One of the best things about
getting kicked out of your hometown by non-profiteering liars-and-thieves are the people you meet on
medicine's yellow-brick-road. I most certainly would not trade some of the friends-I-never-would-have-met-had-I-not-saved-the-life-and-blown-that-whistle for sixteen peaceful/uneventful years in Asheboro working for the losers running Randolph Medical Associates & Randolph Hospital.
Before we get started talking about my stunningly-beautiful, totally-fricking-amazing friend, Charlene, I have a new "Freaky Mennonite" update.
(For the record, I have dutifully confessed all of my more bloodthirsty/less-than-Christian urges regarding Osama Bin Laden to the Freaky Mennonite. . . we've discussed them philosophically . . . and she's agreed to pray for my redemption . . . which means I just might have a chance at not going to Hell quite so fast as some of Greensboro's higher-minded bloggers might wish me/others of "my kind" to go there.)
The Mennonite's hours at the hospital were cut, so she had to find alternative ways to bring in money and support her Mother. It's America, so she started a business. It's rural America, so much like an Amish farm-raising, the Mennonite men of her church came together and helped her build a greenhouse - where she now grows fresh vegetables and herbs - and puts together secret Mennonite concoctions that are designed to make you healthier and happier. She also sells things that other Mennonites make . . . and calls her little business-that-could, "The Hodgepodge Lodge".
I've told her that she needs to blog . . . or have one of the younger, perhaps more computer-savvy Mennonites in her church help her build a website that she could then play with. But that's hard because her only Internet access is from work (
where non-medical surfing is technically frowned upon) or the public library.
I am particularly fond of the "
Ezekiel Bread" that one of her Mennonite friends bakes. With the Smuckers peanut butter I can scarf from the doctor's lounge, it's great for breakfast.
But I am very jealous now, because the Mennonite has gotten some local press coverage (
the kind I've always screamed for back home).
For your reading pleasure, Housecalls presents, "The Freak Speaks" (for the record, lest you too think I deserve to fry, the Mennonite suggested the title for the link).
Before we leave the subject, as a "citizen journalist" who (
FOR OBVIOUS REASONS) has been less-than-happy with the "real" journalists back home, I was amused that the Mennonite was just a little put-out (
but not a lot put-out because Mennonites don't really get - or stay - put-out for long) with the noble young journalist's spin on her endeavor. She had wanted the reporter to focus a little bit more on how the Mennonite community came together, when she had very little start-up money, to help her get things off the ground (
literally), expecting nothing in return . . . and perhaps publish some pictures of all that. But the well-meaning/do-gooding reporter chose to go with an angle of how the Mennonite's little greenhouse-that-could has become a way to educate schoolchildren about healthy eating.
Of course, it's all good. Because, you know, she's a Mennonite. And they're all good.
Since I'm one post away from a summer sign-off, I've got another nurse-friend that I'd love to blog about (the community is throwing this busy-bee a party next week for all of her good works), but she's a feisty thing and has threatened to off me if I blog about her (and I sincerely believe that she would/could), so we'll move right on along to Charlene.
Back in mid-November, I alluded to
a freakish accident suffered by a dear friend and nursing colleague at the little hospital where I work down East. Charlene is a tiny little spit-fire (
who reminds me very much of couple of other tiny spit-fires I've known over the years), and LDRP (
Labor/Delivery/Recovery/Post-Partum) nurse extraordinaire. Her ability to place IV's in tiny sick infants rivals my own - as does her gift for wry sarcasm and biting commentary on the sorry state of our world.
Her humor is often blunt, self-depreciating and/or raunchy, and on any day she's working, you KNOW you are going to laugh and laugh and laugh your arse off.
Today, I actually went in the nursery to hide/cry. But they were tears of happiness, and we'll get to that.
Charlene is absolutely gorgeous too (
I say this not in a "gay" way - not that there's anything wrong with that) . . . in a wholesome (
at least until she opens her mouth) redneck, farm-girl kind of way. But to say so embarrasses the crap out of her (
which is really funny). She's married to a local, plain-speaking, pick-up-driving, steel-working man who worships and adores her (
as well he should), and they have three little girls who are as gorgeous and smart as their Mother.
(She is so going to kick my ass when she reads this. She's been trying to get sneak peeks all day.)
Charlene's nightmare started with a slip in her bath-tub, very early in the morning, on a day that she actually had off from work. The culprit was a container of bodywash that had tipped over and leaked all over the bottom of the tub. Charlene fell forward on an outstretched hand - feeling a "pop" as she went down.
