The Phantom Of The V.A.
December 29, 2008
During the second half of my surgical internship, I was assigned to the VA Hospital in Richmond. At that time, and it probably hasn’t changed, everyone wanted to go to the VA because you got to do surgeries that were way beyond your usual fare. As an intern, I got to do surgeries that I normally wouldn’t be given to do for at least another two years, or so, at the regular hospitals.
When you think about it, that’s really unfair to the vets. I mean, here are guys that have sacrificed for their country and here they’re being used as guinea pigs for some young punks looking to learn surgery. But, of course, at that time, all I cared about was doing more surgery. The fairness of the situation never even entered my mind–that’s just the way things were.
Anyway, one of the patients on my ward was a guy who had been operated on by every house officer who had rotated through that surgical service since he had been admitted over three years before. The guy was an old man, a real basket case.
He couldn’t even eat because he had NO intestines left. He was fed through a vein, by I.V. hyperalimentation–a very fancy term for total parenteral (by vein) nutrition. Every few weeks or months, he would develop some complication or another that required another surgery. There was hardly anything left of him, but he kept on chuggin’ along, educating generations of interns.
Then, one of the residents told me how he came to be like this and my blood just froze. You see, he originally came in for a “minor surgery.” He was just supposed to have a simple bunionectomy. But, hard luck guy that he proved to be, it got infected.
So he got a second surgery to drain the infection. And I.V. antibiotics, of course. But, the surgical site turned into osteomyelitis–bone infection. And of course, this required another surgery.
Then, he needed a toe amputation. Then another. Then, his veins clotted up, so he needed a central I.V. line, for long term antibiotics. Which also got infected and needed removal. And a new central line. Then, one day, he got horrible stomach pains, which required a full work up. Turns out he had now developed a real problem: mesenteric embolism — a shower of clots that blocked off the arteries which feed the intestines. Without blood, the intestines literally die and develop gangrene. Which requires their removal. Naturally, you try to leave what you think will live and only remove the dead or dying tissues.
But the same thing happened again. And again. Each time, taking more and more of the man’s intestines, until finally, he had nothing left. By the time I showed up, he was The “Phantom” of the V.A.–a shell of his former self–quite literally.
And then he got really sick and resistant to the antibiotics. Turns out he had developed a subphrenic abcess (a big infected collection of pus, under the liver) and it was my job to take him to the OR and drain this mess. Which I did. If that didn’t gross me out, nothing ever would again.
Well, he rallied, but eventually it was just too much for the poor man. He died. Finally at peace. I came upon him one morning, while making rounds, already cold. And I also noted that he had perfect vital signs charted, right up until 8AM, when I found him. Hmmmmm…Guess the VA night nurses were too busy with other things to notice that this patient had passed on.
I was sent to the autopsy, to learn what had finally gotten him. And I was shocked to see that when they opened him up, there was almost nothing left–he was like a used up, empty shell. Cause of death? Organ failure–take your pick. Poor guy. No one deserves this.
And I reflected, not for the first or last time, that our bodies were merely machines, shells driven by an animating spirit and that whatever made us “us,” the soul, if you will, was long gone from him.
The horror of all this is that it started with a “minor surgery,” a “simple procedure.” And like that poem, “For Want of a Nail, the Kingdom Was Lost,” one thing led to another, and another, until the final, pathetic denouement.
Lessons learned here? 1. Ain’t no such thing as a “minor surgery” (only minor surgeons). 2. “One never knows, do one?” 3. Murphy is always waiting. 4. Whenever possible, avoid surgery…and you avoid its complications.
And after a lifetime in the OR, I’ve distilled the lessons I’ve learned in my newest healing program, HOW TO AVOID KNEE SURGERY, which you can get here at http://drbillsclinic.com/avoid_knee_surgery.html
Think you need surgery if you have a torn meniscus? Maybe you do. But then again, maybe some of the tips I teach you in this program can relieve your pain, but keep you out of the O.R. See for yourself, at http://drbillsclinic.com/avoid_knee_surgery.html
Til next time, my friend, be well.
Yours for a pain-free tomorrow,
Dr. Bill
P.S. For DR. BILL’S LITTLE GREEN BOOK ON ELIMINATING KNEE PAIN, a concise, but complete handbook on the root causes and the various options for treating knee pain, go to http://drbillsclinic.com/eliminate_knee_pain.html
P.P.S. For DR. BILL’S PAIN-FREE PROGRAM: EXERCISES TO PREVENT OR ELIMINATE KNEE PAIN, please go to
http://drbillsclinic.com/exercise_eliminate.html
P.P.P.S. For the giant, comprehensive ADVANCED MASTERS’ COURSE: HOW TO ELIMINATE KNEE PAIN–ONCE & FOR ALL!, everything you need to know on causes and solutions for knee pain and the complete exercise program, too, go to
http://drbillsclinic.com/advanced_masters.html
FREE BONUS CD with any order: THE HEALING POWER OF POSITIVE PAIN PERCEPTION
Copyright, 2008 by William Thomas Stillwell, MD
All rights reserved
Tags: avoid surgery, complications, minor surgery, relieve your pain, torn meniscus