When is a spade not a spade.

I was visiting professor of anaesthetics in a hospital outside Britain when I was asked to see an emergency admission with a severe haematemesis. The patient was elderly, wasted, disoriented, somewhat dehydrated, hypotensive, and tachycardic. He had a chronic gastric ulcer. He had been an inmate of the local mental hospital for the previous 20 years. He was a Jehovah's Witness. His medical superintendent left the decision about blood transfusion to his wife who was on her way in. The surgeon would accept my decision about whether to operate or not.

I telephoned the chief administrator. He would not give permission but would consult the minister of health (it was that …