It's the classic scenario in which one suffers a
Colles fracture at the wrist as I did several years ago. Six weeks in a cast, and apart from knowing before it's going to rain long before it rains, you're good-as-new.
The Fates were kind that day as Charlene fell on her non-dominant hand. We'll get to that too.
Outwardly uninjured, Charlene got back up, finished her shower and continued to get dressed - figuring that if she had broken something, she'd just go on in to the hospital for an X-Ray later in the day. Being a good nurse, she iced it from the start and eventually started holding it high over her head - to reduce the rapidly increasing swelling.
Problem was, the hand didn't stop swelling. It felt funny - like pins and needles. And it began to turn blue. And it throbbed/hurt like HELL - with 10/10 "crying-face" spasms radiating up her entire arm.
And then, her fingers started to turn while/lose sensation.
And then her hand got very cold. She could not feel a pulse.
And then it was clear it was time for the nurse to become a patient.
In the Emergency Department, the physician-on-duty took one look at Charlene's hand and STAT-paged the Orthopedic surgeon. And the Orthopedic surgeon wasted no time dithering about . . . rolling her on to the OR himself, barking orders as he whisked her down the hall.
We're going to keep this medically simple. Charlene did not break a bone or (
as I understand it) even tear a ligament. But she had somehow managed to twist & lacerate the blood vessels supplying her right hand at the wrist . . . resulting in a wicked case of
compartment syndrome. In compartment syndrome, bleeding into the enclosed space of a limb causes swelling and severe pain . . . and the blood pulsating from the lacerated arteries filled up poor Charlene's hand like a water faucet expanding a rubber-glove. This kind of injury creates tremendous internal pressure that damages nerves and cuts off circulation to the soft tissue very quickly.
Compartment syndrome is a true surgical emergency - because there is a very narrow window of time in which a surgeon can act to minimize the damage and save the hand. By the time Charlene got to the ED, most of that window was gone.
(It's actually probably fortunate that the skin was not broken when she fell, or Charlene might have bled to death on the bathroom floor before being able to get help.)
Her surgeon knew he was charging a hill that he might not be able to take.
Minimizing the damage involved repairing the vessels and stopping the bleeding (
duh), and making strategically-placed incisions on the surface of the hand to relieve the pressure. These incisions are called
fasciotomies - wounds that are left open until the swelling subsides.
The rest is about pain control, sedation (
to relieve anxiety) and waiting to see what tissue survived the trauma and remains viable. Re-perfusion of the injured tissue is also very painful and can actually cause irreversible damage itself.
There is a big risk of infection setting in as well.
I did not find out about Charlene's injury until later that morning - after I had finished nursery rounds and heard someone say that they thought Charlene was in the PACU (
post-anesthesia-care unit). I was confused, and asked why she was working over there, and was then informed of the accident, "
We're sorry, Dr. J, we thought you knew".
It was like being kicked in the gut.
Charlene was actually in the ICU, and it seemed like the whole hospital was determined to visit her and collectively will her hand to repair itself. That afternoon, it was rather like watching an adored queen greet her subjects. Many of her friends at the hospital were discretely ushered in-and-out past the nursing desk during those first few hours after her surgery. She tells me now that she was in so much pain, and so floating so high on a fog of anesthesia and narcotics, that she does not remember my initial reaction to seeing her hand . . . and I'm glad she does not. For despite all of my best efforts to keep on "the doctor's game face", I know that all the color left my countenance to reside in the pit of my stomach when I saw her impossibly-swollen, unnaturally-white, horribly-blotchy fingers peaking out above the surgical dressing. It was hard to murmur the niceties as she re-introduced me to her sick-with-worry husband, harder still to offer hope that she'd keep any of the fingers after seeing them for the first time - knowing full well that hope was slim.
Lying has never been my strong point.
Charlene's thumb appeared to be in the worst shape - which was especially distressing given its importance in terms of retaining some useful function of her all-too-human hand.
Later that evening, Charlene was flown-out to Duke to see the gurus. I remember watching the bird disappear into the stars over my head with tears streaming down my face.
I was pretty pissed-off at God, you see. Charlene and her young family had already overcome so much - most of that is not cannon-fodder for this blog.
Her only brother had died just months before - after an accidental overdose of prescription medications taken in lethal combination. The siblings were close (
he left a daughter behind), and on the day she slipped in the tub, Charlene had only just begun to emerge out of "the numb" that enveloped her being after her brother's death. She and I had actually had several very deep conversations about the smorgasbord of feelings and survivor's guilt that one copes with after a loved one dies suddenly and under suspicious or violent circumstances.
