There have been a number of times in my life when I wished I
was wrong….oh, how I wished I was wrong!
One day while I was in nursing school, I was assigned to care
for a very large lady who had had gall bladder surgery. In those day, there was no laparoscopic
surgery, so there was a fairly large incision high in the abdomen on the right
side. This often caused people not to
want to breathe deeply and to avoid moving around. It was the nurses’ job to make them do deep
breathing, even if it was uncomfortable, and to get them out of bed and walking
to avoid both pneumonia and pulmonary embolisms resulting from blood pooling
and clotting in the legs.
My obese patient refused to get out of bed and was even resistive
to moving around. Every time I came into
the room, she had talked someone into cranking up the knee gatch. I tried to explain that this was a dangerous position
for her, as it would cause blood to pool in the vessels in her upper legs.
Her response was, “You young things think you know
everything! I know my own body, and I
will know when I am ready to move around.”
Complicating the situation was the fact that she was very good
friends with her doctor’s wife, who showed up with a girdle, so that she could
hold things in when she felt ready to get up.
I wasn’t convinced that was a good idea because I was concerned about
vessels in the groin area being compressed, but how does one tactfully object
to what the doctor’s wife is doing with the patient.
I was not working the next day and was relaxing in the dorm
when I got a phone call. We all knew we
were required to watch a certain number of autopsies. A friend who was working called to clue me in
to the opportunity to watch one that morning.
I inquired who the patient was.
My heart sank when I learned it was my patient the prior day.
I observed the autopsy that morning and two things about it
are vivid to me. One was that she had
eaten scrambled eggs for breakfast, and they were in her stomach undigested. The other….she died of a pulmonary
embolism. Blood had pooled in the leg
vessels and formed a clot. The clot let
loose and traveled to her lungs, and that was it.
Sometimes a young thing knows what she is talking about.
I am old and sometimes I still know what I am talking about.
I will never watch another autopsy. I hope I don’t have to pay my respects at any
coffins.
I want to be wrong. Oh…how
I want to be wrong!