Patients often can’t help but wonder what doctors and nurses are doing while they’re sedated.

Some suspect trash talking. Others are wary of racially charged comments.

On Wednesday, a British surgeon gave patients something new to worry about: Getting their doctors’ initials burned into their organs while they are unconscious.

Simon Bramhall, 53, pleaded guilty to two counts of assault by beating after he used an electric beam – typically used to seal blood vessels – to mark “SB” into a man’s and woman’s livers during their transplant operations in 2013, according to the Telegraph. Doing so usually isn’t harmful, as the marks would typically fade.

But the woman’s liver did not heal normally. During her follow-up operation, doctors allegedly discovered Bramhall’s initials, the Telegraph reported.

Bramhall worked as a liver, spleen and pancreatic surgeon for 12 years at Queen Elizabeth Hospital in Birmingham, West Midlands. He also tutored medical students and supervised postgraduate students pursuing higher degrees, the Telegraph reported. He made headlines in 2010 after he performed a lifesaving transplant operation for a patient with a liver that was recovered from a private plane crash in Birmingham. The two pilots were hurt but the liver was undamaged, allowing the operation to go as planned.

Bramhall at the time said it was “amazing” the organ remained intact.

Bramhall was reinstated in April 2014, pending an internal investigation, but then resigned from the hospital in May 2014 and said he decided to step down because of stress-induced illness, according to the Birmingham Mail.

At the time, he told the BBC that he had made “a mistake.”

“I was not dismissed. I made the decision on 16 May I would hand in my notice,” he said. “It is a bit raw and I have to move on.”

On Wednesday, prosecutor Tony Badenoch said Bramhall’s actions were part of a “highly unusual and complex case” that so far was “without legal precedent in criminal law,” according to the Telegraph.

The guilty pleas “represent an acceptance that that which he did was not just ethically wrong but criminally wrong,” he said, according to the Guardian. He added that it will be up to others to decide whether his license to practice surgery will be compromised.

The General Medical Council in February issued a warning to Bramhall, saying his conduct didn’t meet the standards required of a doctor, the Guardian reported.

“It risks bringing the profession into disrepute and it must not be repeated,” the GMC said at the time. “Whilst this failing in itself is not so serious as to require any restriction on Mr. Bramhall’s registration, it is necessary in response to issue this formal warning.”

On Wednesday, the GMC said it was not uncommon for the council to access doctors’ criminal convictions.

Crown Prosecution Service specialist prosecutor Elizabeth Reid on Wednesday called Bramhall a “respected surgeon” who abused his power.

“It was intentional application of unlawful force to a patient whilst anesthetized,” she said, according to the Telegraph.