Dupuytren's #4

 

There has been a cancellation at my local hospital.
“Can you come in on Tuesday next week?” the admissions secretary had asked on the phone.
Saint Anley had enthusiastically agreed.

 
“Hello,” says the pretty receptionist who doesn’t look a bit like Tracey.
“Please give me your full name.”
“Saint Anley the Incandescent,” I reply.
“ … and what’s your date of birth?”
I confess to advancing years.
“ … and is your address still …?”
“ … and your telephone number ends … ?”
“ … and Dr *** is your GP?”

“Yes, yes ... and I think so,” responds St. A.
“Please have a seat there,” instructs the lady who doesn’t remind me of Tracey.

After a few minutes a nurse approaches: “Hello, what’s your full name?
She checks with my records to make sure I have answered correctly.

“ … and your date of birth?

“ … and your post-code is?

“ … does your telephone number end … ?

“ … and Dr *** is your GP?”

St. A. thinks, “She knows all this already.”

St. A. is directed to a cubicle and commanded to undress and don one of those anonymous looking hospital gowns that tie at the back.

Nobody told this patient that
he may keep his underpants on!

Then, along comes my surgeon, Mr ***. I remember him and we perpetuate our earlier conversation about the postage stamps of Papua New Guinea.

“Oh,” he says, referring to his clip-board, “I suppose I’d better ask you all these questions:

“What’s your full name?”
(You know what’s coming next.)

“Now, here’s your anaesthetist.”
He introduces me to a charming woman who looks like she’s just left school.

She goes through the same questions to establish my identity.
“Allergies?”
“None,” say I.
“Medications?”
“Nope.”

She explains the process of a regional block of the brachial plexus.

“You’re first on Mr ***’s list. We’ll have you in theatre shortly.

In the anaesthetic room, Micky, the theatre technician introduces himself before proceeding, once again, to ensure that I am who I think I am.

Anaesthetist returns and, accompanied by another nurse who insists on asking all the same questions again, proceeds to insert a large needle in the region of my left collar bone. Through this needle she infuses some local anaesthetic, not without some discomfort.

“That’ll take about 20 minutes to work.”

St. A. lies quietly and observes that he is slowly losing all motor function of his left arm.
This is followed by a warm, tingling sensation extending down the arm from his left shoulder. That’s quite pleasant.

Anaesthetist returns and pinches St. A’s left forearm.
“Can you feel that?
“Ouch!”
“Not long now,” she declares.

Indeed, within another few moments the limb seems completely disembodied. It no longer belongs to me and is completely at the direction of these various attendants.

The theatre door opens and I am greeted by a cheery theatre manager: “You must be Saint Anley?”
At last the message is getting through!

It's very bright in here.

I am linked to by a monitor that records my pulse and blood pressure. While my surgeon is scrubbing up I experiment with a variety of self-hypnotic techniques to see if I can reduce my pulse and blood pressure as a matter of will.

I CAN!

Now we’re ready.

My arm, which is now totally alien to me, is carefully placed, palm upwards, on an extension to the operating table. Mr *** paints the limb with some red solution, a tourniquet is applied and he carefully draws some hieroglyphics on the palm of my hand.
I can’t see precisely what is going on, so I ask, “Are you doing anything that might be painful?”

“No,” says my surgeon, “I’m just doodling!”

The anaesthetist light-heartedly fakes offence: “Of course you’ll feel no pain!”

Surgeon asks for scalpel and forceps.
St. Anley doesn’t want to look, but engages in conversation with the nurse who is supervising the aforementioned monitor.
"That's a bit worrying: why does is say 'apnoea'?"
"Oh, that's alright. We can see that you're breathing."

The surgeon patiently explains what he’s doing and, encouraged by feeling no pain whatsoever, St. A. turns his head to sneak a peek.

“Oh, you’d like to look?

“ Nurse, please get Saint Anley another pillow.”

Now I have full view of the internal mechanics of the palm of a hand that looks and feels like it belongs to someone else.

This is a really weird, dream-like experience, and I realise that this is not minor surgery: it is seriously intricate stuff.

No, this is not the hand of Saint Anley.
I wasn't permitted to take my camera into theatre.

Although the major deformity is to my little finger, Mr *** has noticed that Baron Dupuytren is threatening to attack the ring and middle fingers, so a surprising amount of diseased tissue is painstakingly, (and painlessly,) scraped away to reveal some glistening white tendons.

“Look at all this rubbish,” announces the surgeon with considerable satisfaction.

Now it’s time to be sewn up.
“5-0 silk, please, Nurse.”

Then we have a dressing and a plaster of Paris splint that I must wear for a week or so.

My hand, (yes, it is mine!) now appears thus …



Is it a duck?

... and by now, the entire staff of my local infirmary have my name, address, DOB, the last three digits of my telephone number and the name of my GP permanently committed to corporate memory.
Next time I'll take my passport and two recent utility bills.

By the way, my mother's maiden name was ... !