Humpty Dumpty

October 30, 2004, was a glorious fall Saturday high in the Colorado foothills. I was high up on a ladder painting away as I had been every spare moment for the past month. The end was near! I had two great days of weather forecast and only one more side of the house to finish. As I climbed down 17 feet to move the decrepit ladder over, I noticed that the broken legs were digging into my new asphalt driveway. It was then that I embarked on the stupidest act of my entire life: I placed some cardboard under the legs. After climbing back up I made two passes with the spray gun, then found myself lying face-first on the asphalt, unable to breathe. After an eternity of oxygen starvation, I caught a breath and tried to push myself up to my knees. My left arm crumpled under the weight of my body so I crawled across the garage and up the stairs to yell in the door for help. Luckily, Anne and the kids had not left for Halloween parties at the malls and drove my battered, hyperventilating body a mile to the Conifer Medical Center.

It took Doctor Number 1 and three nurses in Halloween clown costumes every bit of strength they had to pull my arm apart so the dislocated elbow would slide back into place. Once reduced, the arm really did not feel bad at all. They took me home and I cleaned up the painting gear and went to bed. Sunday morning I felt great and managed to take the back door off, change the hardware, and rehang it with my arm in a sling. Late Monday morning I went the big ortho clinic in Golden that the initial doctor had recommended. The doctor looked at my x-rays, then said I needed to see their hand specialist the next day. Seemed odd that a shoulder specialist could not fix an elbow but a hand guy could. The hand specialist (Doctor Number 2) said my radial head was cracked and might need to be cut off and a titanium implant installed. Didn’t sound too bad:  six weeks of recovery time meant I could still ski this winter, though house painting would have to wait until spring. On Friday, November 12, as they wheeled me into the operating room I wasn’t the least bit worried. I woke up a nanosecond later in a dark patient room with tubes everywhere, a metal fixator contraption on my arm, and massive pain throughout my arm and head. Doctor Number 2 came in looking extremely ill. I asked him how it went. He said, “Okay.” I told him it looked like they put the maximum amount of hardware on me; he said, “Yeah, we had to.” Then he left without another word. The next morning I discovered my wrist and fingers were totally limp. Four and a half months later my third doctor would discover that the bone drill had pureed four inches of my radial nerve into mush.

Surgery Number 2 in April was a futile attempt to splice three parallel pieces of the spaghetti-size sural nerve from my left calf into the four-inch void in my radial nerve. We knew it had less than a five percent chance of working, but prayed for the best. After seven months of physical therapy from the most amazing therapist in the world, I became impatient and considered elbow capsulectomy surgery to restore range of motion in my very stiff elbow. In the early morning of August 17th I spent two hours on top of Shrine Pass discussing with God my medical options. I had a strong feeling that I should not go ahead with this procedure, but somehow my faith in doctors was still stronger than my faith in God and I went full steam ahead. Not surprisingly, Surgery Number 3 resulted in a very serious MRSE Staph infection. It took two months, four more surgeries, and many gallons of vancomycin to kill the bacteria in my arm. He had to take out my titanium implant but at least I still had my stiff arm and limp hand.

By December, we were confident that the MRSE was gone and the nerve graft was not going to work. I read two textbooks and everything on the Internet on tendon transfers and negotiated which tendons to move with Doctor Number 3. By now, I was a highly informed but quite paranoid patient. On December 9th, I lay in the pre-op center so terrified that I could not speak. The physician’s assistant and Doctor Number 3 could not quite remember which tendons we had agreed to move. I handed them my spreadsheet, pointed excitedly, and prayed. God had finally tested me enough and allowed this surgery to work. I spent another four months in physical therapy and wound up with a 70% elbow and a 60% hand, which works pretty well considering that 10 of the 40 muscles in my arm will never work again.

I had drilled enough things in my life to fully comprehend how bone drills could slip and destroy nerves. Similarly, I had fought enough battles with mold in buildings to understand how difficult it is to control bacteria. Yet what completely astounded me was the medical community’s reaction when things go wrong. Taking responsibility is out of the question. The best they could muster was to weakly blame the fixator manufacturer and hospital staff while sending me truly outrageous bills. It appears that this profession, which was founded on love, has been totally consumed by fear and greed. In response, I started writing letters, giving speeches, and supporting legislation to try to remind physicians how to love their patients when things go wrong.

Kerry O’Connell   9/6/06

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About Kerry O'Connell

Kerry O'Connell is a civil construction project manager and a member of the Colorado Health Facility Acquired Infections Advisory Committee. A committed patient safety advocate, he calls for restoring empathy and compassion in health care. He became a Numerator in 2005.
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