“What would you do?” 

By Spencer Mann, BA, Johns Hopkins Medicine 

I’ve spent the past four years working as a research assistant at Johns Hopkins, helping to improve how care is delivered. One week ago, however, I found myself on the other side of the bed. I was the patient. 

A couple of weeks after surgery to correct a jaw issue, I developed a rare and serious complication—an arterial bleed from a pseudoaneurysm, which occurs in less than four percent of patients. Suddenly, I was back in the hospital, but as a patient this time. I remember the chaos—two IVs placed, four nurses working to keep my blood pressure up, and the neurointerventional radiologist standing at the foot of my bed explaining the need for an immediate embolization procedure. He needed my informed consent, but I felt overwhelmed. It was all moving so fast. 

What is informed consent, really? 

I’ve been taught that informed consent is a process—an ethical, communicative bridge between doctor and patient. It’s supposed to support autonomy, but as a scared 22-year-old being told that I have a risk of stroke or blindness by undergoing the procedure, it didn’t feel empowering. It felt terrifying. 

My choices? Let the bleeding continue (not an option), let the surgeons cut open my face and go searching for the ruptured vessel, or sign the consent form for a potentially risky procedure. 

The neurointerventionalist was calm, professional, and articulate. He was doing exactly what I’d want any physician to do in his place: give the facts, explain the options, and act swiftly. In that moment, however, despite all his skill and steadiness, I felt unsure and scared. 

What helped 

I asked the third-year oral and maxillofacial resident what he would do as he handed me the consent form. He didn’t give me another set of numbers. He just looked at me and said, “If it were me, I’d go with the embolization. You don’t want us going back in.”

Although contrary to contemporary teaching around informed consent, that personal response helped me process the decision. Between the resident’s honesty and the neurointerventionalist’s calm professionalism, I felt surrounded by people who truly wanted the best for me, and that made all the difference. 

Gratitude  

Three and a half hours later, the procedure was done. The pseudoaneurysm was successfully embolized. No stroke. No blindness. Just relief and gratitude for the medical team, whose expertise and precision saved my life. And I will never forget that resident who treated me not as a patient, but as a person. His calm presence and words helped me see the best path forward at a time when I felt confused. 

Practical tips for healthcare professionals from the patient perspective:

1. Explain, then connect.  

Use clear language to explain what’s going on and also take a moment to ask what the patient is feeling, not just what they understand. 

2. Acknowledge fear.  

Validating emotion is just as critical as delivering facts. 

3. Be prepared to answer the question “What would you do?” 

Patients may sometimes ask this. This is an opportunity to ask follow-up questions and understand what’s driving their need to ask this question. 

4. Slow down.  

Even in an urgent situation, a calm and thoughtful pause goes a long way in calming patient fears. 

We often say informed consent is a conversation. It is—but more than that, it’s about the patient-physician relationship. 

This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.