This article is the first of a two-part series from Sonya Sloan, MD, who shares a few of the many unbelievable patient encounters she’s had as a locum tenens physician.
We’ve all had them. Patients presenting with odd complaints or injuries. And as an orthopedic surgeon of nearly two decades, I’ve seen some things. Each patient presents with something different, of course, but some stand out more than others. I have cared for patients with out-of-the-ordinary injuries. And despite such a long career in medicine, I’ll admit I’ve been surprised more than a few times.
I have categorized certain cases as “I can’t make this stuff up.” Here are three of my most memorable patient encounters.
Note: These stories have been slightly altered to protect my patients’ identities.
Black sheep of the family
“My mother just passed, and I inherited a black sheep I didn’t know existed,” says ‘Mary’, a patient I treated on one locums assignment. And upon arrival to deal with her mother’s estate, Mary realized the little lamb she inherited was a rather large and very mean black sheep.
Well, unbeknownst to her, the black sheep did not like anyone but Mary’s recently departed mother. As Mary tried to wrangle the woolly farm animal, she was struck from behind and was sent flying into the air. She landed directly onto her elbow, dislocating it. I reduced the elbow in the emergency room under sedation, with no need for surgery. And Mary did well after treatment, but needless to say, the black sheep was no longer a welcome member of the family.
The hunter or the hunted
I was called to the ER for a femur fracture in an 80-year-old man we’ll call ‘Bo’. I looked at the X-rays, and noticed a unique-shaped foreign body impaled into the mid-shaft of the femur with a longitudinal crack propagating proximal and distal.
While examining the patient, I got the whole story. He had been elk hunting with his son and somehow discharged his arrow into his leg. Of note, there was still a portion of the arrow sticking out of the anterior part of the thigh. Since the fracture was considered stable, the injury could be treated non-operatively. When I informed Bo that he would have to be in a splint and stay off his feet for six weeks, however, he asked — much to my chagrin — if I could take him to surgery and fix it instead, because he didn’t want to miss elk-hunting season.
As a traveling orthopedic surgeon, sometimes I feel like I am in a real-life TV drama. But this patient took the cake (pun intended).
One rainy Saturday afternoon, as I was binge-watching the newest Netflix drama Breaking Bad, I was called to the ER for a patient — we’ll call him ‘Jesse’ — who had an open hand wound contaminated with an unknown substance. I was informed the patient wanted to leave against medical advice. When I asked Jesse what had happened, his reply was straight from the script of my new favorite show.
Jesse said that he was using his grandmother’s crochet hook to crush ingredients at the bottom of a glass beaker while he was making a batch of crystal meth. Unfortunately, Jesse used a little too much force, and the glass beaker broke, and the crochet hook went through the worst possible place in his hand. Not only did Jesse have glass in the wound near lots of nerves and blood vessels, but he also had crystal meth within the wound, which is not good.
I told him it would be best to take him to surgery urgently to save the hand from neurovascular damage and possible soft tissue or bone infection. He agreed to the surgery — as long as he could get back to his batch without his parole officer knowing why he was in the hospital. The surgery was meticulously daunting.
As I was leaving the hospital after Jesse’s three-hour surgery, I got a call from the hospital surgical floor nurse, who said he had left AMA. I never saw him again, but for some reason, I do believe he finished his batch.
This last patient, ‘Tricity’, was a seasoned veteran chef who bought herself a new kitchen electric stovetop and range. She was cleaning up after her first gourmet dinner with the new appliance when it happened: while she had one hand in the sink’s dishwater, she grabbed an iron skillet sitting on the electric stovetop. All she can recall is a very bright light, being thrown backward, and the smell of something burning. She was able to call 911 as she gathered her wits, realizing she had been electrocuted.
On my initial exam of the shoulder, it appeared that the volt of electricity had traveled from the skillet to her hand, up the shoulder, and out through the skin. She had a small quarter-size open wound with burnt muscle belly and fat at the rotator cuff. The proximal shoulder had a small fracture with minimal displacement of the great tuberosity. She was lucky to be alive since her new electric stovetop was never correctly grounded. Ms. Tricity needed a few surgeries to manage her injuries but did make a lightning-fast recovery.
On one of her post-op visits, she brought my staff and me lunch. I asked if it was from the same electric stovetop that injured her. She said heck no, I upgraded for a six-burner gas top!
Stay tuned for my next installment of “I can’t make this stuff up.” You won’t believe what happened next!