I had
been there and done that. The what-ifs and if-onlys will kill you, and it was very nice to be able to help soothe someone else's wounds with the balm of experience.
Alas, with regards to Charlene's physical injury, there was very little I could do to help but pray.
It's my theory that in order for prayer to work, you have to stop being angry at God. Since I'd do just about anything for Charlene, I resolved to put my anger about what had happened to her aside. It wasn't easy. Since the day Randolph Hospital worked its magic thirteen years ago, I've said a lot of prayers, and have had a bit of a love-hate relationship with my Maker.
Of course, a lot of people, with much better connections than me, were praying for Charlene. Prayer chains were formed at local churches . . . and every day, at a designated time, anyone on the LDRP unit who wanted to do so gathered in the hall, held hands and prayed for Charlene's recovery and rehabilitation (
since the hospital accepts Medicare and Medicaid, I'm quite certain it violated someone somewhere's delicate sense of separation of church and state - but such someones could just kiss my ass).
As time progressed, it became clear that Charlene was going to lose portions of every finger on her hand. Her fingertips turned black. Her thumb was in bad shape. The gurus at Duke did their exalted consults and their studies and then sent her home for almost a month to "wait and see". They did not want to remove more than they had to.
Charlene continued to have severe muscle spasms of her arm and "phantom pain" (
for lack of a better description) after her discharge home.
Shortly afterwards, I was Christmas-shopping at the local Walmart. I was in one of the decoration aisles when I heard someone call out, "Dr. Johnson!". I looked up from the box of blue-glitter-birds I was examining to find myself face-to-face with Charlene. She was accompanied by one of her own high-school "Ya-Yas". She looked tired, and I could tell right away she was still on pain medication because she moved so slowly, albeit effortlessly - and was fairly "loose" and faux-animated as we talked.
(
It actually reminded me very much of the time that several of my "Ya-Yas" packed up their-still-heavily-drugged-after-her-hysterectomy-Queen, plopped me in a wheelchair and took me for a spin in my pajamas around the Greensboro Coliseum - for some kind of home show. I held packages and had a glorious time - at least what I can remember of it.)
Charlene's right arm was in a sling (
Anesthesia had mercifully gifted her with a nerve block from her shoulder-down) and her hand was covered with an oven mitt. I was afraid to look at the mitt as we talked, and was trying not to cry. She cocked her head at me, smiled very wickedly and asked, "Aww, Dr. Johnson, You want to see, don't you?"
I swallowed very hard, sheepishly shook my head up-and-down-for-yes (
for once I was speechless), and moved in closer, pulling open my coat to shield "the reveal" from prying eyes. Her "Ya-Ya" looked at me nervously . . . gesturing her head in a barely-perceptible circular motion at the people shopping around us . . . I silently indicated that I understood, and pulled in even tighter for the look.
Meanwhile, it was clear Charlene was devilishly enjoying our discomfort . .. like a kid sharing a big secret.
You think, when you're a doctor, that you're prepared for everything and you've seen it all. I was not, and I have not. Charlene's mauled hand was still swollen and bruised/mottled - the tips of her fingers and a good portion of her thumb were black & scabbed - and the fasciotomy scars on her hand & wrist were still angry red whelps. It physically hurt to look at the devastation, and my knees literally tingled. But as I studied Charlene's injuries with my morbid doctor's fascination, I came to the quick realization that while yes, she would lose some portion of all of her fingers, what she had left would be very workable in terms of rehab - or a prosthesis if she wanted one.
For her part, Charlene spoke very matter-of-factly and clinically about what she was showing me - tuning her hand over repeatedly - examining her hand almost as if it were someone else's.
A few people in the Walmart aisle had noticed, and eyebrows were up, so we wrapped up "the viewing" fairly quickly. Charlene put the mitt back on and we made some small talk. I told her that everyone in my universe - including people she didn't even know - were praying very hard for her. Her "Ya-Ya" nodded and smiled at that. I teased that I was going to get her some Duke "
Spirit Fingerz" gloves to wear, and she cracked jokes about "
Salad Fingers" (
one of our technically-forbidden, totally-warped You Tube distractions during downtime at work).
I told her that she needed to get well, and get her ass back to work, because I had no one to talk real smack to . . . that she had no equal, and no one else on staff was remotely worthy of serious engagement. She really liked that.
(I'm legendary, you see;)
But then, despite all my best efforts to keep things light, I started to tear-up, and buried my face in my coat. The Walmart shoppers were sure getting their money's worth.
