Malpractice makes malperfect

(Note: This is part 3 of a longer story.  Parts 1, 2, and 4 are here, here, and here.)

If Hippocrates were alive today, his oath would look something like this:

“First, don’t screw up.  Then blah blah blah medicine something…”

Thursday was the surgery to fix my (non-itchy) trigger finger.  There’s not much of a coherent narrative here, but I did want to point out a few highlights for those playing along at home.

Tuesday night the hospital called to make all the arrangements.  The call began oddly, with the nurse/receptionist’s first question, “Can you tell me what surgery you’re having?”  Note that she called me, and apparently this question (which I would hear repeatedly before the surgery was over) was a test for me, to see if I was the right person.  Once I guessed right, she proceeded to ask me the exact same 5 pages of questions I had answered when I went to the doctor’s office in the first place.

Now, honor compels me to point out my own shortcomings.  I don’t always pay attention.  I especially don’t pay attention when I think I know what’s what.  I once started an online relationship with a lovely young lady from Greenville.  It wasn’t until we got to the point of arranging to meet that I realized that she lived not in Greenville, NC (about 90 minutes away) but in Greenville, SC (about 5 hours away).  That didn’t work out as well.

I bring this point up only because I went to the wrong hospital.

In my defense, I distinctly heard the doctor’s assistant say the words “Wake”, “North”, and “Raleigh”.  I used to live in North Raleigh, and there is a hospital on Old Wake Forest Road.  So when she said “WakeMed North Hospital on Falls of the Neuse Road in Raleigh”, my brain efficiently (men are all about efficiency) edited out all the unnecessary words that described the hospital I was supposed to go to (which didn’t exist 30 years ago when I moved away from North Raleigh) and went to the old hospital (which I knew had been bought out by one of the local hospital conglomerates and renamed to something I couldn’t remember).

Fortunately, I have a finely honed skill I deploy in such situations.  After a quick call back to the doctor’s office from the wrong hospital parking lot (“Hello, I have a stunningly stupid question — where am I having surgery in an hour?”), I still managed to make it to the hospital on time.  (Note to self: If I ever get married, make sure to write down the name of the church.  And the bride.)

We finally arrived at the hospital about 12:45, where I was asked to provide a picture ID.  (Apparently, trigger release surgery has a high street value, and is strictly controlled.)  The intake receptionist proceeded to review my intake information, which had apparently been cut up like a child’s paper snowflake, so random data points were missing.  (“I see your father is your emergency contact — what is his phone number?”)  It felt very much like they were trying to break my story by having me repeat certain parts over and over.  (“So tell me, John, if that is your real name, where was your trigger finger on Wednesday between 6PM and 9PM?”)

So they whisk me off to pre-op, where I discover that I have to wear a hospital gown for the surgery, instead of the short-sleeved shirt I came in wearing.  (Note: the sleeves of the gown were longer than my shirt sleeves.)  So they took my shirt and sneakers, put them in a plastic bag, and took them away.  The pretty nurse (you knew there had to be one) tells me she is putting them in “the locker”.

A couple minutes later, the doctor comes by to say hi, draws a line on my hand indicating where he’s going to cut, and proceeds to put his initials on my forearm (perhaps so he can claim it later if I don’t survive).  He explains that the surgeons used to just put an X or check mark on the patient, but recently moved to using the surgeon’s initials.  He tells me this because his initials are O.N., and the first time, he had to clarify that he had not written NO on the patient’s arm.

Next came the Valium.  I’ve never had Valium before, and in spite of the fact that I know it’s not a tranquilizer, I expected it to put me to sleep.  So while I waited for it to take effect, the nurse brings me the 75th and final form to authorize the surgery.

It describes the correct surgery… for the wrong finger.  It says “right hand long finger trigger release”.  Now, all of my fingers are long, so I call over the nurse, hold up my marked-up, surgeon-approved triggery right ring finger, point to the form and ask her, “Is this right?”

It’s not.  They scramble, call over the doctor, who explains that the “long finger” is not the ring finger.  (An actual snippet of this conversation: “What should we call this finger?”)  Then they have me initial the change on the form and sign it.

While I’m waiting to be wheeled off to surgery, I happen to notice a sign across the room.  It piques my curiosity, so I ask the nurse about it.  She tells me it’s a safety warning for the nurses, alerting them to be on the lookout for patients on High Alert Medications (blood thinners, insulin, etc.) and Sound-Alike and Look-Alike Drugs (Zocor and Zoloft, for example).

Of course, from where I’m sitting, I can’t see all that information.  All I see are large, friendly letters reading HAM SALAD.  Which is #4 on my list of things you don’t want to hear in a surgical ward.  (Following “Oops”, “Has anybody found an earring today?”, and “Hey, Bob, you ever seen anything like this?”)

When they wheeled me into the OR, there were seven or eight people in there:

  • the surgeon
  • the tray concierge (the nurse that hands the doctor scalpels and forceps and retractors and stuff)
  • the restraintmeister (the orderly in charge of strapping me down to the table)
  • the “there-there” nurse (she sat by my head and said soothing things to distract me from the guy cutting my hand open)
  • the key grip (not sure what his job is – I think he just grips the keys for the surgeon)
  • the extras (off in the distance were three or four guys talking among themselves – don’t know who they were or why they were there, except for visual interest for the viewers)

The surgery itself went very smoothly.  I was awake the entire time, mostly wondering when the Valium was going to kick in.  (I foolishly went to the hospital in a state of low anxiety, so I had no edge for the Valium to take off.)  I learned once again that having a giant needle of Lidocaine stabbed into your hand does not dull the pain of having a giant needle of Lidocaine stabbed into your hand.  And I discovered that a one-inch incision in my palm required me to be mummified from my knuckles to above my wrist.

So they wheel me back to post-op (which looks suspiciously like the pre-op set, redressed), and the there-there nurse comes to ask me, “Where are your clothes?”  I explain the bit about “the locker”, and she says “They’re not there.”  So we have a brief discussion of my “no shoes, no shirt, no payment” policy, and a few minutes later she comes back with the plastic bag.  “They put your bag under the wrong name.”  I assume it was the name of the guy getting surgery on his middle finger.

Today, the bandages came off.  Honestly, my hand looks like someone cut it open with a knife, then sewed the hole shut with black thread.  The finger moves less and hurts more than it did before, but it doesn’t stick.

At least it probably won’t go on a killing spree… I hope.

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