Not everyone likes you and patients are no exception. Although this little boy’s story is by no means, of any exemplary plastic surgery and absolutely not of one of the cases/surgeries I consider an achievement in terms of skill. Yet I feel extremely happy to see him on the road to recovery because he is an example of teamwork and perseverance.
After a truck ran over both his legs, he was told at a primary care centre that one of his limbs may not survive, given the condition. He was taken up for an emergency surgery and planned for major surgery where we would have reconstructed leg tissue from back muscle, after 48 hrs. Unfortunately, his condition deteriorated. His haemoglobin dropped and transfusing blood was a major problem as he was running a high-grade fever. Simply put, he just didn’t get fit for a major procedure.
So, we took to simpler and multiple surgeries. and simpler surgeries. It took time but he gradually improved. I remember wishing hard to see him walk someday. Everyone from our anaesthetists, orthopedicians, OT staff, and technicians were involved in the effort. The management of our hospital was kind enough to help waive off his bills as much as they could. There was more help from all quarters than I would have imagined.
But the boy wouldn’t talk to me at all, which I attributed to the language problem. Later I saw him talking happily to ICU nurses in both Hindi and English. Of course. I was the one who more often than not had approached him with a blade in hand to open his dressing. On the contrary young and sweet ICU nurses who were pampering him must’ve seemed angels in comparison. The extent of pampering boiled my blood one day when I walked into ICU to see him munching ‘Kurkure’. This, when I was, had kept him nil per oral as I was ruling out injuries inside the abdomen.
When we finally discharged him, he was lost to follow up for a couple of weeks. But one fine day I got a call from a young doctor, posted in the remote area that was the boy’s village. The boy’s father had lost his phone. Luckily they fell in hands of this young yet dedicated lady doctor posted there for her internship. She somehow traced my number and soon after video calls to see his condition and for dressing instructions, followed.
He will be coming to us soon to get rid of his external fixator. Hopefully, he will walk then. He may adapt or may require another surgery later on, but God willing he will walk. And who knows, someday he may start liking me also!
Technical jargon for doctors: After debridement, he was planned for a Lattisimus Dorsi muscle free flap reconstruction. But due to low haemoglobin and persistent fever he wasn’t fit. We took the aid of negative pressure wound therapy and did a local flap (tibialis anterior muscle flap), skin grafting and external fixator application.
Orthopaedic surgeons will remove exfix and we will try to make him walk with a splint. He may or may not require tendon transfer later.