In a surgical practice, the treatment of certain types of wounds requires patience and the presence of a strong stomach in the care givers. As surgeons we become accustomed to sights and smells that often are unpleasant at best and downright repulsive at worst. Infection in a surgical wound is a dreaded complication, and the treatment of such a wound can be unpleasant both to the patient and to the care giver.That’s just part of the job, but thankfully does not represent the majority of the care giving experience.
One of my senior partners, Dr. C. E. Tommey was one of the best surgeons I’ve known, and also one of the most beloved doctors in El Dorado. His surgical technique was superb, and his patients usually did very well and recovered quickly. In addition, he had a quiet and very kind demeanor which not only promoted confidence in his abilities, but made his patients believe that he always had their best interests in mind. I admired and respected him so much that when I had to have several operations, Dr. Tommey was my surgeon. Also when I had a particularly complicated surgical case that I needed a special assistant, it would usually be Dr. Tommey that I would call to help. On one particular holiday weekend when Dr. Tommey and I happened to be the only surgeons in town, he was on call on Friday and I was on call for Saturday and Sunday. We had agreed that we would assist each other on the surgical cases that were done in the OR that weekend. As I recall, we did 11 operations on Friday and then did 12 more operations on Saturday. We did take breaks between procedures to rest and have a snack or even a meal when it was time. I have never done so many procedures in a 48 hour span!
On one particular afternoon, Dr. Tommey was scheduled to see patients in the clinic as he had completed his operative surgical cases for the day. Clinic patients included new patients and doctor referrals for consultation. Also scheduled were post-operative patients for suture removal, and patients seen and treated in the ER who needed more care. One of the patients to be seen was Mr. Johnson who Dr. Tommey had treated in the ER for an abscess in the groin area. He had never met him prior to this ER visit. Mr. Johnson was an elderly gentleman that had never had a serious infection problem because he was healthy for his age and in addition, he avoided doctors as much as possible. The abscess was quite large but Dr. Tommey had drained it completely and left surgical packing in the wound to facilitate rapid and complete healing.
Dr. Tommey’s nurse, Reba called the patient into the treatment room and prepared him for the packing removal and wound cleansing. Because of the location of the wound and its’ size, the entire groin area had to be exposed and was done in such a way to guard his modesty as much as possible. When Dr. Tommey entered the room and inspected the wound, he told Reba that Mr. Johnson needed to have someone cleanse and pack the wound for him daily. He asked Mr. Johnson if he thought his wife would be able to do that, to which he said she could do it, and it wouldn’t bother her at all. Reba went to the waiting room and called for Mrs. Johnson to come back to the treatment room. Reba had not met either one of the Johnson’s prior to this visit.
When the elderly, grey-haired lady entered the room, Dr. Tommey said that he wanted to show her just how to cleanse and re-pack the groin wound which needed to be done daily. Dr. Tommey gave her some surgical tools to aid in the process and guided her as she successfully removed the packing , cleansed the wound and re-packed it properly. She applied a very neat outer dressing and then assisted Mr. Johnson in putting on his underwear and trousers. As he walked out of the room, Dr. Tommey told him he needed to see him again in 2 weeks, and Mr. Johnson thanked him for his help. The lady went to the corner of the room and sat down in the chair, to which Reba said, that was all that was needed. She told Reba that she had an appointment and Reba said, “Oh, you have an appointment on the same day as your husband?” The lady said, “That was not my husband. I’ve never seen him before.” Reba said, “I called for Mrs. Johnson and you stood up came into the room.” She said, “I misunderstood. I don’t hear very well. My name is Jamison and I thought you called for me!” Both Dr. Tommey and Reba were flabbergasted and apologized profusely to Mrs. Jamison for placing her in such an embarrassing situation. Mrs. Jamison said it was alright, and she was glad to help in any way she could. Apparently Mrs. Jamison thought it was required for each patient to assist in the care of the patient ahead of them in order to speed up the treatment time and reduce the waiting time.
As a physician, it is very gratifying to have a patient or family member follow our instructions to the letter, but in the case of Mrs. Jamison and Mr. Johnson, perhaps she should have been a little more suspicious of the circumstances of the wound care training she received that afternoon. The positive aspect was that she was prepared to administer good home care if her own husband were to ever need it!