Sunday, February 7, 2010

Nobody Can Fix You But You.

One of the most entertaining things about my socializing with doctors and nurses is the bizarre-but-true war stories that they enjoy relating in all their gory detail. A favorite medical topic is the extreme lengths to which many individuals will go to avoid dealing with a chronic debilitating problem.

One common scenario that is intriguing is the ability many people have to ignore a jaw-dropping circumstance that is not only a serious threat to their lives, but which is extremely uncomfortable, and looks awful at the same time.

One doctor related a story about a morbidly obese woman admitted to his San Francisco teaching hospital who carried dozens of copies of something called “The Large Person’s Bill Of Rights” everywhere. She handed one of these sheets to every person in the hospital who she came in contact with. The manifesto proclaimed her inner beauty and outlined her expectations about of how deferentially she expected to be treated as a “woman of size”, as she described herself.

While she was being admitted, one of the nurses suffered a serious back injury while trying to help her team transfer the patient’s nearly 500-pound bulk from a gurney to a hospital bed. This feat took the cooperation of many hands, as one could imagine. The patient expressed little concern that the nurse was injured at her behest. When told about it, her reaction was “Well, that’s her job”.

The patient’s pressing problem was an enormous hernia literally as large as a beach ball located below her left ribcage. To reach this size, the hernia would had to have been ignored for years until its sheer volume and impediment overcame the impressive degree of detachment and denial the patient had been capable of.

While she sat propped up in bed, the doctor recalled with amusement that the patient nonchalantly used the enormous bulge that the hernia created as a convenient elbow rest while she lectured medical personnel about her expectations of digified treatment and complained bitterly about not being able to eat solid food before her operation.

Her husband was a very thin man who appeared quiet and brow-beaten. In between his running errands for her he sat dutifully by her side as she lectured and complained.

Her operation was initially a success, and the patient remained intabated in the ICU, meaning a tube was placed down her throat to facilitate breathing. However, while in recovery she began convulsing, and despite emergency medical personnel‘s attempts to resuscitate her, she died. During the process of trying to save her, the doctors removed the intabation tube from her throat and discovered it was packed solid with chunks of undigested hamburgers and French fries, which she had vomited up, then choked on while unconscious.

Ignoring orders that she absolutely must not eat any solid food in the 24 hours before her operation, she had her compliant husband go to a close-by fast food restaurant and sneak food into the hospital for her.

The same doctor on another day examined a man who seemed sane enough, but his hernia was so preposterously far gone that his intestines were hanging down almost to his knee under the skin of his inner thigh before he decided to seek medical advice. The doctor laughs about being at first taken aback by seeing the enormous bulge in the man’s pants hanging down his leg, thinking perhaps he had a legendary porn star in his examination room.

Other doctors tell of ignored infections or festering sores that resulted in permanent mutilation and enduring muscle and nerve impairing facial disfigurements which could have been easily treated at their outset. Instead, the patient chose to ignore, tolerate and even worsen his condition by picking at the wounds for months or years on end.

In case you might tend to believe that stories like this just involve the homeless or the ignorant, think again. I was intrigued one day while watching TV to see Rosie O’ Donnell, then the mother of three small children, repeatedly removing a bandage from an injured hand on her talk show to exhibit her wound to each new guest, whether they wanted to look or not.

She admitted she had removed the stitches from the wound herself prematurely instead of waiting for the doctor to do it. She also admitted she couldn’t keep from picking at it. Doctor friends who saw the same show shook their heads and matter-of-factly remarked that she had an obsessive-compulsive disorder. A few days later she was off the show and in the hospital while doctors fought to save her severely infected hand from amputation.

My point in relating these war stories is to illustrate how certain individuals can somehow not only ignore, but learn to casually coexist with conditions that are not only painful, but uncomfortable, disfiguring, and seemingly intolerable. These examples also illustrate the ability of the human body and mind to slowly adapt to, and people’s ability to become fascinated by, dangerous, raw, and disabling conditions.

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