My job this morning is to change the leeches on Gabriel’s fingers. You
read that right. It sounds positively medieval, but there is a role for
leeches in modern medicine. Once the hand surgeon has completed the
daunting challenge of reattaching fingers, which includes the tasks of
realigning and stabilizing the bones, stitching together the tendons, and
sewing the nerves and blood vessels with microscopic suture, he must
monitor the blood flow within the arteries and veins to see if the finger
will thrive. Leeches are used for their bizarre ability to secrete hirudin, a
natural anticoagulant from their salivary glands that facilitates
hematophagy, the ingestion of blood. Attaching a medicinal leech to a
finger decongests the digit, thus increasing the chance of survival. The
leech swells with feeding, and once it is fully engorged, it must be
replaced with a ravenous collaborator to continue the digit-saving
bacchanal.
As I walk into Gabriel’s room, I am greeted with a blast of furnace-hot
air laced with the essence of barnyard manure. In an effort to accentuate
his fingers’ vasodilation (expansion of the blood vessels), we keep
patients’ rooms at 95° F. Inside the room are more than twenty people, all
of whom are Amish; the men with characteristic Abe Lincoln beards,
black wool trousers, suspenders, and white shirts, and women with bonnets
and flowing navy-blue dresses to their ankles. I am reminded that most
Amish bathe once a week, and the combination of heavy wool dark
clothing, blistering hot and muggy Pennsylvania summers, and farm
animal occupations make this room reek, even to me, the son of a large-
animal veterinarian.
I have brought a jar of fresh leeches, skinny and dark wormlike
creatures. I lean over the stoic Gabriel, his hand in a massive dressing
three times the size of a boxing glove. As I undo the layers of white cotton
dressing, my community of witnesses leans closer; I seem to be the only
one sweating in the oven of room 765. With the removal of the final loose
layer of gauze we are all staring at three huge leeches, each attached to a
finger. They are crimson and india ink–black, immobile, and drunk with
blood. They look ready to explode. I begin to tug on the first parasite, and
it won’t budge. A wave of anticipation pulses through the throng, and now
twenty faces are within feet of mine, and a mixture of pig, horse, and cow
manure wafts pungently toward me with essences of molasses, scrapple
(bacon remnant), and chow-chow (pickle relish) mixed in. I could vomit.
marcin
(Marcin)
#1