“Alone we can do so little; together we can do so much.” ~Helen Keller
My patient, John Done, rolled in by ambulance from his home in rural Oregon. As his story unfolded I understood why the nurses and ER doctors in the room were slack-jawed and shaking their heads, and I understood why I had been called to see what the nurse called a “DIY’er.”
I have been a surgeon for over ten years and had never been consulted for a case of do it yourself surgery. John had had a belly button hernia sticking out a couple of inches for many years. It started hurting a few days before I ended up seeing him.
Somehow, John convinced himself that the hernia had turned in to an abscess, even though it had been there for, as I said, many years. The pain changed his mind about an obvious reality. Once he decided it was an abscess, it made sense to lance it.
John was not fond of going to the doctor and usually took care of his own medical care. He opened up his Korean War medic kit and found his sterile scalpel…
When I got to John he had two stab wounds in his abdomen and was leaking intestinal contents onto the dressings. We took him to surgery, took out a segment of his bowel, and repaired his hernia.
He did well and was very happy to be free of the hernia. He agreed to call me prior to embarking on another DIY operation.
Although it seems unbelievable that lancing a hernia could happen, understanding the chain of events is instructive. (more…)