Another OB story

Dr S, the chief of the obstetrical anesthesia division, has been promising to tell us the story about F.C., an interesting patient of his from several years back. He didn't have the time today to tell us the story, but instead related another interesting anecdote.

The day started normally with a couple epidurals for women in labor, overseeing a cesarian section, the usual. He was called to one of the labor rooms with another epidural request. When Dr S walked in, however, he noticed the patient lying stark naked in bed, in labor. A little unusual, perhaps, but nothing too remarkable. After all, patients are very frequently naked in the operating room, though we try to keep at least part of them covered when they're awake.

The vibe here was different. Dr S soon picked up on why when he looked up and saw the patient's husband sitting in the chair beside the bed...also completely naked. They were evidently the "crunchy granola types" and preferred the "natural approach." (Why they were in a top-tier medical institution requesting an epidural rather than squatting at home on the kitchen floor with a bucket of warm water, a pair of gleaming scissors, and some fresh clean towels, I cannot say.) After taking a moment to register the situation, Dr S regained his cool and explained the process, benefits, and risks of an epidural to the patient, who wished to proceed.

As if that weren't weird enough, the story doesn't end quite there. The patient then requested that Dr S remove his clothing before he placed the epidural. This was part of the" natural approach."

This led to a series of musings:

• Hospital policy does not explicitly require that one wear clothing while placing an epidural. It does require gloves, a hat, and mask, though. Would the family object to the hat and mask?
• What, if any, extra documentation would be required? "Patient identification confirmed. Risks, benefits, and alternatives discussed. Consent for epidural obtained. After proper hand hygiene and removing my clothes, the patient was placed in the sitting position. Sterile prep and drape..."
• Was the husband sitting on a towel?
• Where would one put one's pager?

In the end, and probably in part because of the multiple quandaries raised by the circumstances, Dr S told them no, he would remain fully clothed for the epidural.