Hmmm

I think I have a good one, though it didn’t bother me much, and anyone in the same line of work has done similar, so it isn’t as big a deal to us.

But!

Back around the turn of the century, I had a patient that developed a pressure sore on his hip.

This sore broke down fast, and wasn’t responding to treatment well. So it progressed brutally. It then got infected.

By the time all was done and said, the wound was about four inches around, and tunneled from the hip socket down the femur about halfway.

Despite being freshly discharged and on oral antibiotics, the IV antibiotics hadn’t eradicated all of the infection, they just got it under control enough to continue treatment at home.

Enter the wound-vac. Basically, it’s a pump that sucks wounds and makes them heal faster. Amazing fucking devices, totally changed wound care. But I digress.

Part of the way a wound vac works is packing the wound with fancy sponge material. Otherwise, it’d just suck the wound’ sides in and that ain’t good.

Every morning, I’d take the container full of blood and pus to empty it and clean it. Then I’d get busy pulling out the old packing materials, also covered in blood and pus, plus chunky bits. Then I’d irrigate with saline, followed by using pads to pull most of that back out. So, about a half hour of dealing with body fluids that smelled exactly as bad as you’d think infected body fluids would smell.

Then came the fun part! Fifteen minutes of packing the wound.

Now, during all of that process, im wrist deep in this man’s leg. Guess how far gloves go up the arm. We did eventually get longer ones, but guess who has two thumbs and hands that tear regular sized gloves apart.

Exactly, 👍 this guy 👍

So, my choices amounted to refusing to do the job, which was not happening because that ain’t how I roll; using the shorter gloves while the wound shrank, and just taping them up as best I could to keep human juices out of the gloves (or, rather, to a lesser degree), or wear the long gloves and hope they didn’t pop while I was in there.

Truth be told, I had better sensitivity with the popped gloves since that amounted to not wearing any at all, so I probably should have just gone that route, but that’s whatever. I went with regular gloves and tape.

So, every day, by the end of the process, I’d have to pull off gloves that had sweat, blood, and pus in them. Not as much as I’d have had if I went in bare handed, or had a glove break, but enough.

Then I’d scrub my hands for the third time of the morning and think hard about my life choices while drying them.

It may help the description to realize that I can palm a basketball (if I’m careful), or could before arthritis. And, my usual glove size is xxl. So when that hand is in someone up to the wrist with room to spare, you know it’s a party!

I tell this story in person sometimes. I include the sounds of my hand schlucking in the wound. Psshhhsslllccck going in, and thhpppthck coming out. I have seen people almost pass out, have had one person vomit, and many leave the area with haste. It may or may not be the most disgusting thing anyone has ever done, I’m confident it isn’t. But as stories go, it hits hard in person, with all the sounds and hand movements.

Now, old wound care stories abound, but most of them weren’t disgusting on my end. I’d see disgusting things, and do stuff that was disgusting to see if you were standing there, but I’d be gloved up and clean the entire time. Like, if you’ve never seen anyone cutting necrotic tissue out of someone’s body from a wound that covers essentially their entire ass down to the bone, well, you don’t want to see that. It didn’t bother me at that point, but it was definitely disgusting by usual standards. But I find it more sad than disgusting what with the reason it was that bad. She was slowly dying, and her body just couldn’t recover, so she was rotting away. That’s some fucked up shit, and is one of hundreds of reasons I will always advocate for the right to death via assisted euthanasia.

Hell, I’ve seen nastier wounds than either of those. Infected burns are horrifying to see. But I’ve also had to clean diarrhea out of wounds, including that specific one on the lady with only half an ass left. Which, on the scale of things is pretty disgusting, but it was also possible to get the job done without getting anything on me. Well, other than trauma lol. That lol isn’t making light of it. It’s whistling in the dark.

I tell you though, once you’ve handled a few infected wounds, you either adapt to it and do it clinically distant, or you run screaming and never come back. Luckily, I came into this world with a strong stomach, a pervasive curiosity about medical matters, and a stubbornness about retreating from challenges. So it was always easy to turn off the “yuck switch” and just do what needed doing. Most of the time, wound care was awesome. I loved it, and struggled more to keep my enthusiasm for the work hidden than any kind of reaction to the gross parts.

Patients tend to not enjoy you saying things like “okay, that is so cool, I can see your femur”. Or, “oh wow, I can feel bone in here”. So I learned to keep my mouth shut while working. Being gleeful during wound care will get you a visit with your supervisor. Telling said supervisor “but it’s so cool! Nobody else gets to see this kind of thing” is surprisingly not going to be met with shared enthusiasm most of the time.