The patient I couldn’t heal

Tue, 27 Nov 2012 00:00:00 +0000

I take pride in closing surgical incisions. After a cold blade opens the skin and the internal work is done, the only thing the patient sees, or knows, is their incision. Maintaining symmetry, I use the finest threads and the gentlest instruments in an attempt to restore what once was. Some surgical residents leave the wound dressing to the operating room nurses; I personally dress the wound to reassure the patient that his tissues were handled with the utmost respect. For me, it is the last step of any operation.

But as I closed Mr. H’s wound, others in the room looked at me as if I were crazy. After eight hours of surgery, why would I be so careful with something as trivial as the wound closure? The anesthesiologist became impatient, and the medical student stood by awkwardly. Undeterred, I carefully aligned the skin edges and neatly applied the dressing.

A grapefruit-size tumor in Mr. H’s kidney had invaded the spleen and part of his intestine. It was covered with ominous blood vessels, trying to engulf the neighboring organs. The tumor was removed, along with the kidney, spleen and a six-inch segment of intestine. He was going to the intensive care unit with drainage tubes in his chest and abdomen. He needed a breathing tube in his throat while blood was still being poured into his veins.

Salon.com > Alan Kaplan

The patient I couldn’t heal