No womb, no cancer, big problem

August 6, 2009 1:23 PM

My mother does not have cancer, but the doctor thought she did and took out pretty much everything that made her a woman and is pleased with his work. She is devastated. What now?

My mother is in her fifties. She has had her children. She is extremely healthy. The idea of her having cancer is absurd, but doctors over the years have been concerned about her ovarian cysts. Finally, a huge one grew, and the first doctor cried, "Ovarian Cancer!"

Naturally, she freaked out. But, she knew that until you get a biopsy, you don't really know. Her A125 test was really low, pointing to the fact that she didn't have ovarian cancer. Her friend convinced her to see "the best doctor" for this type of thing, got her in, and she went.

The doctor said that it wasn't cancer, but he couldn't guarantee until they took a better look. Fine. So one ovary and tube was to be removed. My mother stressed that she wanted to keep as much of her internal organs as possible. The doctor reassured her that this was his/her plan as well.
Surgery day comes, and everyone was very positive. My mother signed a paper saying that she gave the doctor the power to make the decision, in the the presence of cancer, to remove what was necessary. There wasn't a clear explanation at what stage, even though we tried to ascertain. Basically, it was at the sign of any cancer.

So DURING surgery, her ovary was removed and biopsied. The doctor said he found a tiny bit of cancer, miraculous, had the pathologist confirm it, and then proceeded to take out my mother's other ovary, uterus, cervix, and biopsy pretty much everything else. Tragic, yet, the doctor said the type of cancer he thought it was was always malignant.

My mother was optimistic, until a few days ago when the doctor strode in, proud as could be, and told her that she never had cancer and that in fact, what they had thought was malignant cancer was in fact NOTHING.
So yay, you don't have cancer, but you also don't have a your healthy, normal organs anymore. Cue hormone therapy, giant menopausal symptoms, making sure your organs don't slide down.

She is angry, in fact, we all are. So here are my questions:

I am not an oncologist or a pathologist, but maybe you are, so why in the world would they do a biopsy while she's unconscious, on the fly, and make such a quick decision when they could always just biopsy what they need in the first surgery and come back? Isn't the risk of living another few weeks with cancer worth keeping your otherwise healthy organs?

I am not a lawyer, but maybe you are, doesn't the fact that there wasn't any cancer and they imagined it make what she signed void? She will now suffer terribly for no reason other than they *thought* she had cancer. Malpractice? Any legal leg to stand on? This will cost her so much money to deal with, and may in fact shorten her life. For nothing.

I am not a psychologist, but are there support groups for women like this? Or therapists who specialize of being robbed of your lady parts?
I'm sure my parents will speak to a lawyer, but I wanted to get your opinions as well. Thank you. By the way, this is in CA.

posted by anonymous to health & fitness (54 comments total)

As for being helpful and supportive, I'd start with this:

    took out pretty much everything that made her a woman

Don't ever say that. Don't even think that. That's ridiculous.

She's exactly as much of a woman now, and to be practical, how many more children was she planning to have, exactly?
posted by rokusan at 1:26 PM on August 6 [31 favorites]

My mother is in her fifties. She has had her children. She is extremely healthy. The idea of her having cancer is absurd...

My dad was diagnosed with cancer at the age of 54 and was dead less than a year later.
posted by The Straightener at 1:26 PM on August 6 [9 favorites]

She's exactly as much of a woman now, and to be practical, how many more children was she planning to have, exactly?

Actually, rokusan, there are some studies that show that removing the ovaries simply because "how many more kids were you planning on having anyway" isn't such a great idea either. I mean, I see your point about "don't say that she's not a woman any more," but I'm also not sure about the idea of removing organs because one of the functions is "gone". We don't quite know what-all everything does (they just found out the spleen is actually way more important than we thought, and a lot of doctors that did routine splenectomies are now rethinking that plan).

OP; I'd check with some ovarian cancer support groups, even though your mother DIDN'T have cancer after all. A lot of their support does deal with people wrapping their heads around the "holy crap, I no longer have some of my own body parts" factor as it is, and at the very least, they would probably have some kind of idea about who you could talk to. Good luck.
posted by EmpressCallipygos at 1:33 PM on August 6 [2 favorites]

Rokusan, the hormonal implications of this type of surgery are enormous. I'm a woman of 50, won't be having any more babies, but I plan on keeping my uterus and overies for life assuming they are cancer free.

This type of surgery does have implications for one's sex life, for one's hormonal balance, etc. This isn't like having your appendix out.
posted by St. Alia of the Bunnies at 1:36 PM on August 6 [8 favorites]

It's hard to tell from a question, but it kinda sounds like you're more angry than she is. Perhaps she should talk to a malpractice lawyer to examine options there, but you may also want to consider talking to a therapist to help cope with any residual stress issues you might have incurred.
posted by Blazecock Pileon at 1:37 PM on August 6

If you think that your mother was a victim of medical malpractice, she should consult a lawyer. The hospital should be able to refer her to specialists and support groups relevant to hysterectomies and hormone therapy.

That being said, this question is written so strangely... "everything that made her a woman," "robbed of lady parts," the doctor was "pleased with his work," and the idea of a her having cancer is "absurd" to the point that it makes me wonder if something else is going on here. (see Blazecock Pileon's response)
posted by emd3737 at 1:40 PM on August 6 [4 favorites]

I'm so sorry to hear this; I can only imagine how violated your mother must feel.

However, it's hard for me to read "the idea of her having cancer is absurd". My sister died last year of breast cancer at age 32.

From what I've read, ovarian cancer is extremely difficult to detect and, because of that, has a very high fatality rate. I'm not saying that the doctor was right to do what he did, but it is a terrifying disease, so if they legitimately thought that there was a bit of cancer in there, it's hard to blame them for removing as much as they felt they needed to in order to be safe.
posted by cider at 1:41 PM on August 6 [7 favorites]

I'm very sorry for your and your mother's situation - I hope your mother finds the resources she needs to cope and adjust to this. I think in your position it's probably very, very difficult to maintain perspective about this - I would probably be appalled and furious. And perhaps you should be. I think you should talk to a medical malpractice lawyer about this (although perhaps take their advice with a grain of salt, considering their motivations), and I would also recommend scheduling an appointment with at least one other oncologist to ask their opinion about how the procedure went and whether the doctor's mistake should have been preventable, or if it was just a difficult, unfortunate situation.