Charlene smiled at me when I was able to poke my head back out . . . reminded me that it was her non-dominant hand . . . and together . . . right there in the Walmart aisle . . . we decided everything would be all right. I asked her if I could hug her - but I did not want to do anything that would hurt her. She laughed and pulled me in for a good squeeze with her good arm. We walked around the Christmas aisles for a while and then parted ways.
And I went home very satisfied that God does answer prayer . . . maybe not always with what you want to hear . . . but He is there . . . and He does answer.
He also helps those who help themselves. I started researching prostheses - and contacted a
world-renowned company that might ultimately be able to help Charlene.
I also made of point of seeking out the Orthopedic surgeon who had done everything in his power to save Charlene's entire hand - in order to tell him what a fantastic job he had done in the face of ugly odds. People on the front lines of medicine- the physicians in Podunk - often do not get the credit they deserve. All the glory goes to the mega-centers with the big names. I felt like this doctor needed to hear from a colleague that he didn't just save a workable portion of Charlene's hand.
He saved her life . . . as well as big and little piece of the lives of all the people that love her.
On December 7th, Charlene went back to Duke. Her pinkie was amputated at the distal metacarpophalangial (MCP) joint. Her 2nd, 3rd, and 4th fingers were amputated at the proximal MCP joint. Her thumb was amputated at the proximal interphalangeal (PIP) joint.
Her world-renowned surgeons could do no more and sent her to rehab. The nurses at the hospital rallied around their friend for day-to-day support. I saw Charlene a few times about town, but for the most part got updates from the girls - and elected not to otherwise intrude.
The next time I spent any time with Charlene was at our unit Christmas party. The nurses all bring in food for a buffet, and gifts are exchanged. The unit "adopts" two needy children in the community, and builds Christmas packages for them. This time we also adopted Charlene's girls (
who came to the party). By that time, Charlene had taken to wearing socks over her injured hand. The drug cocktails and nerve blocks were a thing of the past, and she was much more self-conscious about her hand (
of course, it was also the dead of winter and her hand was exquisitely sensitive to the cold).
The body-issue thing is something that all amputees have to come to terms with, and Charlene was clearly struggling.
Again, the silly girl simply does not appreciate how stunningly beautiful she is. But it's not just about her physical appearance, it's about her essence. She lights up any room she is in. People love her.
I was a bit vexed over the sock business, because I had ordered a buschel full of
Maggie's Organic Tie-Dyed Socks - in order to gift all of the nurses with a pair for Christmas (
I wear them every day). I had wanted to give Charlene several pair, but they were back-ordered (
the socks eventually arrived and became Valentine's Day gifts). I gave everybody IOU's.
The medical staff had raised a respectable sum of money to help Charlene and her family out with expenses while she was out on short-term disability. As people ate, and we admired a premie-in-her-bassinet destined to spend her first Christmas at the hospital, I slipped my friend a Christmas card with a check enclosed that matched the staff's effort.
This time, Charlene was speechless.
(Dr. Johnson is like a stealth drone.)
I also slipped her a packet of information from the company I had contacted about prosthesis possibilities. She was eager to review the information. Later on, she would tell me that she was not quite ready for something like that - because she needed to come to better terms with what she had - and learn how to use it.
And that's okay. Because the technology will always be there if she wants it.
And did I mention that my stunningly-beautiful, totally-fricking-amazing friend, Charlene is also incredibly brave?
For the last nearly five months, Charlene has been in rehab. Her hand looks amazing-for-what-it's-been-through now . . . scarred to-be-sure, but much better than I ever dreamed it would. Sometime down the road she may need some more surgery - to release scar tissue and improve her range of motion/ability to oppose. But right now, it's all good.
I'll be standing back and letting her try the IV's if she wants to.
And today, my stunningly-beautiful, totally-fricking-amazing, incredibly brave friend came back to work. I rounded the corner of LDRP's back hall to see her bright shiny face sitting at the post-partum desk . . . giggling with Delivery Nurse Pam (
who we like to call "The Vagina Whisperer") over all the computer & security updates she's missed.
And my heart sang. I could literally hear the angels laughing (
or maybe it was the nursery ghosts - but it's okay, because they're all very friendly).
It was as if Charlene had never left us.
The tears I slipped away to shed in the nursery a short time later were tears of pure joy.
And it gets better. Tommorrow, the Freaky Mennonite is working a shift. And Charlene will be there. The "family" . . . my family . . . will all be back together.
Do not tell me that God does not answer prayer.
