The Ironmen vs. Herbie...



Me and two of my little guys!



This morning on rounds I had to start saying my goodbyes...I discharged 2 of my kids on the service and won't be around for their follow-up visit in the clinic.  Remember the little boy with the bilateral femur fractures and girl with the bad knee flexion contracture?  Those two.  It's so gratifying to be able to help so many people, but it's really special when you can touch a child.  With all that these kids have to go through growing up in this environment, if you can instill a pleasant or special memory in them that will last a lifetime, what more can you ask for...

Clinic was good today. Finished up at a reasonable hour.  I was surprised today because my medical student showed up for clinic after already having finished his Orthopaedic rotation with me.  He said that he enjoyed his experience and wanted to spend the last few days with me!  Nice gesture.  There were alot of patients today that came in for surgery, but I unfortunately had to tell some that I wouldn't be able to do it because of my departure.  It's very humbling to see how many people have come during my time here requesting my services-I wish I could help each and every one of them.  I had another guy come in today with a mangled finger after getting it caught in a generator.  Another clinic amputation!  The clinic and ER have been my second battlefield around here-lidocaine does wonders when you know where to put it!!



After clinic was over I took my amputation patient to the OR.  Poor little girl.  I had to completely open both of her wounds because she had so much nonviable tissue.  It was killing me with every stroke of the scalpel as I removed more and more dead tissue.  She left the OR with a great deal of tissue loss.  Her wounds were left open because of the infection-she will need to come back for a few more debridements...it was a pretty tough case.  Usually I'm playing music and talking in the OR.  This afternoon, apart from me asking for surgical instruments, I was silent...



Preparing for my last day of surgery...

Afterwards I made my way back down to the floor to make sure everyone was tucked away and ready to go for tomorrrow's cases.  The one patient that was transferred in with the floating knee was saying that he wanted to sign out AMA and go to herbie!  He and his family were concerned about the "iron" that he would have implanted in him.  Many people here think that the "iron" will cause cancer or amputation.  At that point I wasn't trying to hear it!  I went and wheeled every patient on the floor that has had surgery into his room to meet and talk to him about surgery!  You should've seen it-I'm running in and out of rooms wheeling in patients one by one with external fixators on their limbs, hardware implants, those who had been treated previously by herbie, even one of the little kiddies!  There was a gang of people in the room trying to encourage this guy and share their stories with him, telling him that there is nothing wrong with the "iron!"  It was quite a scene.  It was actually pretty funny-the nurses were all smiling about the whole thing.  I ended up leaving all the patients in the room together to talk after I had spoken with everyone.  It was like a little houseparty in room 210 this afternoon!!

I went through the ER on my way out and ended up having the same conversation with another patient and his family who had sustained a femur fracture after being hit by a car...I swear man, that chicken must be great!!

Goodnight guys.

There's something about this shot...I call it 'The Poetry of Surgery'

"A great man is always willing to be little."

-Ralph Waldo Emerson