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The_Ink_Goddess
08-25-2010, 06:23 PM
Yay, it's creepy question time again from terminal story researcher. :D

Basically, yeah. I'm writing a story about a girl who does some intern stuff (basic receptionist stuff) at her father's plastic surgery practice. But she becomes increasingly opposed to this pursuit of beauty until her sabotage escalates from minor screwing around to full-blown assault and she commits herself to the destruction of her father's "masterpieces." Uh-huh. Seriously effed up book.

Butttt. I have no idea how a plastic surgery practice works...so, give me ANYTHING. How easy would it be to access files? (MC's dad owns the surgery, does the stuff himself.) What kind of authorities do private practices answer to? Who works there, beside from the obvious surgeons etc.? Is it realistic that police would or wouldn't notice the link between the assaults? Any other stuff that anyone knows that they can throw out there that they think could be interesting or flesh it out?

RJK
08-25-2010, 06:47 PM
I know nothing about plastic surgery, but if your character were to find a way to contaminate the surgical instruments, all the patients' incisions would become infected. I think that would result in permanent scaring, if it didn't kill them.

GeorgeK
08-25-2010, 10:12 PM
Plastic Surgeon or Cosmetic?

A Plastic Surgeon will have done an acreditted residency of 3 years General Surgery plus three years of Plastic and Reconstructive Surgery or 5 of General and 2 of Plastics (this is minimum and after receiving an MD or DO). It's the Plastic and Reconstructive people you call when a dog rips off a kid's face or there are big holes to close that have too many missing parts. A "Cosmetic Surgeon" could be a Chiropractor, Dentist, or any MD or DO who just wanted to do a few particular procedures frequently that pay well. They can just go do a 1 week course here or there for each procedure. These are the ones who typically have eyelid and tummy tuck clinics. They aren't real Plastic Surgeons but since those are not legally defined, they often bill themselves as "plastic surgeons". The second group would be far easier to sabotage because they just don't know as much and so would be easier to fool. They often don't have the knowledge to deal with complications. It would be ridiculously easy to contaminate surgical instruments, just drop them on the floor or spit on them or wipe them on the outside of your nose after they are supposedly sterilized. Wound infections from dirty instruments (despite that the instruments might look clean to the naked eye) will typically be obvious in under 48 hours. Often people who aren't that skilled in sterilizing techniques will respond by simply putting the patients on antibiotics. Adulterating or switching the drugs or altering doses would be another avenue of causing complications. These things have happened before in real life. Often it has been spurned love interests starting it.

The_Ink_Goddess
08-25-2010, 10:22 PM
Thank you so much, GeorgeK. That has truly opened up a wealth of possibilities.

A question about cosmetic surgeons: do they have their own practices? What kind of surgery do they do? You mentioned tummy tucks, eyelid lifts -- could they do stuff like nose jobs, breast augmentation, Botox too?

Giant Baby
08-26-2010, 02:15 AM
Thank you so much, GeorgeK. That has truly opened up a wealth of possibilities.

A question about cosmetic surgeons: do they have their own practices? What kind of surgery do they do? You mentioned tummy tucks, eyelid lifts -- could they do stuff like nose jobs, breast augmentation, Botox too?

I had rhinoplasty (nose job) when I was seventeen. It's some years ago now, but the procedure was performed under general anesthesia in an OR suite in his private office. Present was the surgeon, an anesthesiologist, nurses, and office/administrative staff. There may have been others as well, but those were who I came into contact with. This was pre-Botox, but the other procedures you've mentioned were all certainly on the menu.

There would also likely be staff to handle billing, but that may be on or off site.

A trusted employee of a practice like this would certainly have access to just about anything she needs. I work in a major medical center, and while I would/could never walk into an OR suite while an operation was in progress, I can certainly access the supplies/drugs before they're stocked for the procedure. In a smaller office, she'd have no problem if she was motivated.

Tsu Dho Nimh
08-26-2010, 02:56 AM
If she's daddy's receptionist and file clerk, she has access to the patient records, which would include home and work addresses and phone numbers.

What sort of mayhem will she do? Sabotage or assault after the patients have gone home?

lbender
08-26-2010, 09:14 PM
I agree with most of what's been posted in reply, but nobody addressed the police question. You can bet that if there were a group of complications and/or deaths, all affecting patients of a particular plastic surgeon, a number of people will draw the connection.

In addition to the police and, probably, certain government health services, her father is going to figure out pretty quickly that something is going on. Although he might not automatically suspect his daughter or sabotage, any respectable doctor is going to go crazy until he figures out what's happening.

GeorgeK
08-26-2010, 09:39 PM
Most likely the police, if even called, will brush it aside and tell the people to contact the state medical board. A malpractice insurance adjuster is the most likely person to realize the trend. In the scenario given by the OP, I don't imagine this "surgeon" to be the cream of the crop to have a daughter so...out there. Of course it's possible, but for the plot to work he can't realize what's going on until it's way out of control and so he can't be the best surgeon since sliced bread. He's most likely what we used to call a radical sphincterotomy (an incompetent asshole), because their shit won't stop flowing. They are often borderline compulsive liars, narcissists and womanizers.

And btw, for these kind of "surgeons" (they do exist) they have it go on longer if the population base is larger. In small towns, the patients are more likely to talk to each other more and the bad ones usually move about every 7-10 years. Of course people move for all sorts of reasons so that is not to imply that people who move must be defective.