Self-Surgery
The Conclusion
What did the surgeon say to the patient who insisted on closing up their own incision?
“Suture self.”
“Biting the bullet” was a movie “meme” before the word came into everyday use.
Many western films of the mid-twentieth century had a scene where the hard-bitten frontier doctor tells the cowboy to bite down on a cartridge before digging out a bullet, and saying, “This is gonna hurt.”
Presumably, it gave the patient something to bite down on when the pain was unbearable; an ineffectual proxy for anesthesia at best, and hard on the teeth, as well.
“Biting the bullet” carries an altogether different connotation today. Like the terms “man up” or “buck up,” it is an admonishment to do something difficult or painful despite the immediate unpleasantness.
Consider how many times in our lives we have been out alone and could have been a victim of entrapment – many, I would guess. Particularly so, here in the mountains. Our rugged landscape is one of our best natural features, but it is prime topography for serious injuries.
Just in my little corner of the world, I have many friends who hunt, fish and hike alone, often off the beaten path. A moment’s negligence, or failing to tell others of your plans, could have devastating consequences.
With its 300,000 acres of national forest, Pocahontas County has hundreds of miles of rarely-tread trails. And that’s not counting the additional 30,000 acres of state forest and parks, and even more private acreage. We are a densely forested county of steep mountains, deep hollows, rivers and streams.
In an area dominated by forest industries, outdoor recreation and agriculture, it is not uncommon to be working alone in remote locations. Put a chainsaw in your hand, and the risk of entrapment increases. Hiking on a scree slope can dislodge unstable rocks that can pin a leg or arm without warning.
Are you prepared for such an eventuality? Are you willing to bite the bullet for the sake of yourself or your loved ones?
People like the ones we shall soon meet not only have what it takes to amputate limbs or operate on themselves, but often have some knowledge of the human body. For example, knowing how and where to place a tourniquet can make the difference between living or dying.
“Honey, I’ll be home late tonight; I’m cutting off my left leg. But I do have a three-pound rainbow trout for dinner. Love you.”
On a fine Colorado October day in 1993, William Jeracki, of Conifer, decided to get one more day of fly-fishing under his belt before winter set in. He was hiking through a talus slope in the St. Mary’s Glacier area when he dislodged a large boulder, hopelessly trapping his leg.
The 38-year-old father of two had not brought along a jacket and knew the temperature would drop precipitously when the sun went down. He only had to think of his young family to determine his course of action.
He would sever the lower leg at the kneecap, leaving the amputated portion of the leg behind, and crawl to his truck.
Digging through the pockets of his fishing vest, he retrieved some nylon line, a filleting knife and fly-tying forceps. Mr. Jeracki was, above all else, a cool-headed man.
Using a rope to tie a tourniquet, Jeracki cut through the connective tissue under the kneecap. He took the additional step of using the forceps to clamp the major blood vessels. He was soon free from the trapped lower leg.
Now free, Jeracki was faced with the excruciating task of crawling back through the boulder field to his truck some half-mile away. And, wouldn’t you know, Jeracki’s truck was a stick shift, further complicating his escape to safety.
A half-mile down the road, Jeracki arrived at a small group of house trailers. A resident summoned help in the form of a helicopter, and Jeracki was flown to a hospital in Denver.
Jeracki’s surgery required two hours to clean and suture the wound. His amputated leg was recovered and brought straightaway to the hospital; however, too much time had passed, and the severed leg was not viable for reattachment.
An attending physician’s assistant would later say of William Jeracki’s actions, “It was a reasonably good surgical procedure. The man had such an amazing presence of mind. I’ve never seen anybody in such pain do what Mr. Jeracki did.”
I wouldn’t argue with that astute observation!
Jock McLaren soldier and surgical do-it-yourselfer extraordinaire.
Talk about pluck; speak of moxie; Jock McLaren could have been the inspiration for the character Rambo.
A veteran of WWI, volunteering for the British Army when he was still a teenager, McLaren began his distinguished and decorated career as a guerrilla fighter possessing unparalleled courage.
He continued to serve as a veterinary officer between the two world wars.
Shortly after WWII began, he re-upped with the Australian Forces and was assigned to British Malay. Not long after Singapore fell to the Japanese, McLaren was captured and put in a brutal Japanese POW camp.