IANAD, but I know that invasive surgery, even for biopsies, caries significant risk; simply putting someone under general anesthesia is a fairly dangerous procedure. So from the doctor's point of view, if he suspected cancer during the first biopsy, he may have judged it riskier to close her up, do the biopsy, then go in again to remove a cancer. But....IANAD.
posted by Salvor Hardin at 1:49 PM on August 6

...why in the world would they do a biopsy while she's unconscious, on the fly, and make such a quick decision when they could always just biopsy what they need in the first surgery and come back? Isn't the risk of living another few weeks with cancer worth keeping your otherwise healthy organs?

There is also considerable risk associated with a second surgery (including but not limited to anesthesia, complications, infection, healing, etc.).
posted by onshi at 1:51 PM on August 6

A family friend died of ovarian cancer in her early 40s. It is an extremely aggressive disease, and death is painful and drawn out. Your mother has been through a very traumatic and possibly unnecessary experience, but please don't think that ovarian cancer was out of the realm of possibility. Many doctors in particular are terrified of ovarian cancer, as it usually does not respond well to treatment by the time it has been detected, and the victims are often younger than your mother is and die very unpleasant deaths. Your doctor may have been overzealous, but, based on the facts you present, it is possible that his course of treatment was entire appropriate.
posted by sid at 1:54 PM on August 6 [5 favorites]

The idea of her having cancer is absurd

Unless you're a four year old child in the Hunza valley, the idea of just about anyone having cancer is somewhat less than absurd. As others have said, talk with a lawyer if you think there was malpractice. That's an awful, awful situation, but you need to make sure you're being totally rational before you do anything drastic about it.
posted by resiny at 1:56 PM on August 6 [1 favorite]

I'm sorry that you and your mother are dealing with this, but you need to talk to a counselor and take a few deep breaths. The way you're describing things now is, sincerely, borderline irrational, particularly the clear malice you're assigning to the surgeon.

took out pretty much everything that made her a woman

Yes, this is a horrifyingly awful, nonsupportive, and just plain dumb way to think about it.

Unless you mean that the surgeon invaded each of her cells, removed one of the X chromosomes, replaced it with a Y chromosome, altered her skeletal structure, restructured her brain to remove all effects of female adolescence and induce structures common to men, removed her breasts, increased her upper body strength and made other changes to her musculature, massively enlarged her clitoris and rerouted her urethra through it, and so on. But that seems a tad unlikely.

why in the world would they do a biopsy while she's unconscious, on the fly, and make such a quick decision when they could always just biopsy what they need in the first surgery and come back?

For some cancers, a few weeks matter. As well, anaesthetizing people, cutting them open, and poking around in their guts is not without risk so it can make sense not to do it again.

doesn't the fact that there wasn't any cancer and they imagined it make what she signed void?

What? No. Of course not. That's crazy insane unless the thing that turned out not to be cancer was so clearly, obviously not cancer that no reasonable surgeon would ever have thought it was.

are there support groups for women like this?

Of course there are. At least, there are support groups for women who've had ovariohysterectomies. I don't know if you'll find specific support groups for women who had ovariohysterectomies because of misdiagnosed ovarian cancer.
posted by ROU_Xenophobe at 1:57 PM on August 6 [18 favorites]

What rokusan said. Your mother is still a woman. Many women have hysterectomies and undergo early menopause, and they are still women. So, thinking differently about this might help cope with what is still quite an emotional and physical shock.

Along similar lines of what The Straightener said, age and apparent health have very little to do with whether one has cancer or not. My Dad was never sick and lived a very healthy and active lifestyle, until he was diagnosed with esophageal cancer and died three difficult years later at age 48. The reason that there's no cure for cancer is that while we have some clues, unfortunately we don't know exactly what causes it.

I understand why your mother and your family are upset, but it also sounds like maybe there wasn't clear communication between the doctor and your mom. With the benefit of hindsight and a cancer-free diagnosis, it's easy to look at this as a drastic move on the doctor's part, but maybe it wasn't. IANAD, IANADL, & IANAT, but from my perspective, the doctor could have just as easily walked in and said that there were malignancies present, but he thought they got them all. Then your Mom would be dealing with an entirely different turmoil. She is entitled to her feelings and being upset, but this doesn't sound to me like the doctor acted negligently. I could be wrong, but that's my initial reading of the situation.
posted by katemcd at 2:01 PM on August 6 [3 favorites]

I am neither a doctor nor a lawyer, but I would guess that there are lots of malpractice suits out there against doctors who have done the opposite - identified something as non-cancerous, only to later (possibly too late) find out that it is cancer. (My father died of cancer, and the doctors discovered, in retrospect, that it had appeared a year earlier than his diagnosis but they had failed to detect it then.) Perhaps this doctor built up his good reputation by erring on the side of caution. It's a tough call to make.

I'm sorry that this happened, Anonymous, and although it's hard to tell whether this was malpractice I can understand why it would be so upsetting. One-on-one therapy might be more beneficial than a support group in this instance since your mother's situation is uncommon.
posted by Metroid Baby at 2:08 PM on August 6

From my limited understanding, I don't think you look at a pathology sample and say "omg so obviously cancer" or "100% not cancer". I would be inclined to believe that the surgeon thought that the tissue he was looking at was cancer, and that he was interested in saving your mother's life.

To me the idea that you can take a tissue sample while a surgery is taking place, and then examine it, identify it as cancer and proceed with further surgery, all while the patient is in the operating room, is pretty amazing.

I totally understand your frustration and the issues your mother will have in the future.

The thing is, medicine isn't perfect. This sounds like a sticky situation. I'm sure if you call a malpractice lawyer, he's going to be all over it, but not necessarily because the surgeon did something wrong. It will be because he thinks he can make money off of it.

Was the surgeon smug about it? I sort of appreciate his honesty at a certain level. He's not hiding from the truth, and he's giving your mom the truth about her cancer (or lack thereof) situation, so he's not trying to trick you.

I'm sorry this happened to you.
posted by sully75 at 2:08 PM on August 6 [1 favorite]

But I 100% disagree that the idea of your mother, or anyone else, having cancer as being absurd. I know a girl who lost an eye to cancer when she was a year old. You can certainly get cancer at any time in your life. That goes for very healthy people who jog, eat organic food, etc. If your mom was prone to cysts I think that would make doctors even more cautious about the risk of cancer.
posted by sully75 at 2:11 PM on August 6 [1 favorite]

A few years ago, my mom was scheduled for a biopsy, and was weirded-out enough by the informed consent that she showed it to me. It said the same thing your mother's did -- that, once she's opened up, they could take out anything they wanted. What the hell? That's crazy, she said -- no way am I consenting to that. Right, I said, how could they even ask for that kind of blanket consent? We thought she had some kind of rogue doctor. But OK -- so she doesn't have the biopsy, now what? I had a pathophysiology book lying around, so we looked to see what it had to say about ovarian cancer.

