter on the nature and relevance of the laboratory
tests and imaging techniques performed in hospital. Youngson makes a brave
attempt to describe magnetic resonance imaging in half a page without using
technical terms; he does much better describing radionuclide (gamma) imaging,
so that no one reading this book would be worried about being radioactive.

Throughout the book, he suggests questions about treatment that patients
may want to consider and ask hospital staff prior to their operation. The
patient’s rights are stated frequently and there is a long chapter on consenting
to be operated upon. This chapter explains that a doctor requires permission
before he or she can treat or indeed even examine a patient. Before an operation
the patient will be asked to sign a consent form. This generally gives the
surgeon fairly comprehensive permission to operate on the patient in any
way he or she sees fit in the best interests of the patient. Youngson advises
the patient to alter the consent form if they are unhappy with any part
of it, perhaps reducing the scope of the permission granted. There is also
a short chapter telling the patient how to complain if they are unhappy
with their treatment.

The book is well indexed; however, terms in the glossary are not always
clearly defined. For example, the term ‘telescope’ used to describe an endoscope
could lead to a certain degree of anxiety in anyone admitted for colonoscopy.
This procedure is described as ‘examination of the inside of the large bowel
with a telescope inserted through the back passage’.

All in all, this generally well-written book provides a clear and fairly
comprehensive guide to hospital existence. Reading it should make the experience
of being a surgical patient less confusing and hence less stressful. Operation
might also provide a good introduction to hospitals for medical and nursing
students about to work on the wards for the first time.

Graham Clarke lectures in the School of Biological Sciences and Faculty
of Health Studies, University of Wales, Bangor.