Something

Saturday 23 January 2010

I ran into one of my favorite people yesterday in the smoke shack on the roof, an Air Force vascular surgeon who was intently examining his cigar and immediately said to me in an exasperated tone as I entered our little Shangri La, “You Army guys are something.” I could sense that he wasn’t exactly complimenting me, so I inquired as to the inspiration for this sudden realization. He told me that one of our FOB’s was rocketed yesterday, injuring several medical personnel. One of the casualties was a general surgeon, who was then flown here on a medevac flight for treatment. The surgeon actually walked off of the helicopter and into the trauma room, saying loudly “Where’s the latrine?” As he walked out of the bathroom, he then exclaimed, ”There. Now there’s no need for a foley (catheter).”

After agreeing to finally lay down and get examined, the “patient” said “I’ve already explored the wound- there’s no intraperitoneal injury.” My friend inquired how the surgeon had managed to explore his own wound, upon which he replied, “With my finger.” Some eyebrows were raised, but the patient did agree to undergo imaging (x-ray and CT) studies, which actually showed that he had free air in his belly. This finding indicated that he did indeed have some shrapnel that entered his abdominal cavity, necessitating a laparotomy- a surgery to explore the abdomen and remove the shrapnel. After my friend reviewed the films with him and briefly discussed the procedure, with which both surgeons were of course familiar and which was completely necessary, the patient said, “No.”

“No?”

The patient said that he had no fevers and didn’t want to have surgery or be air-evacuated to Germany. He wanted to be observed for 48 hours, and if he didn’t develop peritonitis (an infected abdomen), he wanted to go back to his FOB and get back to work.

Funny enough, noone has ever said “no” here before. I won’t go into the medical details of the situation, but the request was risky, unusual, and caused a bit of head-scratching on the part of my friend and our entire medical command structure.

I’ll let you know how it turns out.