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Two Cases

By Orhan Kaymakcalan, MD

Case 1:

Patient is a 54-year-old male admitted with a diagnosis of acute renal failure, rhabdomyolysis, severe upper G.I. bleeding, and dry gangrene on both upper and lower extremities. By the time he was admitted, he had been rejected by one hospital and transferred by another. The patient stated he was homeless and had been sleeping in the street for about two weeks during freezing temperatures. He underwent bilateral hands and below the knee amputations. On his left hand, the amputation was transmetacarpal with saving of the thumb at the proximal phalanx, radial artery forearm flap, and phalangealization at the metacarpals. On his right side, distal forearm amputation was performed and later a Krukenberg procedure. The patient is now living in a nursing home. After multiple requests for insurance authorization, he will soon receive bilateral lower extremities prosthesis. He is using his reconstructed left hand for self-care while using his right hand as a “chopstick”. He is very happy, says he is a new man and has not had any alcohol since his injury 2 years ago. In the future, he would like to become a social worker. Not long ago, as I was going to the Lyric Opera, a man working in the newspaper stand yelled out as he saw me, “This guy made my friend a new hand!”

 

Case 2:

Patient was a 16-year-old male seen due to multiple gunshot wounds to his right hand resulting in multiple metacarpals and carpal fractures as well as flexor tendon and digital nerve injuries. He had to have multiple surgeries and, even though he was born in the United States, he had no insurance at the time. To help his parents not worry about the finances of his treatment, I paid for his antibiotics. He was a very smart boy, very good at mathematics and wanted to be a basketball player. With the kind of injury he sustained, I explained to him that he would have difficulties playing basketball and that he should instead concentrate on studying Math. During his course of treatment, I prescribed very little narcotics, concentrated on hand therapy, TENS unit, and anti-inflammatories. He was discharged from my treatment after eight months. Seven years after his discharge, he came back to my office driving a BMW. As a token toke of gratitude, he brought me Godiva chocolate and tequila. He said he became a stockbroker, citing his gunshot wound and my many talks with him as motivation to change his life around. He vowed to never touch a gun again.

***Due to this case being over 25 years old, medical records are not available.  

Comment (1)
Mary Dykstra
February 14, 2020 1:59 am

This is amazing. You can tell this MD really cares about his patients despite their ability (or inability) to pay. Thank you for the obvious sacrifices you have made to improve your patient’s lives!

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