ZMD: Good morning. I'm Dr. Z. I'll be your anesthesiologist today.
Patient: They told you I was crazy, right?
ZMD: Uh, no. Why do you say that?
Patient: I said I don't want general anesthesia under any circumstance.
ZMD: Well most of the time this procedure is done with only IV sedation. I was not planning on giving you a general.
Patient: What do you mean "most of the time"?
ZMD: Well some patients require a general anesthesia if it is too risky to have only sedation, such as patients with morbid obesity or severe lung disease.
Patient: I have neither of that. Can you guarantee that I won't get a general anesthetic?
ZMD: I can't guarantee that. Some patients may require that an IV sedation be converted to a general anesthetic if there are unforeseen problems with ventilation during the procedure. But that would only be done if there is no other way to save the patient's life.
Patient: I don't care. I want a written guarantee that I won't get general anesthesia during the procedure.
ZMD: I'm sorry. I can't do that. Is there a reason you have such fear of anesthesia? Did you have a bad experience in the past?
Patient: No but I've done a lot of research and anesthesia just scares me. I just don't want to have it.
ZMD: Do you have any particular questions and concerns about anesthesia that we can discuss?
Patient: I know what you're trying to do. You want me to talk about anesthesia to try to change my mind. I told you I've already done a lot of research and I don't need to talk about anesthesia with you.
ZMD: So there is nothing I can do to try to relieve your anxiety and fears of anesthesia?
ZMD: Okay. Let's wait for the surgeon so we can all talk about this together.
An uneasy quiet settles over the room as ZMD writes an extensive note chronicling the encounter with the patient in his H+P
Patient: I have a bad feeling about this. I don't want to do this today.
ZMD: Do you want to wait for the surgeon first to talk this over?
Patient: No. I don't feel good about this. I want to leave.
ZMD: Okay. Have a nice life.
ZMD thinking: Thank God. That was just a malpractice suit waiting to happen. Don't let the door hit you in the ass on the way out you paranoid freak.