Oh.

Well, she had the biopsy. They took out a shopping bag's worth of stuff. She died anyway, four years later. What the book had said -- and this is 10 years ago -- was that ovarian cancer had a 90% mortality rate at diagnosis.

My sister had breast cancer last year and now has no breasts, ovaries or ladyparts at all.

I have a full complement or parts, thank you very much, one of which has a lump in it. I feel very whole and womanly and unviolated. I feel pretty and witty and gay. I am 39. I don't have health insurance.

Of course this is a very emotional thing for you and your mom, but please try to remember that her outcome was a good one, the best one. Love her and enjoy your long lives together.
posted by Methylviolet at 2:18 PM on August 6 [24 favorites]

I had one of my ovaries and one of my phallopian tubes removes when I was two years old because of an aggressive, pre-cancerous tumour growing on them. I haven't ever considered myself "half a woman", and I'm pretty sure everyone who knows my surgical history hasn't thought this either. Hopefully you and your mom will be able to cope with this traumatic event that thankfully turned out not to be cancer, but please realize your mom is just as much a woman as ever, even if she's missing a few parts.
posted by just_ducky at 2:21 PM on August 6

I'd suggest that if you do go to a lawyer, you talk about it as unnecessary surgery and drop the "no longer a woman" angle. It would be ironic to find yourself talking to a female lawyer who had an elective hysterectomy and feels perfectly female.

I went through a couple of extremely crappy months dealing with a "maybe you have ovarian cancer/maybe you don't" situation, so I realize that this is a challenging diagnosis, and ovarian cancer is one of the scarier ones.

I no longer have my ovaries but am still 100% a woman. My recovery from the surgery would have been harder if people around me were lamenting that I was no longer a woman as you seem to be doing.

And regarding "absurd" cancer in young women: My mother, age 37. Her mother, in her 30s. My aunt, in her 40s. My great-grandmother, in her 30s. I'm sorry you're upset about what seems to you to be unnecessary surgery, but cancer isn't "absurd" and its effects are devastating.

Maybe the biopsy was botched; maybe the surgeon overreacted; maybe suing for malpractice is the right thing to do. But you might want to keep in mind that ovarian cancer is evil, and it's entirely possible the surgeon was acting in what he believed to be your mother's best interest.
posted by PatoPata at 2:22 PM on August 6 [6 favorites]

In 1973, I watched my best friend's wife die of ovarian cancer, over a period of 13 months. I introduced them, and I danced at their wedding, and we were all business partners, as well as friends. Her suffering was so palpable and so extended, despite her great courage and humor through a long course of chemotherapy and radiation treatments, that it has ever after shaped our friendship, to the point that we have only managed 5 or 6 reunion meetings in the intervening decades. And at those, we both leave, if not in tears, in the kind of funk you can't keep back in memory, forever, having been helpless in the face of such tragedy.

Unfortunately, in the intervening 36 years, neither detection or treatment of ovarian cancer has advanced nearly as much as have treatments for other forms of cancer. If the surgeon erred on the side of safety, I, for one, can tell you that his choice wasn't necessarily unkind, given the alternative.

At the end, I was grateful for my friend's wife's death, and angry at the doctors and nurses who would not help her with it, as she hoped they would, as soon as it was clear she knew she'd lost her fight. In those last days, I would have shot Grace, as she nearly begged me to do, if it hadn't meant shooting my friend, out of simple pity, too. And among other things, that lack of courage, for them both, still hangs between us, that yet remain, whenever we have met.
posted by paulsc at 2:23 PM on August 6 [15 favorites]

There are 2 things to do here:

1. Get in tune with the universe. Know that everything happens for a reason. Thats the way of the universe. Can that or other similar lines of thought make you happy after this?

2. If not:
GET A LAWYER!

I'm dead serious. GET A LAWYER.

The lawyer will use their own trusted docs to find out whether the doctor acted appropriately or not.

This is the ONLY recourse you have that will yield you some satisfaction.

If you need help narrowing down a lawyer in SoCal, memail me up.

Good luck!
posted by hal_c_on at 2:31 PM on August 6 [1 favorite]

I can't speak to the legal aspects of this, but you should be aware of the possibilities-- you had a doctor who was doing his best to protect your mother. There's no absurdity in thinking your mom may have had ovarian cancer-- it sounds like her medical history and the preliminary pathology pointed to that.

You could have the flip side, like my mom, who went to the doctor for five months with symptoms before being taken seriously and diagnosed with an aggressive form of cancer. She's still alive... but maybe if those five months had not elapsed she wouldn't be battling metastatic disease right now.

Definitely go see a malpractice attorney. But this wasn't a robbery. It was a mistake, which sounds like it was made in good faith. Pathology isn't like on CSI, where they swab some chemical over the tissue and if it lights up bright red it's cancer. It's a judgment call.

Your mom is alive, and healthy, and she is battling menopause symptoms that unfortunately she would have battled eventually anyway. There are good doctors who can help with the sudden menopause symptoms. And good doctors (psychologists or therapists) who might be able to help you and your mom sort through your feelings.
posted by miss tea at 2:37 PM on August 6 [3 favorites]

Fifteen years or so ago, my mom had a lump detected on her ovary. It was believed to be cancerous, and, much like your mom, during the biopsy the doctor took it all out. Upon further review it was discovered that it was just a fibroid tumor and would have been harmless. She was annoyed, but overwhelmingly happy it wasn't cancer.

Last year, my mom was diagnosed with breast cancer. She had both breasts removed. If they had told her after the fact that they had made a mistake and it wasn't breast cancer, i think she'd still be overjoyed.

She's still quite a woman, and she has the perkiest boobs of an 60+ year old woman in her church.

