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Sometimes, Doctors Get Really Sick, Too

Friday, June 10, 2011, 16:20 EDT Leave a comment Go to comments

I had a check-up with my pulmonologist yesterday, a month after my originally scheduled appointment. His office had called me several weeks ago to advise that he had “an infection” and was not seeing patients until he was fully recovered. I took this to mean that whatever had afflicted him was contagious, so I was more than willing to reschedule.

I sat in an exam room at the local medical center where my pulmonologist practices, bringing him up to speed on my health, symptoms, etc. He was writing notes in my chart as I spoke. It took a minute before I looked down at what he was writing and noticed a bandage where his index finger used to be.

“Um, what happened to your finger?” I asked sheepishly. I expected to hear about some embarrassing power tool mishap.

“It’s gone,” he replied, deadpan. You have to know him to understand why this kind of response was not unexpected.

“Yes, I can see that. Why?” Maybe I was prying, but when you notice a body part missing that was there the last time you saw its owner, you get curious.

“I had something called necrotizing fasciitis,” and no sooner were the words out of his mouth that I gasped in horror.

I have mentioned before on this blog that I had a cousin who died from necrotizing fasciitis (NF), colloquially known as the flesh-eating disease. I also worked with a woman several years ago whose mother had NF but survived with all body parts intact, albeit scarred from surgical removal of necrosed tissue and subsequent grafting. Somewhere between those two ends of the spectrum is Dr. S., the third person I know who has been afflicted with this condition. He survived but lost an appendage.

He described the infection as having started in the index finger of his right hand, whence it spread rapidly throughout his hand and traveled up his arm almost to the shoulder before it was finally brought under control. In addition to the digital amputation, he also underwent an incision in his palm to relieve pressure from the severe swelling in the hand. Unlike many NF patients, he remained conscious throughout the course of the illness and never had to go on a ventilator, though he said he came close. He was hospitalized for a total of twelve days and spent an unspecified amount of recovery time at home before returning to work; he is undergoing rehabilitation on his affected hand to recovery full use as the swelling continues to subside. He now writes by holding the pen between his thumb and middle finger instead of thumb and index finger, but “it isn’t very neat.” I broke the news to him that it wasn’t very neat when he had the index finger, either.

Dr. S. readily acknowledged that he was lucky to have gotten off with just one fewer finger. He could have left the hospital missing the whole hand or, worse still, the arm. Even if he had lost just another finger, he pointed out, his functioning would have been compromised. This way, he is able to continue in his chosen vocation and just about every other activity without limitation and with minimal adjustment. He knows it could have been much worse.

But I was also aware that, even though he emerged relatively unscathed, the fact remains that he lost a finger. That must be difficult on a mental/emotional level, particularly for a physician. Part of the psyche of doctors (the ones I have known, at least, and there are many since I used to work in a hospital) is the knowledge that they can heal even some very serious conditions. Think about the sense of control that knowledge brings. How disconcerting must it be for a doctor to find himself or herself on the other side of the doctor-patient interaction, especially when the condition being treated is potentially fatal and most likely disfiguring? He didn’t talk about that and I didn’t ask. Unlike my push for an explanation of the missing finger, it seemed too personal to probe.

He said something else in the course of relating his ordeal. He said that as soon as he began having symptoms of fever and chills to go along with the rapid swelling and discoloration of his hand, he had a pretty good idea what was happening and went immediately to the emergency room. He is convinced that his rapid action saved his life, and I don’t doubt it. When my cousin got sick, he went to bed; by the time anyone found him, he was in a coma from which he never awoke.

The lesson for all of us, most of all those of us who are not medical professionals, is that sometimes time is the difference between life and death. The chances of developing NF are minuscule, yet I now know three people who have been afflicted. You don’t have to be able to diagnose yourself to help yourself. If you have any wound, discoloration, rash, or other visible abnormality that worsens rapidly, get to a hospital immediately. If it also comes with a fever, get there more than immediately. It might not be NF or any other serious condition, but the worst that will happen is that you might feel a little foolish for overreacting. That beats losing a limb or losing your life.

Here are some web sites containing further information about necrotizing fasciitis:

  1. WebMD — Necrotizing Fasciitis (Flesh-Eating Bacteria)
  2. National Center for Biotechnology Information — Necrotizing soft tissue infection
  3. National Library of Medicine, National Institutes of Health — Necrotizing soft tissue infection
  4. Overcoming Necrotizing Fasciitis — one survivor’s story
  5. MedicineNet — Necrotizing Fasciitis
  6. National Necrotizing Fasciitis Foundation
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