A Scalpel

A general surgeon with a busy practice in a small town will have the opportunity to operate on a large number of patients with a wide variety of surgical problems. The vast majority of these surgical problems are not out of the ordinary. In the 36 years I practiced medicine as a general surgeon I estimate I performed approximately 12,000 operations and assisted other surgeons on an additional 1000 procedures. Most of the unusual operations were related to a traumatic injury of some type, and often the full extent of the injuries were not determined until the operation was done. I have written several accounts of unusual major injuries I’ve encountered. (I Was Just Walking Down The Highway, Feb. 2017; Pinned To His Work, May 2013). I believe the most interesting and unusual stab wound injury I ever treated occurred in the operating room!

During the majority of the 30 years I was a general surgeon in El Dorado, Arkansas there were 2 hospitals available for patients to be treated. Even though the population of El Dorado in those days was approximately 20,000, the medical drawing area population approached 75,000 which supported having two hospitals. The physicians in general loved having two hospitals because we knew if we needed a particular piece of equipment we could get one of the hospitals to purchase it. There was continual competition between the two, and I believe it created an environment conducive to excellent medical care. I tried dividing my surgical workload evenly between the two hospitals, but ultimately the patient’s preference of hospitals was the deciding factor.

I was finishing a surgical procedure one morning at Warner Brown Hospital, when one of the circulating nurses came into my room and said I was needed urgently in an adjacent operating room. It was one of the rooms used for orthopedic surgical procedures and I knew Dr. John Giller was doing a case in that room. Dr. Giller was one of 4 orthopedic surgeons practicing in El Dorado at the time, and he was a good friend.

John and I graduated from El Dorado High School in the Class of 1957. He was the class president and destined to do well in his chosen field of medicine. Because we took different college routes, he was two years behind me and graduated from medical school in 1966. He took his orthopedic training at Wilford Hall Medical Center, the US Air Force Hospital in San Antonio, and following his military obligation for active duty he established his orthopedic practice in El Dorado with Drs. Ernest Hartmann and J. C. Callaway. John continued his Air Force commitment by remaining in the Air Force Medical Reserves and advanced to the rank of Major General in the Medical Corps. At his retirement in the late 1990’s he was the highest ranking medical officer in the Air Force Reserves. He was a very busy orthopedist in El Dorado.

As I entered the orthopedic operating room thinking Dr. Giller had a patient with a vascular problem for which he needed a general surgical consultation, I discovered an entirely different problem. Dr. Giller was sitting on a stool in the corner of the room, still in his sterile gown, looking very pale and said, “I have sustained a stab wound of the abdomen!” “How in the world did that happen?”, I asked while telling the nurses to take Dr. Giller’s vital signs.

“After using the scalpel to incise some soft tissue I handed the scalpel back to the scrub nurse, and she accidentally dropped it.. I reflexively leaned forward to keep the scalpel from falling on the floor; the scalpel caught on the side of the OR table with the sharp end pointed outward, and when I leaned forward I was stabbed in the abdomen!”

I told the nurses to help Dr. Giller to an adjacent empty room so I could thoroughly examine his wound to determine the next step. He said the procedure he was doing was completed except for the wound closure which could be done by his assistant. With Dr. Giller lying on the operating table, he had suddenly become a patient where moments before he had been the provider. I thoroughly examined his wound which was at mid-abdomen just below the naval, and with probing I determined the scalpel had penetrated the muscular wall, but had not penetrated internally into the intestinal tract.

I placed a sterile bandage on the wound, prescribed an oral antibiotic and advised Dr. Giller to take the remainder of the day to go home and rest. I don’t believe he followed my instructions which is typical of many doctors!

Dr. Giller recovered quickly from the physical effects of an accidental self-inflicted abdominal stab wound, but the emotional trauma and the light-hearted ribbing of fellow surgeons took a little longer. As far as I remember the scrub nurse involved in the incident also recovered quickly!

Dr. John