During my years of surgical training at Charity Hospital in New Orleans I was either the operating surgeon or first assistant on many lower limb amputations. A large percentage of the patient population of the largest teaching hospital in the country (at the time) were disadvantaged elderly, and a very large percentage of that group had peripheral vascular disease related to diabetes. I became skilled at amputations, both above and below the knee since those procedures were life-saving for the patients, and not because I sought to do them or even enjoyed that type of operation.
When I began my private practice of general surgery in El Dorado, Arkansas in the early 1970’s I discovered the orthopedic surgeons in town seldom if ever did limb amputations, so the procedure was done by the general surgeons when needed. An additional skill I learned in private practice involved the fitting and maintenance of the prosthetic device (artificial limb).
One afternoon I admitted a patient from my office named Alvin who had classic symptoms of acute, severe gall bladder disease, and because of his gender and physical findings I knew he needed an immediate operation. He had been tolerating his gall bladder symptoms for several weeks thinking he had a “bad case of indigestion.” Throughout my years of experience in surgery I observed men in general delayed seeking treatment, and when they did come for an evaluation their condition was more severe than a woman of comparable age and health status.
Alvin was a Deputy Sheriff of Bradley County and lived in Warren, Arkansas which is about 50 miles from El Dorado. Another important part of his past history involved an injury to his right leg sustained by a gun shot wound years before while doing security work in South America. The injury was so severe his leg could not be saved, and he had a below the knee amputation of his leg. He had successfully worn a prosthesis (artificial leg) for approximately 10 years..
The gall bladder operation done that same afternoon was difficult because of his size and the severity of the infection, but he was a very strong man and tolerated the procedure much better than I thought. When I visited him in his room later in the evening he was sitting up in bed with his glasses on reading the local newspaper! He even said his right side “felt much better” despite having a long incision with multiple staples in his skin. Laparoscopic surgery was not done in those days, and gall bladder surgery was generally much more painful with a longer incision and a longer recovery period. I told him I would see him again in the morning and was confident he would continue to improve rapidly. I noted his prosthetic leg had been removed prior to the operation and was propped against the wall and behind a curtain which partially concealed its’ presence.
The following morning I was making rounds to visit my hospitalized patients and in particular the post-operative patients. With his chart in hand I was walking to the end of the hall where Alvin’s room was located when I saw the door opened quickly, and a man who worked in housekeeping came bursting out of the room and running down the hall. Thinking perhaps Alvin had fallen out of bed or had some severe event such as a heart attack, I began running to his room. As I pushed the door open widely I saw Alvin sitting up in bed holding his right side and laughing as heartily as his painful side would permit. “What in the world just happened Alvin?” Between laughs he said, “The man from housekeeping knocked on my door, and when I gave him permission to enter he asked if he could clean my room to which I consented. He started sweeping first and when he swept the broom into the curtain against the wall he accidentally bumped my artificial leg, and it fell out into the middle of the room with a loud thud! The housekeeper’s eyes widened not recognizing this was an artificial leg and he turned and ran. He was scared to death!”
Later that morning I spoke with the housekeeper and asked him why he was so scared when he saw the leg fall out in the room. He said he didn’t know if it was “alive or dead.” I told him in a joking fashion for him not to worry because Dr. Duzan (the pathologist) kept the legs removed that day in that room before taking them to the basement, and they were not alive. I don’t think he believed me, but occasionally when I would see him working I would ask if any more legs had gotten after him. It took him awhile before he could laugh about the incident with the hidden leg.