Investigate malpractice if you must, but please understand that the doctor did not cavalierly take out your mom's bits. Ovarian cancer is brutal and agressive and it is far, far better to be without ovaries than it is to be without life.
posted by teleri025 at 2:39 PM on August 6

I'm very sorry for what happened to your mother and to you. You are faced with some very difficult decisions to make. Here are some suggestions:

(1) Read this article [PDF] by Atul Gawande on malpractice. It might give you insight into the kind of uncertainty that other patients and doctors have faced when a procedure is performed that may qualify as malpractice. One of the take-home lessons is that a lot of malpractice cases are brought because patients are in the same situation that you are: they simply don't know why something was done. The second lesson is that very, very few cases qualify as genuine malpractice, and fewer still will lead to financial settlements.

(2) Recognize that you will not get any useful medical advice on this forum. No one here can know all the relevant details, much less the beliefs of the doctor(s) in this case. You will get a lot of speculation and anecdote, but nothing that will help you better understand this particular case.

(3) Recognize that you will not get any useful legal advice on this forum. No one here can know all the relevant details about whether you have a legal leg to stand on, nor whether or not you should even consult a lawyer in the first place.

(4) What you do need to do is decide whether or not it is important for your mother (not you) to pursue further action in this case, and what you hope to get out of this action. Do you want to know more about the decisions that were made? Do you want an impartial third party to evaluate those decisions? Do you want financial remuneration? Remember that these are your decisions, and that your answers to these questions will guide you to seek out outside help if you need it (this is why immediately going to a lawyer may not be the best course of action).

(5) Consider doing some of the following:

- Contacting the surgeon, and asking him to review what happened and why.
- Contacting the hospital ombudsman or ethics committee, and asking them to review the case (particularly the informed consent document).
- Contacting your mother's original doctor in this case and asking for his/her opinion on the case.
- Contacting a lawyer.

I don't know which of these will be best for you, but I hope that you get the clarification you're looking for.
posted by googly at 2:54 PM on August 6 [7 favorites]

Ask yourself what you think you would gain by suing.
posted by Xoebe at 3:06 PM on August 6 [1 favorite]

This type of surgery does have implications for one's sex life, for one's hormonal balance...

I know, I know. I should have used more words. I meant that in a "yes, it sucks, but you can't put them back." way. And since she has (per the OP's question) "already had her children", there's not much left here to fight for, I don't think:

(1) Focusing on the ovaries etc. as what "makes her a woman" is just going to destroy the rest of her life. That's horribly unhealthy.

(2) Lawyers may correct me, but I predict that the surgeon's form is there to cover his ass for exactly this situation, and its language almost certainly covers this. She gave him permission to use judgment. He did so. I doubt there was any sort of "unless you turn out to have guessed wrong" asterisk.

So those are both losing moves from my perspective. Far better, I think, to focus on the emotional health from here on out, and be supportive of your mother in that way.

A protracted fight will not improve anyone's quality of life.
posted by rokusan at 3:19 PM on August 6

Here's what may have happened. You mother's surgeon probably sent a Frozen Section of the suspicious area. The pathologist probably came back and said "it looks like cancer". Frozen Sections have limitations. Sending the specimen for "permanent" is more reliable than frozen sections. This can take days to result.

That said, she was already "open" from surgery. The surgeon may have felt that if he didn't do a total hysterectomy he would be in trouble. He already had consent to do so.

IANAL. IANAD. Your mother is still a "woman".
posted by 6:1 at 3:31 PM on August 6 [4 favorites]

All good advice above.

Random thoughts on the matter:

It is regrettable, but the general medical/surgical "establishment" has a perspective / standard of care/ value system that does not value the preservation of girl-guts in older women. They simply don't see the lack of an ovary or a uterus as a problem. Your mom's surgeon or pathologist over-called the diagnosis and did way more surgery than she needed.

My mom had almost the exact same thing happen. Ovarian cyst, rule out malignancy, wasn't malignant. The only difference was that she agreed to have everything out regardless of the diagnosis. Beats me why. It would "prevent problems later." I didn't agree with it then and still don't now. She, however, was perfectly happy with it.

N-th'ing the 'always a woman' theme.

This is likely not a clear case of malpractice. What is to be gained by dwelling on recrimination? Do make sure that to talk it through with the surgeon, with and advocate if necessary. Then help your mom to move on and enjoy her very healthy life.
posted by SLC Mom at 3:37 PM on August 6

I guess she could sue. (Not you.) Will money make your mother happy? Will it make her whole? Will punishing the doctor do some good in society? Maybe. (Keep in mind that a lawsuit will be governed by his medical malpractice insurance company, so he may not be punished much at all.)

I don't know when this all happened, but consult a lawyer, just to find out the statute of limitations, and sit on it a little while. Let the passions settle, and think about it.
posted by jabberjaw at 3:45 PM on August 6

Was the surgeon smug about it?

You should also probably step back and consider that damn-near all surgeons sound smug.

They've been trained to believe they're amazing brilliant supermen, and the surgeons even more than other doctors.

Get them out of their environment, trying to do their own taxes or fixing a flat tire on the side of the road, and they lose the docattitude and fall back into feeling and talking like normal human beings again.

(I know a lot of doctors.)
posted by rokusan at 3:48 PM on August 6 [7 favorites]

It would "prevent problems later."
Some types of non-cancerous tumors and other conditions put women at a higher risk of developing cancer. Having the at-risk organs removed, even before there is cancer present, can be a good way to prevent cancer from occuring. Many gynecological cancers are very hard to treat and often found at an advanced stage. If she was post-menopausal, there will be some hormonal changes, but since after menopause the ovaries only make a very small amount of estrogen, it's not nearly as drastic as in pre-menopausal women.

A lot of people think they know about cancer and how it works based of some kind of armchair understanding of medicine. Unfortunately, those people usually jump to all kinds of conclusions and assumptions that are incorrect about what is best to do. Doctors are not gods, but they do know far more about their field than laypeople do. IANAD, but I work in a related field.
posted by ishotjr at 3:53 PM on August 6

It's completely normal to do a biopsy while the person is on the table. Certainly this happened with my mother. Who, by the way, had one breast and no ovaries in her thirties, but was alive and very much a woman.

Do you happen to know the risk of anesthesia for a woman your mom's age? That's one of many reasons they try to get as much done as they can while the patient is under. If it had been cancer, and was going to be a few weeks before they could reschedule a second surgery, do you know how fast the cancer could have spread from her ovaries through various systems, all over her body? Do you know how many years she would have had, if they had waited those few weeks and it had spread?

If your mother is really upset, I recommend that she schedule a follow-up meeting with the doctor, so he can explain it more detail why they did what they did.