He soon escaped and made his way to an encampment of Filipino and American guerrilla forces. Using small boats, McLaren would lead daylight raids into Japanese-held harbors, destroying and sinking as many Japanese ships as possible.
The Japanese military officials so feared McLaren that they put a huge reward on his head. One of McLaren’s Malay comrades snitched on him, and the Japanese again imprisoned him.
This time, McLaren and several others escaped in a dugout canoe, ending up in Mindanao in the Philippines.
While he was on the lam in Mindanao, he came down with appendicitis. In keeping with McLaren’s humble, albeit fearless, personality, he seldom spoke of the incident.
What is known is that his entire set of surgical instruments consisted of nothing more than two spoons, a razor blade, and something akin to a needle. That was enough for McLaren to remove his own appendix without so much as nicking a muscle.
When the task was completed, and might I add, without any anesthetic, he sutured his incision with what he referred to as jungle fiber. We can safely assume it was derived from a readily available fibrous plant, probably wild.
I would have said, “They don’t make them like that anymore,” but considering the Jeracki story above – they still do.
Stout-hearted readers weigh in on self-surgery experiences.
Dr. J, a residency-trained emergency medical physician, writes about his self-surgery exploits, including those performed before he attended medical school.
Some of his stories reveal his sharp wit; humor not unlike that of the beloved Gary Larson cartoons. What follows is the doctor’s description of incising swollen tissue on the palm surface of his hand.
“I was suturing a one-centimeter slice on the volar pad (swollen tissue) of my finger once. It was hard to keep the injured finger still to put the stitch in. Every time I started the poke, I would have an involuntary reaction of jerking my arm away from the offending needle.’
“My reptile brain was at work. I chased myself around the house for 15 minutes, cornered myself, and rammed the stitch through. It could have used two stitches. I settled for one.”
Salvage diver and expatriate Dave Lowe of southwestern Luzon in the Philippines tells of a terrifying underwater “close call “while salvaging a 25-ton boat at a marina in St. Petersburg, Florida. Here’s how he described his ordeal.
“I was assigned to hook up airbags and barrels to float her. Somehow a chain slipped, and the 25-ton boat rolled onto me in 10 feet of water. I was pinned. We didn’t have pressure gauges back then, so I wouldn’t know how much air was left in my tank.
“After 20 minutes, I thought it was all over.
“Fortunately, the bottom was three feet of muck, and the tide was incoming. I had one of those giant US Diver knives on my leg. It was dull as hell, but I started digging into the muck to retrieve it.’
Just as I found it, the boat rolled a foot in the other direction, and I was able to dig myself out. I was sure that it was over. But it wasn’t, and I continued salvage diving for another thirty-plus years.’
The human survival instinct is alive and well,” said Dave.
Doug Lucchetti reminds us of a brilliant – some would say eccentric – doctor in the early part of the 20th century. The word unique would fit Dr. Evan O’Neill Kane like a glove – I found his biography fascinating. Dr. Kane’s innovations revolutionized many aspects of medicine.
Regarding our topic of medical self-treatment, Dr. Kane is best known for having performed his own appendectomy using local anesthesia.
This was done to convince other doctors to use local anesthesia when appropriate as a safer alternative to general anesthesia. And he was successful to that end.
Dr. Kane is also acknowledged for his introduction of focused occupational trauma care, particularly in the railroad Industry.
He is also known for his quirky touches, such as tattooing mothers and their newborns to prevent hospital mix-ups of infants. Dr. Kane was also fond of leaving his signature, Morse Code for the letter “K” on his surgical patients (dash dot dash).
Lastly, our own Beth Little submits a DIY surgery experience, not on herself, but on a valued goat. One, not so unusual here in the mountains where DIY is a fact of life.
A friend of Beth’s had a nanny that produced excellent milk. So when she (the goat) got a teat lacerated on a barbed-wire fence with no veterinarian available, Beth looked for a solution in her sewing kit.
Beth made her friend’s goat as good as new using a hooked needle and black polyester thread.
Stories; everybody has one. Let’s hope that technology never replaces the art of telling a good tale.
Ken Springer
Ken1949bongo@gmail.com
