In New York, Dr Andrew Rokito's patient wrote ``Yes'' on one leg and ``No'' on the other. Nearby, Dr Steven Stuchin's patient lay with a pink ribbon she tied around her injured leg.

The message was clear: following surgical gaffes in which doctors amputated the wrong foot, removed the wrong kidney and opened the wrong side of a woman's brain, patients were frightened and mistrustful.

Now hundreds of surgeons are getting the message and putting their John Hancocks on every Tom, Dick and Harriet who comes under the knife.

The trend toward autographing patients' bodies marks a low-tech effort to avoid what doctors call ``wrong-site surgery.''

The 17,000-member National Academy of Orthopedic Surgeons urged surgeons last March to sign their names on the spot to be cut.

In recent months, hospitals across the nationhave adopted the practice to try to curb lawsuits and spare patients undue agony. Among them: the orthopedic surgery departments at New York University, Chicago's Northwestern University Medical Center and Strong Memorial Hospital in Rochester.

``For all the science and technology and out-and-out hardware, which is worth millions of dollars in any operating room, the most important thing that patients and doctors do is talk to each other,'' said Stuchin, director of orthopaedic surgery at NYU's Hospital for Joint Diseases. ``The 1.50 dollar pen is part of the communications process.''

Wrong-site surgery is common enough that the practice has its own euphemisms, such as ``bilateral confusion'' and symmetry failure.''

From 1985 to 1995 the Physicians Insurers Association of America (PIAA) counted 225 claims for wrong-site surgery by its 110,000 doctors. Willie King won 1.2 million dollars after a Tampa, Florida, surgeon amputated the wrong foot in 1995.

Perhaps most alarming to surgeons: patients winmonetary settlements 84 per cent of the time, according to the PIAA.

``In other words, if you operated on the wrong leg, they were going to pay off,'' said Dr S Terry Canale, who led the Surgeon Association's National Campaign and operates at the Campbell Clinic in Memphis, where surgeons now sign their patients.

Orthopaedic surgeons, who specialise in skeletal operations, saw another alarming statistic: one in four of them will operate on the wrong organ in a 30-year career, according to the insurance group.

A number of things can go wrong. In the Tampa case, doctors said both the patient's feet showed signs of gangrene. Dr Joseph Zuckerman, director of orthopaedic surgery at NYU, has walked into the or to find a patient prepared for surgery on the wrong knee. The X-ray had been labelled backwards.

``This is an uncommon problem,'' Dr Zuckerman said, ``but it's indefensible.''

Some victims of wrong-site surgery experience only inconvenience and an unneeded scar. Others pay a hefty price.

HarryJordan visited the hospital often after doctors removed the wrong kidney in 1983. The Long Beach, California, insurance broker was left with one kidney at one-fifth its normal size. He died 13 years after the operation after winning 250,000 dollars in damages.

``Nothing can give me back the kidney they took from me by mistake,'' he said. ``Or let me walk more than a block or so, or relieve the constant fatigue and pain and examinations and tests.''

Rajeswari Ayyappan underwent a second traumatic operation to remove a brain tumor after a surgeon at New York's prestigious Sloan-Kettering Memorial Cancer Centre operated on the wrong side.

``The idea of signing where you're actually doing it is the best idea I've heard yet,'' said Ayyappan's lawyer, Dr Harvey Wachsman, who also teaches neurosurgery at the State University of New York at Stony Brook.

Some of the nation's most prestigious hospitals don't make marking patients mandatory. Among them: the Mayo Clinic of Rochester, Minnesota, John HopkinsMedical Centre in Baltimore, and Sloan-Kettering.

Some hospital officials privately said they fear adding to patients' stress by pointing out the possibility of error.

Marjorie Young, operating room director at NYU, gets a different reaction from patients when a doctor scrawls on them.

``They're loving it,'' she said.