For you, I recommend a basic biology book. Her organs will not "slide down," her organs were not "stolen," and she didn't lose everything that makes her a woman (which is frankly an insult to all women, including and especially to your mother).
posted by Houstonian at 4:20 PM on August 6 [5 favorites]

You know, if I had heard anyone talking about being less of a woman after a hysterectomy before I had one myself, I would have been right up there saying how silly and wrong and hurtful that kind of talk was.

But when I was first opened up for a hysteroscopy to see what was wrong with me, just the possibility that I was losing my *ovary* upset me so much--I couldn't believe the emotional intensity of my own reaction. Had no idea I would feel that way.

And then, when the endometriosis that had fused that ovary to my fallopian tube to begin with became so extreme that I had to have a total abdominal hysterectomy, as your Mom did, I became so emotional that the depression I had conquered years ago came back worse than ever. I felt I had lost myself.

For me, it was literally a grieving process. Part of this was because the initial symptoms I had mirrored pregnancy (missed period, etc), and so I went from thinking, "could I be having a child again?" to "I can never have children again," which is not where your Mom was.

But to say that she had little to lose because she wasn't going to have more kids is just...well, it's just not the way it is. It's not like having an appendix removed is a huge understatement. You whole life changes. Hormones go nuts. Your entire personality changes as a result. You get night sweats and mood shifts and all the rest, on TOP of recovering from surgery.

So I really feel for your Mom, and if SHE wants to consult a lawyer, if that helps her with closure, she should go ahead.

Just make sure it is what she wants, not what you want. Because your anger could be better turned into support and help for your Mom.
posted by misha at 4:25 PM on August 6 [2 favorites]

Oh, and I meant to link to Hyster Sisters, a support group for women like your Mom.

sorry I was so long-winded.
posted by misha at 4:26 PM on August 6

I jumped in to recommend Hyster Sisters as well. I had a hysterectomy last year, because of childbirth problems when my first child (who died of brain cancer within 10 months) was born. There may or may not have been medical malpractice involved. I am just as much a woman as I ever was, and I'll thank you (on my behalf and others similarly situated) not to imply otherwise.

I still get angry and upset about it though, and those feelings are natural. But I beg you to heed Misha's (and others) warnings that the fury you are showing could be put to much better purpose with kindness and support. Instead of spouting this stolen lady parts nonsense, do something kind for your mother that shows you care and reinforces her femininity, grace and beauty. Show her those things are no less diminished because of it. I would have been (and probably still would be) really thankful to anyone who bothered to be that thoughtful and empathetic.

Education about what will change in her life and what threatened changes are actually just myth, hormone therapies available, etc., along with kind support, will be great things. Emphasizing her victimization and that she is somehow less a woman, will probably make her feel worse.
posted by bunnycup at 5:25 PM on August 6 [3 favorites]

These are great answers you have here.

Just wanted to chime in that nothing even whiffs of malpractice in what you described. She consented. And two surgeries with anesthesia for a woman in her 50s comes with some risk, so going back in after receiving the biopsy results would not have been a great option. (I actually thought: How wonderful that your mom had her surgery at a hospital with the facilities to obtain biopsy results that quickly!)

Ovarian cancer is NOT something you want to chance. Ever. I've watched women far younger than your mother die of it - with little or no symptoms - and quickly.

As for your mom having kit and kaboodle of her "womanhood" out, yeah, it's tough. My mom had everything out in her mid-40s due to cervical cancer. She opted for the ovaries out at the same time (so as not to risk 2 surgeries with anesthesia) because there was the tiniest of a greater risk of ovarian cancer due to the one my mom already had. Long story short: I understand that you're angry, but you are dealing with a great result here. No cancer and no ovarian cancer to develop later. And you're going to have your mom around for probably a long time now. Congratulations.
posted by meerkatty at 5:46 PM on August 6

[few comments removed - if we can stay on topic this will really go a lot better, the question was worded unfortunately, agreed.]
posted by jessamyn at 7:20 PM on August 6

There is nothing absurd about the idea of having cancer. I am very physically fit, eat healthy, have never had any major health problems beyond a cold, and have no history of cancer in my family. I'm 25 and was diagnosed with cancer a month ago.

I understand your anger, but I think you're focusing your energy in the wrong direction. Your mother DOESN'T have cancer. That's what is important. Trust me, the alternative is much more devastating.
posted by NeonBlueDecember at 8:57 PM on August 6

I have nothing to say that isn't redundant, but I just want to make sure you understand that cancer is very difficult to diagnose, and doctors tend to err on assuming that a "maybe" is a "Yes" simply because this is your fucking life. Oncologists in general, however, are very well trained in understanding that the treatment of cancer can sometimes be worse than the cancer itself, and work everyday with balancing quality of life vs. length of life. I worry that your caricaturing the doctor is misguided at best, and malicious at worse.

If, however, you think that this doctor was negligent and could cause harm to other patients, you need to be speaking to a lawyer. That is absolutely step 1.
posted by OrangeDrink at 10:06 PM on August 6

She's exactly as much of a woman now, and to be practical, how many more children was she planning to have, exactly?

rokusan, I couldn't tell from your profile, but I'm guessing you're male. How would you feel if you had your testicles needlessly removed at 50 when you were done having children? Just because you can't see or feel 'em, those organs are very important to women for reasons other than babymaking. I agree with you that it's not helpful to take the attitude that the OP's mom is no longer a woman now that she doesn't have a uterus or ovaries, but I think you're trivializing the loss, which isn't helpful either.
posted by easy_being_green at 10:40 PM on August 6

I wanted to be anonymous, but holy crap you people are ruthless. Really? You want to bash on someone when they're seeing their mother cry hysterically and tell you that she's useless and broken? Telling you she's been mutilated? Over word choice? I wasn't even close to as angry about it as she is, and then I read these responses.

I have been positive and supportive, told her she was beautiful, and tended to her every need calmly and rationally and with the love and respect that you give to the woman who gave you life, raised you, and who you now see crumbling at the hands of fate. But I used the language I did because that was what my mother said.

Perhaps "absurd" needs to be redefined as the definition I meant was:
"inconsistent with reason or logic or common sense" (google it) . I'm not sure what people here think it means, but to me, someone who goes to yoga 5 days a week, eats mostly veggies, and has zero history of this cancer or any other besides skin in the family (and only extended) falls into absurd territory. It defies logic. It does not mean impossible, or even improbable, just outside the realm of what one considers when thinking about one's mother with her perfectly healthy lifestyle. Not ridiculous, or silly, or laughable. But thanks for the lecture.

