Tuesday, January 10, 2012

Ugly side of medicine.

Today started with autopsy sign out, it wasn't on the schedule but as a class we are usually early enough to have significant time in the student room before we're due to be somewhere so we just tagged along when we heard it was happening. Just from conversation with one of the autopsy PAs it reminded me of some of the cadavers and specimens I have seen.

For many people, it is hard to imagine walking around with part of their body mummified or rotting off but for other people it is their normal life. I don't know how long you have to wear your clothes before they fuse to your body, but I've seen it at least once and heard of it from others often enough to know it happens more than someone outside of the medical field would believe.

Where I worked before some specimens made it into legendary status for their odd location, appearance or sheer size. I will never forget the enormous pedunculated skin tag that we dubbed the "back potato" for its shape, color and size. It was massive and I couldn't figure out how you could sit or wear normal clothes while carrying around something so large, and it had to be growing for ages.

Large crusted skin lesions, hoof-like toenails, gangrene going black, sloughing... things allowed to fester for years and years. It could be a matter of not having health insurance, a neglected geriatric patient or that deep seated human belief that if you ignore it long enough it might go away (ignoring the evidence of past experience, of course).

It can be heartbreaking to imagine living your life like that, especially for the elderly patients who aren't necessarily the one making the decision to go for medical care or not. For that, I am actually grateful that in pathology we won't have to see the patients whose specimens we receive and that the autopsy patients are beyond pain.

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