another service? Why not general surgery?”
Paul retorts, a little frustrated, “I dunno, maybe they thought you guys
would do a better job of sewing the skin.”
Dang it. No way out. I gather my ID badge, phone, and keys, changing
into my green scrubs for the short drive to the hospital.
On my way to the ER, I call the Plastics fellow who is on call as my
supervisor tonight. “Fungus balls?” he fires back at me. Okay, now I don’t
feel so ignorant. I really have no idea what I’m about to see.
Walking into the emergency room, I make a beeline for bay 15. I am
intercepted by the ER nurse, a young rookie like myself, asking if she can
be there when I talk to the patient. “Sure, but I have no idea what I’m
going to say. I’ve never heard of this. What’s his name?”
“His name is Rick, and he seems pretty nice. But his infection is gross.”
Folding back the privacy curtain in bay 15, I see Rick on a gurney, in a
hospital gown. Seated next to him is an elderly woman with ashen hair in a
ponytail, dressed in a gray Penn State T-shirt, jeans, and worn out New
Balance shoes. “Hi Rick, I’m Dr. Schneider. I’m an intern on the Plastic
surgery team. The infectious disease doctors have asked us to come talk to
you and to see if we can help you. I know things aren’t great for you—how
do you feel?”
“Not too bad, I guess,” Rick replies with a palpable sense of fatigue. It
sounds like he is genuinely exhausted and is barely able to suppress a
cough. He is thin, has no teeth, and conspicuously, has grotesque tumor-
like nodules the size of small tangerines on his arms and his right hand. I
glance back at his face. “Kinda gross, huh?” he responds.
“Well, I’ve never seen anything like it, but I’m only an intern, so that
doesn’t mean much,” I say. “Anywhere else on your body?”
“There’s one on my right leg,” Rick concedes, folding the sheet to the
side, showing me the protuberance over his right calf. This one looks like
it’s about to explode, looking more like a huge pimple with a thin sheen of
protective skin overlying a congealed glob of pus. It is now becoming very
hard not to grimace in disgust. I’m not sure how to examine the patient,
and it seems pretty obvious that treatment with drugs is not working here.
I call the Plastics fellow, Ken, explaining Rick’s surreal situation. We
agree—surgical excision of these fungus colonies is imperative. “Put it on
the schedule for tomorrow in the main OR. We’ll figure it out then,” Ken
concludes.
marcin
(Marcin)
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