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Comment by lostlogin | Hacker News Reader

> At the other extreme you have the medical profession where the first thing you learn in medical school is that left/right always refer to the patient's perspective.

I was recently involved in a case where a patient decided that their left should be called the right side during a phone consultation as that would help their doctor.

Good times.

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I have heard stories of patients, entirely on their own, using black markers to indicate which leg/arm was to be operated upon. Surgeons are entirely OK with this. They appreciate it. I also heard a legend of a patient who themselves marked the wrong leg. This wasn't discovered until after sedation. The procedure was canceled until everything was clarified.

When having my arm x-rayed years ago they places a small pad with an embedded metal "L" to indicate that it was my left arm. But if you place the L backwards, then they will think the image has been reversed, which just makes everything more complicated. So the L-pad needed "this side up" label.

The letter being revered is a way of indicating if the beam went from the back to front (posterior to anterior) PA or front to back, AP.

X-rays are effectively shadows and things further from the X-ray plate get more magnified. Large structures like the chest benefit from being done a certain way, like having the heart near the plate. That way it’s less magnified.

PA or AP is often a thing you see on the corner of films, indicating the technique.

The film also used to be processed in a film processor, and it was very easy to accidentally flip. This is another reason we have conventions.

The surgeon has no issue with it because it is essentially universal policy in the US (don't know about other countries but can't imagine they don't have similar) that the surgeon must, prior to sedation, mark the surgical site themselves and put their initials on it. Exceptions are made for cases where there isn't a "side" (you only have one gall bladder), or where the wound is "obvious", or for exploratory surgeries where the actual site of all injuries is not yet known.

I can add to these stories because one time I needed to overrule my doctors opinion and use a digital interface to point where the problem is. The peoblem involved X-ray.

That's a particularly strange kind of overthinking, implicitly acknowledging the medical field is complex enough to consult a professional, and yet thinking something as common and (relatively) simple as interpreting left/right from patient descriptions hasn't already been considered.

That's before even getting into the assumption of face to face orientation over a phone... is that in virtual terms, or in terms of absolute orientation, I hope they took into consideration the curvature of the Earth.

As I said elsewhere, but I think it's worth repeating here - In an effort to avoid ambiguity, I always talk to my doctor in terms of "driver's side" and "passenger side" - thus adopting the maritime approach, but in more common terms.

Until you call a doctor in the UK.

To whit, having learned to drive on the left, the “easy” turn that does not cross traffic is always a “left” turn to me, regardless of living in a country that drives on the right. Makes giving directions to others quite interesting.

I learned to drive in the US, but lived over 10 years in Hong Kong, and have driven in New Zealand and South Africa.

When I first moved to Hong Kong, I kept making eye contact with passengers instead of drivers when crossing the road on foot.

In New Zealand (my first experience driving on the left), I turned on my wipers (on a sunny day) the first couple of times entering a roundabout (the turn signal is on the other side of the steering wheel). Also, I couldn't resist the urge to glance over my left shoulder for oncoming traffic in my blind spot when making left-hand turns, despite the fact that traffic approaching me from there would need to be driving the wrong way down the road.

Thank goodness that the manual shift pattern and pedal layouts are kept the same between left-hand and right-hand drive models. Driving in South Africa could have been a disaster had the shift pattern been reversed.

I drove a Japanese car in NL traffic and whenever I had to downshift for turns in the first couple of hours after switching cars my right hand would slam into the door :)

I just try to prepend "my". It's usually natural to do this anyway ("my left knee" e.g.) but can always be done ("I fell to my left" instead of "I fell to the left").

And then you get a doctor from Japan!

That's country specific, maybe you should use port and starboard.

Really though, just use _your_ left and right as most people do, because as has been mentioned, the standard is for doctors to refer to and visualise left and right from the patients perspective - so every time you do something different they have to transform, translate or clarify which increases chance of mistakes.

It reminds me of a lot of hackernews comments on technical topics from non-software fields.

Only on HN would the domain of "technical topics" be constrained to software.

Is this the story of how someone ended up with one less appendix than they should have?

People only have one appendix to start with. Did you mean appendage?

No, that's what I meant, but said in a facetious way. If someone is complaining about lower right abdominal pain that could be the appendix, when lower left would not be.

Ah I get it now. Sorry for the density.

Don’t apologize; we all benefit from a good chuckle.

Unless the patient is one of the 0.01% - https://en.wikipedia.org/wiki/Situs_inversus

Perhaps they have -1 now.

Either that or my recent C excursions have me thinking in buffer overruns and index errors.

The official recordbooks will now show that patient is officially the first to lose an appendix but gain a preface.

That would be two less than they should have? Unless you're commenting on its uselessness that they 'should' have zero despite one being normal?

Last I heard, there's an idea that it might help recolonize the gut with good flora after infections and such.

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