- Email: [email protected]
First Hand
A TOUCH OF HUMANITY
First Hand By Charles Eaton, MD URRICANE JEANNE CAME THROUGH Saturday night, and once again my home is hot and dark. I have the family camped out in my office, waiting for the electricity to be restored. We were off the grid for 6 days last month with Hurricane Francis. It looks like it will be a similar run this time. Francis broke and felled many trees, but this was a much stronger storm, and the ground was softened by a month of water saturation, so there was a fair bit of additional damage. I took pictures yesterday afternoon on the route I normally take to work: horizontal palm trees; defoliated shade trees; power lines dangling in the street; power poles fallen, broken, and dangling; trees on lines; my 4 sons standing on a freshly fallen tree in my office parking lot; Jupiter hospital, boarded up. But life is more complex than hurricanes. My sweet wife, confused, pancytopenic and cartoonishly cushingoid from the decadron and chemo she’s been getting for her recurrent brain tumor, has been recovering from a T12 compression fracture she sustained in a fall a few days before we got hit by Hurricane Francis less than a month ago. This week, as Hurricane Jeanne grew in strength, so did my wife’s intermittent shortness of breath. Friday morning, plain films confirm a very unusual pattern of bilateral pulmonary infiltrates. She is admitted to the hospital—rapid clinical deterioration, multiple consultations and tests, doesn’t look like bacterial pneumonia, pneumocystis, aspergillosis, atypical TB, PE, CHF, blah, blah, blah. The final recommendation is for open lung biopsy in the morning—Saturday morning, hours before the hurricane is due to hit. Done. Recovery in intensive care unit, oxygenation poor enough to expect that it will take at least a few days to wean from the vent.
H
From The Hand Center, Jupiter, FL. Received for publication December 9, 2010; accepted in revised form December 11, 2010. No benefits in any form have been received or will be received related directly or indirectly to the subject of this article. Corresponding author: Charles Eaton, MD, The Hand Center, 1002 S Old Dixie Hwy #105, Jupiter, FL 33458; e-mail: [email protected]. 0363-5023/11/36A03-0021$36.00/0 doi:10.1016/j.jhsa.2010.12.013
In the meantime, the same day as the surgery, this hurricane is coming fast, looking mean, and I’m making last-minute home preparations and fortifications, in my head singing that old Talking Heads song “Burning Down the House,” but with new lyrics: “Boarding up the house.” There’s a huge royal palm tree in my tiny front yard that could fall through my roof like Gallagher’s mallet through a watermelon. It is directly in front of my home office. I put a tarp over the bookshelves to protect my extensive personal library—all the latest publications and many rare, out-of-print handrelated books—all of Bunnell’s editions, old books by Kanavel, Brown, Tubiana, Hueston, McFarlane, Zancolli, Chase, and so forth. I pull the hard drives and put them in a safe place, etc., etc, a million things to remember. Done. I hunker down at home with my children, knowing that in the intensive care unit, my wife is safer than we are. After all, the hospital is a fortress on high ground and has an infallible backup generator. We pull mattresses into the master bedroom and plan to sleep there. The storm is powerful by the afternoon— can’t go outside. Night comes. The hurricane comes. As expected, we lose electricity and cell phone in the early evening, but fortunately the landline phone still works (it didn’t with the last hurricane). I stay in touch with the intensive care unit, wanting to hear “She’s great, tube’s out, want to talk to her?” Instead, because I’m a doc, I’m given the uncomforting technical details of her urine output, her platelet transfusions, her poor O2 sats, how her pressure bottoms out every time she’s given sedation. The wind howls and whistles, the shutters creak and groan, a tree limb bangs incessantly on the bedroom roof like an insane golem outside knocking on the front door with a bowling ball– size fist. The house is hot, humid, and dark. Distracted by the storm, the cat poops in the crowded bedroom about 3:00 AM. A first! Intolerably stinky. Sniffing like a Neanderthal detective in the pitch black, I search among the mattresses and the sleeping children using a penlight and then clean up the mess holding the penlight in my teeth without
© ASSH 䉬 Published by Elsevier, Inc. All rights reserved. 䉬 507
508
SPALTED SILVER MAPLE BOWL
waking anyone—pretty comical, actually. When I’m not pacing in the living room by candlelight, I pretend to sleep, but fool no one. As expected, the hospital lost power in the early evening and went on generator. What I was blissfully unaware of was that around the time that our cat was clawing at the bedroom carpet in a vain attempt to sweep imaginary sand over its very real poop, the hospital generator failed. For a few hours. Failed. For hours. Failed. Flashlights in the intensive care unit. Monitors offline. My wife, the love of my life and mother of my children, is on mechanical ventilation when the power goes out in the middle of the night in the middle of a hurricane! Fortunately, the vents have solid battery backups, the intensive care unit staff were seasoned and unflappable, and order and life were
maintained. The nurses, doctors, and other staff just . . . handled it. They just carried on. During that time elsewhere in the same hospital, a baby was delivered under flashlight illumination. When the storm cleared enough for me to venture out, everyone at the hospital was on the ball, pleasant and professional, despite having a much more stressful night than I had. I have seen a lot of life and death drama in my time, as we all have, but I am humbled by the compassion and strength of character of the folks at the hospital who worked through this crisis. In a time when the fundamental medical concepts of healing, caring, and giving have been nearly obscured by economics and opportunism, this experience reaffirms the impractical, naive reason I became a doctor: to help others, when they need help, because it is the right thing to do. I am grateful.
