Stunned, I tried recalibrating, sensing the need to educate Mark about
the grave consequences he was facing. I couldn’t break through. He
equated Karen’s successful shoulder reconstruction and stabilization to his
present situation. I mentioned the 80 percent death rate associated with
“open fractures” just one hundred years ago, and tried to convey the
complex nature of the ligaments, tendons, and muscles that held his elbow
together, and the challenge of closing gnarly traumatic lacerations, but to
no avail. Although I liked Mark’s optimism, I was concerned he wasn’t
grasping the potential for serious complications, and the certainty that his
arm would never be the same.
By dint of miracle, his surgery went extremely well. He didn’t die, he
didn’t lose his arm, and he (somehow) ended up with superb function and
had no disability. In fact, his scars were unnoticeable.
At his final appointment (following a softball game), we recalled his
travails and assessed his final outcome. I tried one last time to discuss how
close he came to losing his arm and how just a short time ago he would
have almost certainly perished from this injury. Mark is an aerospace
engineer, so common here in Boulder, Colorado, and despite his great
intelligence, has no perspective about modern surgery. In fact, almost no
one does, including surgeons. So when I reviewed his progress and
compared it to how it would have gone just seventy-five years ago, Mark
was shocked that there was no such thing as plates and screws, or even
antibiotics, in the years before World War II.
Not that long ago, no one believed in germs. Although the first
anesthetic drugs were discovered in the mid–19th century, surgery was
still extremely dangerous until a small group of physicians and scientists
were able to prove that the minuscule organisms that invisibly inhabit our
world are the cause of infections. This knowledge triggered a revolution in
medicine and surgery, and the first triumph was convincing surgeons to
wash their hands before surgery.
An agonizing interval of seventy years passed from the acceptance of
the germ theory to the development of antibiotics. During that period,
surgery slowly developed, but to our modern eyes was highly limited in
scope and efficacy. But a simultaneous series of inventions, like the
development of polymers and transistors, modern alloys and antibiotics,
and the undergirding establishment of private health insurance and
Medicare, made modern surgery what it is.
marcin
(Marcin)
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