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procedure.” Helen could not hear me. In clinic, we then Have you ever parted ways with someone that you
ask for verbal permission to proceed. Helen could not rather enjoyed — maybe someone who brought up
speak. In clinic, we attempt to guide the patient so she topics that sparked interesting conversation, imparted
knows what to expect by saying something to the effect wisdom to you, and frequently made you feel good —
of “I am going to touch your knee with my gloved hand but life forced you in different directions? On the tenth
so you know how it might feel.” Helen did not have the Friday of our friendship, Helen and I reached that
ability to interpret the feeling of my touch. Failing to moment. She had new students to teach, and I had other
find a way to gain specific consent from Helen, I professional endeavors to explore. I brought the finest
proceeded. I kept in mind that she had willed herself to wine available that day: the ability to identify every bone
be here. Nevertheless, my heart rate quickened, and the and muscle in her body, knowledge of each muscular
palms of my hands became clammy under my gloves. origin and insertion, skills from each dissection that she
The sounds in the room faded away, and for several hosted, and genuine gratitude for our experience. To
minutes Helen, my instruments and I were alone while commemorate our time together, we did something we
she taught me something that was not on the syllabus. had never done before. We completed an oral exam. I
presented Helen’s muscles, bones, and features as a
I have always perceived consent as an act that occurs professional. When I got nervous during the exam, she
primarily for the benefit of the patient. The dialogue soothed me by allowing me to caress her median nerve
around consent allows the patient to gain an between my thumb and index finger while I spoke. We
understanding about their condition and thereby make made a good team.
informed decisions about their care. In those moments,
however, I realized that holding the conversations that After the exam, we did not explicitly say goodbye. Helen
make up consent also help the individuals on the clinical was wrapped in materials that would preserve her
team. I would have felt a lot better about what I was muscles, then was stored in her metal tank, and the lights
doing if Helen could tell me that she was OK with this, were shut off. Helen and I will likely never spend time
that she knew this is what would happen. This would together again, but I will forever be grateful for all the
have reassured me that I was behaving ethically, morally, lessons she provided. Not only did she teach me anatomy
and in a fashion Helen also saw as acceptable. in a way nobody else had ever done, but she also helped
me evolve my beliefs so that I can offer a more mature
As I finished performing the methodical steps I had bottle of wine in the future. She taught me that as I begin
mentally practiced multiple times, my surroundings my career as a physician assistant, there will be times
slowly returned to normal. As the pounding of my heart that I will be told to do something because it is current
subsided, I revisited the muscles of her upper arm, which industry standard, but it is up to me as an individual
I had been working on for several weeks. I quietly professional to truly understand the deeper meaning of
smoothed over the brachialis. The music, conversations, these best practices. In the case of clinical consent, she
and occasional laughter that made up the environment of helped me understand that consent is not just a box we
the lab slowly returned to an audible level to me. People check so that we can start the clinical process. Rather, it
were still learning from their respective cadavers, as I is the foundational step of the clinical process, and the
was still learning from Helen, but our time together was interpersonal dialogue threaded in a clinical encounter
approaching an end.
from beginning to end. n
HUMANISM IN THE HEALTH SCIENCES 2018 • VOL. 21 27
ask for verbal permission to proceed. Helen could not rather enjoyed — maybe someone who brought up
speak. In clinic, we attempt to guide the patient so she topics that sparked interesting conversation, imparted
knows what to expect by saying something to the effect wisdom to you, and frequently made you feel good —
of “I am going to touch your knee with my gloved hand but life forced you in different directions? On the tenth
so you know how it might feel.” Helen did not have the Friday of our friendship, Helen and I reached that
ability to interpret the feeling of my touch. Failing to moment. She had new students to teach, and I had other
find a way to gain specific consent from Helen, I professional endeavors to explore. I brought the finest
proceeded. I kept in mind that she had willed herself to wine available that day: the ability to identify every bone
be here. Nevertheless, my heart rate quickened, and the and muscle in her body, knowledge of each muscular
palms of my hands became clammy under my gloves. origin and insertion, skills from each dissection that she
The sounds in the room faded away, and for several hosted, and genuine gratitude for our experience. To
minutes Helen, my instruments and I were alone while commemorate our time together, we did something we
she taught me something that was not on the syllabus. had never done before. We completed an oral exam. I
presented Helen’s muscles, bones, and features as a
I have always perceived consent as an act that occurs professional. When I got nervous during the exam, she
primarily for the benefit of the patient. The dialogue soothed me by allowing me to caress her median nerve
around consent allows the patient to gain an between my thumb and index finger while I spoke. We
understanding about their condition and thereby make made a good team.
informed decisions about their care. In those moments,
however, I realized that holding the conversations that After the exam, we did not explicitly say goodbye. Helen
make up consent also help the individuals on the clinical was wrapped in materials that would preserve her
team. I would have felt a lot better about what I was muscles, then was stored in her metal tank, and the lights
doing if Helen could tell me that she was OK with this, were shut off. Helen and I will likely never spend time
that she knew this is what would happen. This would together again, but I will forever be grateful for all the
have reassured me that I was behaving ethically, morally, lessons she provided. Not only did she teach me anatomy
and in a fashion Helen also saw as acceptable. in a way nobody else had ever done, but she also helped
me evolve my beliefs so that I can offer a more mature
As I finished performing the methodical steps I had bottle of wine in the future. She taught me that as I begin
mentally practiced multiple times, my surroundings my career as a physician assistant, there will be times
slowly returned to normal. As the pounding of my heart that I will be told to do something because it is current
subsided, I revisited the muscles of her upper arm, which industry standard, but it is up to me as an individual
I had been working on for several weeks. I quietly professional to truly understand the deeper meaning of
smoothed over the brachialis. The music, conversations, these best practices. In the case of clinical consent, she
and occasional laughter that made up the environment of helped me understand that consent is not just a box we
the lab slowly returned to an audible level to me. People check so that we can start the clinical process. Rather, it
were still learning from their respective cadavers, as I is the foundational step of the clinical process, and the
was still learning from Helen, but our time together was interpersonal dialogue threaded in a clinical encounter
approaching an end.
from beginning to end. n
HUMANISM IN THE HEALTH SCIENCES 2018 • VOL. 21 27
