Benadryl Cabbagepatch is a second year engineering student at the University of East Brisbane. She works part-time as a school bus driver (three mornings a week, from 7 am to 8 am) Benadryl was born with a heart condition. She has had several operations to try to correct her heart condition, with mixed success. Benadryl tires on exertion. Her physical limitations cause her extreme embarrassment and also constrain the extent to which she is free to participate in energetic and strenuous work placements as part of her course. Benadryl wants to be a mining engineer, so needs to be able to explore small spaces. In 2020, a "miracle cure" for Benadryl's heart condition is discovered by Dr Gentle. The surgery involves, not an operation on the heart, but deep brain stimulation using electric probes. Excitedly, Benadryl arranges an appointment to see Dr Gentle. Dr Gentle gives Benadryl a sample of a drug, Referrex. He tells Benadryl it is important that she takes the drug three times a day in the time leading up to the surgery. Referrex is a slow acting anti-hypertensive drug (i.e. it is designed, over time, to lower a person's blood pressure). Benadryl, excited by the prospect of finally being cured, Googles Referrex on her home computer. Information provided on the drug indicates: Referrex is a clear liquid, to be administered three times a day via oral route. Referrex's active ingredient is bi-rambutamol (0.5%). Other ingredients include sugar, ascorbic acid, stabiliser, and sodium chloride. Referrex is generally well tolerated, but in 1 in 100 patients Referrex produces nerve damage rendering the patient permanently paralysed on the left hand side of the body (hemi-paralysis). Referrex may be taken with or without food, but should not be taken in conjunction with potassium or grapefruit juice. Referrex is best consumed in the afternoon and at night. Benadryl takes her first dose of Referrex when she gets home that night. She continues to take the drug in the lead up to her surgery. At about the same time as Benadryl takes her first dose of Referrex, Dr Gentle has dinner with his partner, Dr Righteous. Dr Righteous is a physiotherapist. Dr Gentle tells his partner about Benadryl and how she is funny and engaging, but is being held back by her heart condition, which he intends to cure. He describes in some detail, the nature of Benadryl's illness. Dr Righteous asks Dr Gentle if this is the same Benadryl as drives their daughter, Aspidistra, to school on Mondays, Wednesdays and Fridays. Dr Gentle says "the one and the same". Dr Righteous gets very upset. He rushes to the phone, calls the TV show "In Brisbane Tonight" and tells them there is rogue bus driver who is at risk of killing children because of her illness. Dr Gentle performs surgery on Benadryl. During the surgery, Benadryl (who is unconscious as she has been anaesthetised) starts thrashing about. Alarmed that Benadryl's movement might dislodge one of the electric probes, Dr Gentle considers stopping the surgery, but decides to simply operate faster. One of the probes slices through a part of Benadryl's brain, permanently affecting her sense of balance. It transpires that: There are two known risks of the surgery that Dr Gentle performed on Benadryl: an eye droop (which occurs in approximately 1 in 14,000 cases); and permanent hearing loss (which occurs in approximately 1 in 10,000 cases). Benadryl says she wasn't overly concerned about the risk of an eye droop, but if she had have been told of the risk of permanent hearing loss, there is no way she would have undergone the procedure. Benadryl develops an eye droop as a result of the surgery. Had Dr Scramjet (a doctor in post-operative care) administered a CT scan immediately after the surgery, the eye droop would have been evident. There is a 48% chance that corrective treatment involving nerve stimulation which would then have been carried out, would have corrected the droop. Dr Scramjet did not administer a CT scan. Benadryl has been rendered permanently semi-paralysed from ingesting Referrex. Dr Gentle did not mention any side effects of Referrex or of the surgery. There is a dispute in the literature as to whether a doctor should advise of the risk of hemi-paralysis from ingesting Referrex. An article in "Allergies" (an English Journal) says that they need not. An article in "Allergies Today" (an American Journal) describes the view that they need not as "irrational and non sensical". Had Benadryl known of the side effects of Referrex, there was a 40% chance she would have taken it anyway. Twenty eminent surgeons are willing to give evidence that what Dr Gentle did in the surgery, in response to Benadryl thrashing about, was reasonable. The procedure is so new there is no accepted practice. Dr Rough (Dr Gentle's half-sister) is a colorectal surgeon. She is consulted by Fred. Fred has had stage 4 bowel cancer, and suffered two heart attacks and a stroke. He is fed via a PEG (percutaneous endoscopic gastrostomy a plastic tube which has been inserted via his abdomen into his stomach). Dr Rough advises Fred to undergo further bowel surgery. Dr Rough performs the surgery on Fred. The surgery is performed competently, but Fred dies shortly thereafter. Fred was simply too sick to have undergone the surgery. Aspidistra, who is aged 14, has a large nose, relative to the size of her face. She has changed her mind about going through with a rhinoplasty operation (a nose job). Dr Gentle and Dr Righteous both think that the operation is a good idea and have told the surgeon, with whom the three of them consulted, to go ahead with the operation. Aspidistra is concerned about the extended hospital stay and pain involved with the procedure and is adamant she doesn't want the operation. Advise generally