Scrub, Rinse, Repeat

A Surgeon’s View of on Patients, Doctors, and Health

by Dr. Arnon Krongrad

Appendicitis

A thing that brings us together.

Published on September 24, 2010 by Dr. Arnon Krongrad in Scrub, Rinse, Repeat

The streets were deserted. We would get to the hospital faster.

My wife took her car and I took mine. In the passenger seat was my daughter, complaining of pain in her belly. She first thought it was her menstruation, but changed her mind and woke us up. Something was wrong: Not once did she turn on the music.

I called Donald from the car. I felt a little guilty calling so early but I knew I had no choice. There was a little comfort in knowing that I would deprive him of only an hour of sleep. I asked him to meet us as soon as he could. He asked me to get the CAT scan started.

The gate lifted to the doctor's lot. We parked and walked in, using my magnetized ID to go straight to a gurney inside. While my wife filled out insurance paperwork, my old instincts took over. I don't do trauma or surgical emergency any more, but this is like riding a bike and the orders came out one after the last. You: Draw the following labs. You: Tell the CAT scan techs to start their engines.

She had just turned 18, so she had to sign her own consents. It meant the gynecologist wouldn't reveal her findings from the pelvic exam. She said she was sure I would want my daughter to tell me herself what she had found. I found this annoying. Who did she think was running this show?

Somewhere along the way, somebody sent her to ultrasound. What for? Well, we thought as long as the oral contrast wasn't in her long enough we'd just do an ultrasound. It had no value. It drove up cost.

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Along the way, her IV bag ran out and I sent someone to get a replacement. This was not an episode of Shlock and Awe. This had to be right.

The radiologist argued that it was too soon for a CAT scan. The writhing on the gurney argued the reverse. She had the CAT scan with no further delay, which instantly made the diagnosis.

The morning shift was shuffling in and happily an operating room was available. Donald had come in, reviewed the films, pushed on the belly, and nodded. The young, sweet anesthesiologist, who looked herself barely out of high school, assured me they would do a quick intubation to account for the contrast still in her belly. She does my prostate cancer cases and she's good. I was relieved when I saw her.

She was out in 40 minutes. Donald said the appendix was on the verge of perforation and showed me some photos. She had done right to wake us up. With delay, this would have become complicated.

My daughter left the hospital that night. Donald said nobody leaves that early and made me swear that I would call him for anything. Having a surgeon for a father gets you home sooner but it doesn't mean the surgeon rests easy. Having a surgeon for a father also means you have to listen to him fuss about a followup appointment, saying your wounds look fine and what's the point but Donald did come in early and he did a good job with surgery so I suppose we have to be civil about all this and let him do his job and check your wounds even though you don't neet it.

Her abdominal pain resolved but her surgical pain began. She talked a little different then. She said maybe plastic surgery was a bad idea. She said she wondered where her friends were when she was home recovering. Where was Matty? She'd gone to see her when she was sick, so why was she now absent? She talked about finding out who your real friends are.

She brought cakes to the doctors and staff at the hospital. She had baked them where she works in the summer. I'm the father. I don't get cakes like the others. I get the cup that she made when she was little, the one that says "Arnon" on the side, which is the only one of its kind. I know who her real friends are.

Now her nose is stuffed up and she sounds a little sad. I can tell when she calls home from college. And I worry: How can I help if she's so far away?