ABSTRACT
A 34-year-old, tattooed, Italian American construction worker received emergency surgery for acute appendicitis from a Chinese American surgeon. The case was complicated by peritonitis causing an extended stay in the hospital while the patient received intravenous antibiotics. Although the patient received intravenous patient-controlled analgesia postoperatively, the analgesic dose was quite low. The patient had tested positive for THC (marijuana) on admission, and the surgeon believed the analgesic dose should be kept low because of a suspected addiction history. The patient demanded more medication, screaming for the nurses to increase his pain medication. The surgeon berated the patient for his behavior and asked for psychiatric consultation to control the patient. The psychiatric consultant recommended increasing the dose and frequency of pain medication, telling the surgeon that the patient was emotional and fearful of pain because of his cultural background. The surgeon accepted this, and the rest of the hospital course was uneventful.