A TOUCH OF HUMANITY
Hand Made: Spalted Silver Maple Bowl Dean Sherwood Louis, MD This bowl was made from a silver maple tree that was harvested from my property. The patterning known as spalting is prized by wood turners. It is caused by the invasion of nondestructive, pigmented fungal hyphae. The bowl measures 22 cm in diameter and 13 cm high. I sanded it to 800 grit and wiped on a polyester finish. Total time to completion was about 10 nonconsecutive hours. From the Department of Orthopedic Surgery, University of Michigan, Ann Arbor, MI. Received for publication December 9, 2010; accepted in revised form December 14, 2010. No benefits in any form have been received or will be received related directly or indirectly to the subject of this article. Corresponding author: Dean Sherwood Louis, MD, Department of Orthopedic Surgery, UniversityofMichigan,1500EastMedicalCenterDrive,AnnArbor,MI48109;e-mail:[email protected]. 0363-5023/11/36A03-0022$36.00/0 doi:10.1016/j.jhsa.2010.12.018
JHS 䉬 Vol A, March
First Hand By Charles Eaton, MD URRICANE JEANNE CAME THROUGH Saturday night, and once again my home is hot and dark. I have the family camped out in my office, waiting for the electricity to be restored. We were off the grid for 6 days last month with Hurricane Francis. It looks like it will be a similar run this time. Francis broke and felled many trees, but this was a much stronger storm, and the ground was softened by a month of water saturation, so there was a fair bit of additional damage. I took pictures yesterday afternoon on the route I normally take to work: horizontal palm trees; defoliated shade trees; power lines dangling in the street; power poles fallen, broken, and dangling; trees on lines; my 4 sons standing on a freshly fallen tree in my office parking lot; Jupiter hospital, boarded up. But life is more complex than hurricanes. My sweet wife, confused, pancytopenic and cartoonishly cushingoid from the decadron and chemo she’s been getting for her recurrent brain tumor, has been recovering from a T12 compression fracture she sustained in a fall a few days before we got hit by Hurricane Francis less than a month ago. This week, as Hurricane Jeanne grew in strength, so did my wife’s intermittent shortness of breath. Friday morning, plain films confirm a very unusual pattern of bilateral pulmonary infiltrates. She is admitted to the hospital—rapid clinical deterioration, multiple consultations and tests, doesn’t look like bacterial pneumonia, pneumocystis, aspergillosis, atypical TB, PE, CHF, blah, blah, blah. The final recommendation is for open lung biopsy in the morning—Saturday morning, hours before the hurricane is due to hit. Done. Recovery in intensive care unit, oxygenation poor enough to expect that it will take at least a few days to wean from the vent.
