HOSPITAL POLITICS (PART 2)
I hopped into my car and followed the ambulance to the hospital. Then I had the paramedics take Gary straight into the X-ray room, where Carroll Stevenson met me. I explained my findings, and before I could tell him what I wanted, he said, “Got it. I’ll get you plain films with obliques. I presume you’ll want stress views?”
I was impressed with Carroll’s knowledge. This type of X-ray was the standard of care back then—the days before MRI scanners, which is the test of choice now for these types of injuries.
As Carroll was taking the X-rays, I was remembering his involvement in one of my most unusual veterinary events. I had sent a patient with severe flank pain for an X-ray exam called an IVP (intravenous pyelogram). The radiopaque dye injected into a vein is excreted by the kidneys, and over the course of an hour or so it allows the doctor to “see” a shadow of the kidneys and the ureters, with X-rays of the abdomen taken every ten to fifteen minutes.
My patient was in the middle of her IVP when Carroll came into the room. “Margaret,” he told her, “I need to have you take a seat in the waiting room for a minute.” Although she was in great pain, he helped her off the table, placed a second hospital gown over her back, and escorted her out of the X-ray room.
As she was escorted from the room, Dr. Mitchell was carrying one of his injured hunting dogs into the room to be X-rayed. Now, I’d be the first to say that no harm was done to the human patient—other than a tad bit of inconvenience—but it certainly was reflective of the medical politics and the veterinary care provided in our little country hospital.
After Carroll took the X-rays, and while I was waiting for Gary’s films to develop, Don and Billy took Gary back to ER. Louise would get the paperwork in order and re-ice the knee. She would help Gary get out of his uniform and also escort Gary’s parents into his cubicle when they arrived with his clothes.
As Carroll put the films on the viewing box, I carefully looked at them with him.
“No avulsion fractures,” he observed. I agreed.
“Best of all,” I added, “these stress films show virtually no distraction.” If the ligament was torn, the X-rays taken under stress would have shown a separation, or distraction, of the edges of the tibia and femur—an opening up of the joint that wouldn’t occur with an intact ligament.
“You think it’s just a first-degree strain?” Carroll asked.
“Nope. When I examined him on the field, the joint opened up a bit. So I’m pretty sure it’s a very mild second-degree strain. But I’m also worried about the meniscus.”
“Want to get a CT scan when the truck’s here Tuesday?”
“Nope. I don’t like the CT for soft tissues around the knee. I think I’d like to recommend he get scoped.”
Carroll looked at me with a funny expression. “Mitch usually takes these cases to OR.”
I was quiet for a moment, looking at the films and hearing Preston’s warning still ringing in my ears.
“I know. But if we open him up surgically, he’s out for the season. A good sports orthopedist can do an arthroscopy and get a good look at the cartilage and ligaments, repair any damage, and get out quicker than we ever could. Furthermore, if the damage is as minimal as I think it is, we’ve got a good chance of getting Gary back on the field in the not-too-distant future.”
It was Carroll’s turn to be quiet for a moment. Then, in a whisper, he said, “Mitch doesn’t like us referring out things we can do here.”
I knew I needed to be very careful—with both what I said and did. I paused and then nodded. “Carroll, how about we let the parents decide?”
Carroll smiled and nodded his head. “Sounds good.”
But, I’m not sure he meant it.
TO BE CONTINUED
PAST STORIES FROM BRYSON CITY SEASONS
- Dead Man Standing (Part 1), (Part 2), (Part 3)
- Eyes Wide Open (Part 1), (Part 2)
- Auspicious Accidents (Part 1), (Part 2)
- Answered Prayers (Part 1), (Part 2), (Part 3), (Part 4)
- Rotary Luncheon
- Death by Emotion (Part 1), (Part 2), (Part 3), (Part 4)
- The Invitation (Part 1), (Part 2)
- Barbecue and Bacon (Part 1), (Part 2)
- A Touchy Subject
- Family Time (Part 1), (Part 2)
- Chicken Pops (Part 1), (Part 2)
- Swain County Football (Part 1), (Part 2)
- Hospital Politics (Part 1), (Part 2), (Part 3)
PAST STORIES FROM BRYSON CITY TALES
- The Murder (Part 1); (Part 2); (Part 3)
- The Arrival (Part 1); (Part 2)
- The Hemlock Inn (Part 1); (Part 2)
- The Grand Tour (Part 1); (Part 2)
- The Interview (Part 1); (Part 2); (Part 3)
- Settling In (Part 1); (Part 2)
- First-Day Jitters (Part 1); (Part 2)
- Emergency (Part 1); (Part 2)
- The Delivery (Part 1); (Part 2)
- The “Expert” (Part 1); (Part 2)
- The Trial (Part 1); (Part 2)
- Shiitake Sam (Part 1); (Part 2)
- Wet Behind the Ears (Part 1); (Part 2); (Part 3)
- Lessons in Daily Practice (Part 1) — Anal Angina; (Part 2); (Part 3); (Part 4)
- White Lies
- The Epiphany (Part 1); (Part 2)
- Becoming Part of the Team (Part 1); (Part 2)
- Monuments (Part 1); (Part 2)
- My First Home Victory (Part 1); (Part 2)
- Fisher of Men (Part 1); (Part 2)
- Fly-Fishing (Part 1); (Part 2)
- Something Fishy (Part 1); (Part 2)
- A Good Day at the Office
- An Evening to Remember
- Another New Doc Comes to Town
- ‘Twas the Night Before Christmas (Part 1); (Part 2)
- A Surprising Gift
- The New Year (Part 1); (Part 2)
- The Home Birth (Part1); (Part 2); (Part 3)
- The Showdown (Part1); (Part 2); (Part 3)
- The Initiation (Part 1); (Part 2); (Part 3)
- Home at Last (Part 1); (Part 2); (Part 3)
© Copyright WLL, INC. 2017. This blog provides a wide variety of general health information only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment from your regular physician. If you are concerned about your health, take what you learn from this blog and meet with your personal doctor to discuss your concerns.