Obviously, I am not going to sue anyone. Nor am I going to talk to the doctor. It is not my place. I THOUGHT metafilter was a place where you could ask people's opinions for hypothetical solutions/options in sensitive situations and not get stoned. Apparently I was wrong.

I want to thank those of you who have come up with actual, constructive answers instead of NOT answering my question and browbeating me for choice of words. Especially, 6:1, googly, EmpressCallipygos, sully75, St. Alia of the Bunnies, Salvor Hardin, onshi, sid, Metroid Baby. Some of those had a bit of the judgersons going on as well, but were at least kind, or on point, instead of just mean.

I'm also sorry for everyone who has had to see their friends and loved ones suffer, and perhaps this is why the judgment came on so strong. You see, I understand that you all have feelings that are legitimate and that spawn from somewhere. It seemed that my definition of "absurd" is not that of others, and people got a bit emotional. I get it, but realize what I meant was different. Also, the information about her organs falling I got from her, because her GP told her about it, as did her best friend, who also had a hysterectomy.

I am happy my mother doesn't have cancer, but hate to see her in such a terrible state. I was looking for help and compassion, and am now sitting here, on my couch, holding back tears because of those of you who just couldn't help but kick a person when they're down.

I will be okay. It is not my body, and I do believe everything happens for a reason. In my family, I am the one who does the research first, and so I did, and now I know that my mother needs to speak with the doctor to clarify what happened and express her frustration, if nothing else. My parents are not litigious, they have never sued anyone and I don't expect them to here.

If the moderator reads this, I need to either cancel my account or change my name.
posted by anniek at 11:03 PM on August 6 [2 favorites]

I couldn't tell from your profile, but I'm guessing you're male.

The posting history is a big fat dangler. You can learn a lot more about someone from that, I've found.

How would you feel if you had your testicles needlessly removed at 50 when you were done having children?

Naturally, that is exactly what I considered before answering. I don't agree with "needlessly" in the OP's case, though. Hindsight is 20:20, and that doesn't apply when you're on the table.

If I was over fifty, already in surgery, had a medical history suggesting likelihood of cancer, had already had all the children I was planning to have, AND the doctor's tests/experience suggested a positive for testicular cancer, I'd damn well expect him to remove them. With extreme prejudice.

I'd be pretty annoyed if he did not, and then told me in recovery that "Yeah, we did a sample and it came up positive, but I didn't want to remove what makes you a man just in case I was wrong." I might consider that malpractice, since this is my life, here.

The doctor's first job is to keep you alive, and not to put your possible future feelings of loss or a lesser problem like hormonal change ahead of that priority. So yes, just like I said for the person in question, paraphrased: "Yes, that really sucks, but, well, they can't put them back. So be supportive and don't turn the rest of your life into some bitter revenge fantasy."

Feeling like less of a woman, or less of a man, is unfortunate. Hormone changes and hormone therapy are annoying. But that's "unfortunate" and "annoying".

Cancer, on other hand, is so aggressively dangerous that we use the word as a synonym for "deadly."

So a little perspective, I think: do you want all your parts, or do you want to be alive?
posted by rokusan at 12:08 AM on August 7

anniek, 6:1 gave great advice. I just want to address a couple things (and I'm sorry that this thread has been upsetting to you, that really sucks).

First, the CA125 test is not an accurate assessment for ovarian cancer. It gives many falls negatives and false positives. This is why imaging and sometimes surgery/biopsy is necessary.

Second, as for doing a biopsy on the fly while your mother is unconcious -- this is, as far as I am aware, typical for women who may have ovarian cancer. I'm assuming your mother saw a gynecologic oncologist who would be best trained and suited to deal with an ovarian cancer-related hysterectomy. When ovarian cancer is suspected or found, staging is an important part of the surgery and greatly influences prognosis. Surgical staging means removing the diseased organs and washing out the pelvic/abdominal cavity to test for stray cancer cells in the cavity, sometimes testing lymph nodes. Simply removing a (possibly) diseased organ can free cancer cells into the pelvic cavity which can increase the chance of metastases. This is one of the reasons why hysterectomy and oopherectomy are generally done in the initial biopsy surgery. Also, the biopsy surgery for ovarian cancer is major, major abdominal surgery. It is not easy to recover from, and it is not something that one would want repeated. It is a dangerous surgery to undergo.

From your question, it sounds to me that your mother may not have had a proper discussion with her surgeon about what would happen -- and what she wanted to happen -- prior to her surgery. When I went for my surgery at age 22, my surgeon met with me and discussed what would happen. He explained frozen section biopsy (and explained that it would be the biopsy they would use to decide what course of action to take while I was open on the table, but that the *real* biopsy to determine the exact grade of cancer would take several days), that they would open me up, take an ovary, test it, and if it came back cancerous, remove the other ovary if it appeared affected. We talked about removing or leaving my uterus. I told him to take it if he thought it looked affected, but to leave it if he thought it wasn't. We discussed in great detail what he was looking for and what he would do if he found anything.

In the end, my gyn/onc didn't have to do a frozen biopsy because he opened me up and saw cancer everywhere -- he recognized and knew it from sight. The best and safest thing he could do for me was to remove everything -- both ovaries, my uterus and cervix, in one piece. It sucked, it still sucks, but I was maybe better prepared for all of that than your mom was.

I don't know if what happened to your mom was malpractice. I don't know if the doctor made an error or did the best thing he could with the information he had at hand. If he did think it was cancer based on the frozen section, he probably did exactly what he felt he should do to save your mother's life.

I don't know that I recommend the Hyster Sisters site -- it actually made me feel worse about my very medically necessary hysterectomy than I originally felt -- but I know that many people find it a good resource.

Your mom will pull through this. It sucks -- she lost organs unnecessarily, but it sounds as though the doctor was doing what he thought best at the time. I would not suggest an ovarian cancer support group for your mother as I know that when I was going through treatment, if someone came to my group looking for support because she had a hysterectomy but didn't have cancer, I'd probably have been incredibly uncharitable towards her for complaining about having the same surgery I had without the added inconvenience of chemotherapy and a life-threatening illness. That's not to diminish your mother's experience, but those who suggested an ovarian cancer support group may be forgetting that people in the midst of their own personal hell may not be sensitive to situations which seem less significant to them. It wouldn't be fair to those women coping with actual cancer diagnoses, and it wouldn't be fair to your mom who is looking for support. General hysterectomy support groups (if available in her town) would be better, as would individual counseling or therapy.

