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 which 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. This is 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 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 for which I needed a special assistant, it would usually be Dr. Tommey I would call to help. On one particular Fourth of July holiday weekend when Dr. Tommey and I happened to be the only surgeons in town we decided to assist each other on all the emergency cases. We did a total of twenty-three major operations from Friday evening to Monday morning, and were both relieved when the weekend was over.
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 seen and treated in the ER for an abscess in the groin area. He had never met Mr. Johnson prior to this ER visit, and Dr. Tommey did not see the patient’s wife in the ER. Apparently he had been brought by another family member. Mr. Johnson was an elderly gentleman who 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 but was done in such a way to protect 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, and he replied she could do it and not be bothered too much by the wound. Reba went to the waiting room and called for Mrs. Johnson to come back to the treatment room. Reba had never met either one of the Johnson’s prior to this visit.
When the elderly, grey-haired lady entered the room, Dr. Tommey said he wanted to show her just how to cleanse and re-pack the groin wound, and it needed to be done each day. Dr. Tommey gave her the surgical tools to aid in the process and guided her as she successfully removed the packing , cleansed the wound and re-packed it correctly. 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 one week, and Mr. Johnson thanked him for his help. The lady went to the corner of the room and sat down in the chair, and Reba told her the appointment was over. She told Reba 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 in my life.” Reba said, “I called for Mrs. Johnson and you stood up and came into the room.” She said, “I misunderstood. I don’t hear very well. My name is Jackson 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. Jackson said it was alright, and she was glad to help in any way she could. Apparently she 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. Jackson and Mr. Johnson perhaps she should have been a little more suspicious of the wound care training she received. The positive aspect was she was certainly prepared to provide good home care if her own husband ever developed a wound abscess.