Over my seven years in orthopedics, I run into a patient every now and then who has done something so stupid that I might be tempted to make fun of them...if only their action hadn't ruined the rest of their life. Numerous examples spring to mind -- the 24-year-old man who was playing "chicken" on a snowmobile and lost his right arm. The chronic alcoholic who decided it was a good idea to try operating a chainsaw while drunk, and came close to losing his arm. The young IV drug user who shot up with saliva rather than water, and now can't figure out why he might have endocarditis.
My (un)favorite was the lady whose friend told her that her PEG tube looked infected. Rather than come to the ED, she cut it off close to the skin with scissors. She gave herself an air embolus, which resulted in a stroke and the loss of half her body function. She's bedridden, dependent and aphasic, and only in her 50's.
I can't figure out why people do this to themselves. I'm sure the rest of you all have had patients like this more than once. How did you handle it?