H
From The Hand Center, Jupiter, FL. Received for publication December 9, 2010; accepted in revised form December 11, 2010. No benefits in any form have been received or will be received related directly or indirectly to the subject of this article. Corresponding author: Charles Eaton, MD, The Hand Center, 1002 S Old Dixie Hwy #105, Jupiter, FL 33458; e-mail: [email protected]. 0363-5023/11/36A03-0021$36.00/0 doi:10.1016/j.jhsa.2010.12.013
In the meantime, the same day as the surgery, this hurricane is coming fast, looking mean, and I’m making last-minute home preparations and fortifications, in my head singing that old Talking Heads song “Burning Down the House,” but with new lyrics: “Boarding up the house.” There’s a huge royal palm tree in my tiny front yard that could fall through my roof like Gallagher’s mallet through a watermelon. It is directly in front of my home office. I put a tarp over the bookshelves to protect my extensive personal library—all the latest publications and many rare, out-of-print handrelated books—all of Bunnell’s editions, old books by Kanavel, Brown, Tubiana, Hueston, McFarlane, Zancolli, Chase, and so forth. I pull the hard drives and put them in a safe place, etc., etc, a million things to remember. Done. I hunker down at home with my children, knowing that in the intensive care unit, my wife is safer than we are. After all, the hospital is a fortress on high ground and has an infallible backup generator. We pull mattresses into the master bedroom and plan to sleep there. The storm is powerful by the afternoon— can’t go outside. Night comes. The hurricane comes. As expected, we lose electricity and cell phone in the early evening, but fortunately the landline phone still works (it didn’t with the last hurricane). I stay in touch with the intensive care unit, wanting to hear “She’s great, tube’s out, want to talk to her?” Instead, because I’m a doc, I’m given the uncomforting technical details of her urine output, her platelet transfusions, her poor O2 sats, how her pressure bottoms out every time she’s given sedation. The wind howls and whistles, the shutters creak and groan, a tree limb bangs incessantly on the bedroom roof like an insane golem outside knocking on the front door with a bowling ball– size fist. The house is hot, humid, and dark. Distracted by the storm, the cat poops in the crowded bedroom about 3:00 AM. A first! Intolerably stinky. Sniffing like a Neanderthal detective in the pitch black, I search among the mattresses and the sleeping children using a penlight and then clean up the mess holding the penlight in my teeth without
© ASSH 䉬 Published by Elsevier, Inc. All rights reserved. 䉬 507
508
SPALTED SILVER MAPLE BOWL
waking anyone—pretty comical, actually. When I’m not pacing in the living room by candlelight, I pretend to sleep, but fool no one. As expected, the hospital lost power in the early evening and went on generator. What I was blissfully unaware of was that around the time that our cat was clawing at the bedroom carpet in a vain attempt to sweep imaginary sand over its very real poop, the hospital generator failed. For a few hours. Failed. For hours. Failed. Flashlights in the intensive care unit. Monitors offline. My wife, the love of my life and mother of my children, is on mechanical ventilation when the power goes out in the middle of the night in the middle of a hurricane! Fortunately, the vents have solid battery backups, the intensive care unit staff were seasoned and unflappable, and order and life were
maintained. The nurses, doctors, and other staff just . . . handled it. They just carried on. During that time elsewhere in the same hospital, a baby was delivered under flashlight illumination. When the storm cleared enough for me to venture out, everyone at the hospital was on the ball, pleasant and professional, despite having a much more stressful night than I had. I have seen a lot of life and death drama in my time, as we all have, but I am humbled by the compassion and strength of character of the folks at the hospital who worked through this crisis. In a time when the fundamental medical concepts of healing, caring, and giving have been nearly obscured by economics and opportunism, this experience reaffirms the impractical, naive reason I became a doctor: to help others, when they need help, because it is the right thing to do. I am grateful.
A TOUCH OF HUMANITY
Hand Made: Spalted Silver Maple Bowl Dean Sherwood Louis, MD This bowl was made from a silver maple tree that was harvested from my property. The patterning known as spalting is prized by wood turners. It is caused by the invasion of nondestructive, pigmented fungal hyphae. The bowl measures 22 cm in diameter and 13 cm high. I sanded it to 800 grit and wiped on a polyester finish. Total time to completion was about 10 nonconsecutive hours. From the Department of Orthopedic Surgery, University of Michigan, Ann Arbor, MI. Received for publication December 9, 2010; accepted in revised form December 14, 2010. No benefits in any form have been received or will be received related directly or indirectly to the subject of this article. Corresponding author: Dean Sherwood Louis, MD, Department of Orthopedic Surgery, UniversityofMichigan,1500EastMedicalCenterDrive,AnnArbor,MI48109;e-mail:[email protected]. 0363-5023/11/36A03-0022$36.00/0 doi:10.1016/j.jhsa.2010.12.018
JHS 䉬 Vol A, March