Sorry if this answer is all over the place, but I did want to respond as I have experience with this, but it is late so I'm not entirely together.
posted by Felicity Rilke at 12:17 AM on August 7 [2 favorites]

anniek: Sorry to hear about your mother's experience; I hope she can get some satisfaction or at least make her peace with it. I just wanted to quasi-apologize: I almost said something about the "absurd"-ity earlier, but didn't because other folks had already covered it. It certainly wasn't my intention at that point to kick you when you're down. Obviously, I don't know what was in the other commenters' heads, but I'd like to think, at least, that there was a miscommunication; that, hopefully, most of those commenters didn't want to make you feel bad, either.

What I think they probably meant--and what I almost said--is that, although it's terrible to realize that having a healthy lifestyle doesn't prevent cancer, at least there might be some small consolation in the fact that the doctor was right to not rule out the possibility of cancer because of your mother's lifestyle. It must be very painful to think that you may have been operated on--violated, even--by someone incompetent; so maybe there's some small comfort in knowing that even if it turns out he did screw up, at least he didn't screw that up.

Or to put it a little differently: during surgery he said he'd found cancer, and that statement turned out to be wrong. So that calls into question all his statements from various stages of the process; you can't trust his words anymore. One of his many statements was probably something like "being healthy doesn't make this kind of cancer less likely". Well, at least you can know that that particular statement was correct; hopefully, one correct statement and N uncertain statements is a little better than N+1 uncertain statements.

Hope you guys both feel better soon.
posted by equalpants at 12:20 AM on August 7

I recently read Malcolm Gladwell's Blink, and the following is cut and pasted from a review and may give you something to reflect upon when considering whether to sue or not:

"One of the more convincing experiments involves electronically filtered recordings of doctors speaking with their patients. Using only the tone of voice as a predictor, experimenters found they could determine which group of doctors had been sued for malpractice and which group had not. "If the surgeon's voice was judged to sound dominant, the surgeon tended to be in the sued group. If the voice sounded less dominant and more concerned, the surgeon tended to be in the non-sued group." Further, "the surgeons who had never been sued spent more than three minutes longer with each patient than those who had been sued did (18.3 minutes versus 15 minutes)." Gladwell points out that although malpractice appears to be an infinitely complicated and multidimensional problem, this is actually how patients thin-slice their doctors."

The conclusion is essentially that people sue doctors they don't like. If the doctor made a mistake, but the patients like him, they tend to give him the benefit of the doubt. Consider the possibility that you might want to sue less because it was malpractice, but more because he was smug about his mistake.

My father died two years ago almost to the day, and I know that if the oncologist had acted with greater care in our meetings, less like she had somewhere more important to be, I wouldn't have been so angry at the time.

Good luck with whatever you decide.
posted by Sully at 2:20 AM on August 7

[D]oesn't the fact that there wasn't any cancer and they imagined it make what she signed void?

No. Your mother signed the consent form for exactly this kind of eventuality. Essentially, the form says "I give permission for my surgeon to do anything which appears to be medically necessary." Which is what he did. She might be able to recover something in a malpractice suit if she can establish that a reasonable gynecological surgeon would not have done what your mother's surgeon did (that's the essential element of malpractice, a gross error in judgment, not a bad outcome), but she'd have to argue that another surgeon would not have considered the tissue samples, as confirmed by the pathologist, to be dangerous. That's gonna be a tough sell.

Either way, I think it's highly unlikely that she will be able to recover anything on the basis of the consent form. That would transform this from a malpractice action into a battery action, and that dog won't hunt, given these facts.

IANYL.
posted by valkyryn at 4:35 AM on August 7 [1 favorite]

they could always just biopsy what they need in the first surgery and come back?

Because any surgery is a risk. General anesthetic isn't 'safe.' It's not something to be just taken lightly. If you can avoid being 'put under' you should.

But the biggest thing is the risk of infection and complications that come just from your skin being breached and foreign *things* being introduced or allowed to enter.
On top of that, hospitals are germ central. You should be kinda wary of those places even when you're healthy, let alone if you're in there and in some way compromised.
(This being why deaths from 'unnecessary plastic surgery' are really so sad.)

I don't know that you'd get much money...? Some might argue that they did nothing wrong and acted responsibly. It just happened to turn out in the end that your mom was ok and would not need to endure further treatment. (Was there talk of the operation being followed by aggressive chemo because of what they had found? Did they take everything out in an effort to try to avoid that?)
They weren't catastrophically negligent, if anything the crime might be that they were overly diligent.

Then there is her loss. She's in her 50's and has had children. But you're right though. She was using those things to keep her guts in place. And if she hadn't gone through menopause yet they should've taken more care. Just don't expect it to be worth as much as it would for a woman in her 20's with no children.

The kind of cancer that the Doctor and the Pathologist had thought they were dealing with is probably a really pertinent detail too.

Lawyers are expensive so any money you stand to gain may not be worth it. Make sure you do lots of research on this yourself.

I imagine you could always file a complaint at the hospital? (Just on the chance that this was not an isolated incident. You hate to think it but it's not like that kind of thing doesn't happen... )
posted by mu~ha~ha~ha~har at 5:30 AM on August 7

The tension in this thread is boiling over. Don't make this more complicated than it needs to be. I know this must be difficult for the both of you but to do what is necessary, you need to stay calm and try not to let your emotions get the better of you. Of course you are angry, but the simple fact is that certain features of your case are striking you as odd/crazy, when to me they are not necessarily outside the bounds of appropriate care.

Why not talk to the doctor? This really is the best thing to do. There are unanswered questions you have that are clearly eating away at you and there is no reason to think it is not your place. Tell your mom that lots of things bother you about her story and you'd like to talk with the doctor about it. If she agrees, do so. Make a less of the questions you have about the case in advance, and try to use neutral language. This really does seem like the kind of case where misunderstandings and miscommunication have lead to a lot of what may be needless anxiety and anger. Whether something was done inappropriately is impossible for us to say here for sure, but I guarantee you that at least some of the features of what happened to your mother that are upsetting you have either been poorly communicated to you or misunderstood. And at the very least your mother (and you if allowed as a proxy) are entitled to some answers directly from the horse's mouth.
posted by drpynchon at 6:34 AM on August 7

The people saying the contract your mother signed probably voids any malpractice action options you may have may be right, but they might not be. A lawyer friend of mine once told me that some waiver sections common to apartment leases pertaining to giving up the right to sue the landlord over certain issues don't actually hold up in court, whether the tenant signed it or not.

