#254 - Dr. GH

This post is about an old school doctor who taught a brand new PT a lesson about "tough love." 

It was a Saturday and I was filling in the Saturday morning hospital shift for my partner.  He had given me the list of patients that I needed to see that morning.  One of them included a young boy, I would say around 5 or so, who had been burned on his legs.  I can't really remember what caused the burn, but the treatment was to put him in a whirlpool bath, and then gently, but effectively rub over the burned areas with a towel or gauze to remove all the burned tissue.  Let me just say that in my opinion, burns are the most painful injury in the world.  The treatment for the injury is just as brutal. 

Anyway, I got the orders, knew I had a task in front of me, so I proceeded to his room.  This is where the fun started.  I introduced myself and did a little kidding around with the boy.  I love kids and they usually love me, so this part went okay.  Then I told him why I was there.  I could see the fear come over his face when he realized what was coming.  My mission was to take him in a wheelchair to a room just down the hall where a luke-warm tub of water waited.  This proved to be extremely difficult when the child vaulted out of the bed and then hid beneath it.  After about 20 minutes of coaxing that we would take it slow and he could say "stop" if he needed a break, his mom and dad and I convinced him to get into the wheelchair.  We started down the hallway and all was going well until we got to the door to the room.  Have you ever seen on cartoons when the cartoon character puts arms and legs on the door frame and blocks the entryway?  That was this kid.  He turned into Spiderman and it took mom, dad, and I plus a nurse to pry his fingers off of the door frame to get him into the room.  Let me just interject here that he was screaming his head off, trying to bite us, and throwing kicks and punches for all he was worth. 

My empathetic self continued to try to reassure him and give him some semblance of being in control.  My heart ached for him, but I really needed to do the treatment.  He had already been to surgery once for debridement, and if he didn't get the therapy, he would need another surgery.  Enter the subject of my post, #254.  He heard the commotion from down the hallway when he was making rounds.  He burst into the room, and in the loudest voice I'm sure the hospital wing has ever heard, he screams, "Shut up!  Quit yelling!"  I don't know who was more shocked, the kid or me.  It made the kid stop screaming and kicking for about 3 seconds before he resumed with a vengeance.  #254 was having none of it.  He basically grabbed the kid by the shoulders, put his face right in the kid's face, and said to him, "If you don't stop RIGHT THIS INSTANT and let this therapist clean your burns, I am going to take a needle out of my pocket, give you a huge shot, and take you right back to surgery and I'll do it for you!"

I immediately became the little boys best friend again.  "No! I don't want you!  I want her!  I want her!"  I shook myself out of my shock, jumped in front of #254 and got to work before the child could change his mind.  I started to gently rub the dead skin off.  #254 looked at me and said, "You have to do it faster and harder or he is going to start screaming again."  And so it went for the next 15-30 minutes.  The little boy crying (but not screaming), me crying and scrubbing, and #254 standing like a sentinel by the door in case he was needed again. 

To say that I was shook up by the incident is an understatement.  At the time, I had no children and I did not know the meaning of tough love.  #254 not only had around nine children, but he had been practicing medicine for many years and he knew that the only shot this kid had was this.  #254 pulled me off to the side after the ordeal was over and told me that he know how painful it was for the child, but he really did not want to have to take him back to surgery and that on Sunday, when I did it again, I really needed to clean it thoroughly.  Then with a smile he added, "Page me if you need me." 

Long story long, the little boy did much better on Sunday because I was able to get so much of the dead tissue off on Saturday.  He healed quickly and was able to get by without another surgery or a skin graft.  He was so young and so traumatized that I'm sure he would not think to thank #254, but on his behalf, I am glad that #254 was his doctor and he was there that day.  He taught me that it isn't always easy, but sometimes you have to just do it and throw nice out of the window if it is for the good of the patient. 

Tough patient love...tough lesson.