That probably won't apply here, but you won't know until you and/or your mother talk to a lawyer. Do that before you talk to the doctor or anyone else.

As for MetaFilter being dicks about a really sensitive issue because of some wording: It happens, and I think it's a bad idea to hang your hopes on getting insightful compassion from an AskMe question. It happens, but not reliably.
posted by ignignokt at 7:44 AM on August 7

The tension in this thread is boiling over.
Indeed it is. Anniek, I am deifintely sorry for you and your mother. While I can imagine what you are going through, not having experienced it, nobody can know.

That being said, as others have pointed out, Ovarian cancer is the "widower-maker" cancer. Not to diss breast cancer, e.g., but as others have said, ovarian cancer is difficult to diagnose, often not diagnosed until it is too late, and then everyone, oncologist included stands around and watchers the patient suffer and die.

Again, this doctor could've screwed up. But this doctor, knowing about Ovarian cancer could've said to himself,

"well biopsy guy said it looked like cancer, hmmm, s/he's pretty good. I trust his/her judgement, well if it is and I don't take everything out, what if it metastesizes because I didn't take the other ovary out? If it is not, well then at least she's alive!"

when the doctor strode in, proud as could be, and told her that she never had cancer and that in fact, what they had thought was malignant cancer was in fact NOTHING.

He could've been an arrogant asshole, or he could've been thinking "Wow, she DOESN'T have cancer, that is a big relief, no chemo, no waiting to see if we got it all or if it metastesizes. Boo-yah!"

So not being a doctor or a lawyer, just nth the peopel who suggest that you talk to your doctor frankly but not in an accusative way - which I know how hard that must be because you and your mother are both upset now, but you must keep your emotion sin check, at least for the conversation. Doctor, given how malpractice goes, might switch into "defense cover-up" mode even if no cover up is necessary. You want information.


An anecdote
I know the absurd part has been argued to death - with less sensitivity than it should have, but I have to tell you - a very good friend of mine died of colon cancer two years ago. We were born within three months of each other and our mothers were best friends since they were little girls. so it was tough to see . He was the healthy one who was a vegetarian, a tall lean wiry athlete (he got all the chicks, a source of endless resentment from me) and I was the fat, fast food junkie who until a year ago didn't exercise and didn't eat right. But he was cut down in the prime of life. Life isn't fair like that and life is absurd.

Also, and this might sound very harsh, but forums like this are hard to nuance so forgive me.

While there is no place in Askme for ad hominem attacks or faux Dr. Phil diatribes, I don't think this forum's place is for support. It really isn't. It is to ask questions, and to use the hive mind to answer them or if it is a life/health question to formulate a possible plant to answer the question or to solve the problem. This doesn't mean people are free to be dicks, just that emotionally fraught questions sometimes have tough answers.

Good luck, do let us know how you and your mother are coping, and even if you feel up to it, post a follow-up.
posted by xetere at 11:06 AM on August 7 [4 favorites]

I wish I had read this thread earlier, so I could have put this answer further up the page.

I am glad your mother doesn't have cancer, and I am sorry she was frightened and had to lose so much in order to discover this. I am also sorry she is placed into a situation where it will cost her money to have had this experience.

Imagine, instead of the callous, "guess what? she never had cancer!" the doctor had said, "we removed the suspicious tissue, and I am pleased to be able to tell you there is no sign of cancer!" If this helps at all, it would seem that at least part of the reason for your anger is because the doctor was an asshole. This is something you can let go of.

I won't try to talk you out of having your mom talk to a lawyer, but she is almost certainly not going to get anywhere with it, for many good reasons outlined above. Please do continue to look for support for your mom, online or otherwise.

A lot of the responses you got are people berating you for your words. Surely it is obvious that your use of the words "stolen" and "absurd" are an emotional response to this incident and not nits to be picked.

More sensitive, and more useful, is the discussion around what makes someone a woman. While I agree with those who say your mother is no less a woman than she was the day before, the reality is she is now immediately in menopause. She is a fit, active, healthy woman, and suddenly, she is hollow and scarred where her husband once put his hand to feel you kick. Her sexual response won't be the same without her cervix. Without ovaries, she might need hormone therapy for proper lubrication, or to maintain drive at all. Of the three mythical states of femaleness, this boots her straight from mother to crone, years early and with no warning.

Every person who shamed the poster for using her mother's words of mourning should think about their first menstrual period. Did anyone say, "now you are a woman!" to you? You could perhaps forgive a woman who considers the sudden, fresh, catastrophic loss of her reproductive organs as a step toward being ungendered. (And if you aren't the sort to have had a menstrual period, even moreso.)
posted by Sallyfur at 6:47 PM on August 7

this boots her straight from mother to crone, years early and with no warning.

The average age for menopause is between 45 and 55. The poster's mother is "in her fifties."

To the poster: If you want to know more about the "mythical states of femaleness," I believe she's referring to this neopagan belief.
posted by Houstonian at 7:17 PM on August 7

I'm not, but I can see why it would appear so.
posted by Sallyfur at 9:31 PM on August 7

You want to bash on someone when they're seeing their mother cry hysterically and tell you that she's useless and broken? Telling you she's been mutilated? Over word choice?

I can't speak for others, maybe there was some bashing there. But I know my own "harshness" was deliberate and calculated to (hopefully) make you realize how powerful and important words can be, here.

(The first way to start healing, I think, is to get control over the language and the way that your mother is thinking about this. And the words you are relaying from your mother are a big part of the problem. By steering the words, and even being brutally blunt about it ("you are EXACTLY as much a woman as before!", you can perhaps help guide her to more positive ways of thinking about the situation.)

Words are really powerful, and if you reread your own question, those words really come across as yours, not hers. I think if you'd phrased the question as "My mother is saying these ridiculous things, help me." you might have seen less snapping-back in the responses.

Don't delete your account. I think most of us saw/read what you wrote as emotionally-charged, and for good reason. And probably at least some of the responses were, like mine, meant as cold water, rather than cold-hearted.
posted by rokusan at 1:53 PM on August 10 [3 favorites]