Central PA Medicine Summer2020 - 30

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Afghans and Elephants

By WILLIAM W. DEMUTH, MD, FACS

ast winter I was lying on our sofa. It was a cold evening,
so I wrapped my legs in an afghan. Looking down from
the mantel was a pair of brass elephants. The afghan and
the elephants were gifts from patients. Both have unique
stories.The afghan first.

As an intern, I had just come off of a very stressful rotation,
every other night on call, etc. Often on morning rounds I would
be greeted with, "Why did you do that?" "What were you thinking?" or "Who taught you to sew like that, Victor Frankenstein?"
Self-esteem was at a low point. My next rotation was on the Plastic
Surgery service. One morning in clinic I was sent into a room to
evaluate a mole on a woman's neck. "Take it off with good margins
and send it to pathology. It's probably a basal cell." Indeed, the
path report came back, "Basal cell carcinoma, margins clean." The
elderly woman came back for suture removal the following week.
She was holding a bulky package, handing it to me as I entered
the room. "Thank you," she said. "I was really worried about that
mole. They told me it was cancer." I was dumbfounded. In my
mind I had done virtually nothing, a simple basal cell excision. In
the patient's mind, she was now cured of cancer. I think about her
every time I see that afghan.
The elephants also have a unique story. Both have upturned
trunks, a sign of good luck. A medical colleague asked if I could
see her father. He was visiting from India. I don't remember the
exact problem, probably an arthritic knee. The treatment was a
cortisone shot. He thanked me and left. Several months later I
30 Summer 2020 Central PA Medicine

was summoned to the waiting room. There was the patient with
a cardboard box containing the two brass elephants. Again, I was
speechless. In my mind I had done next to nothing. In his mind,
he was cured of chronic pain.
I pass these stories along not in any way to suggest that I possess
unique skills. Indeed, I was just doing what I was trained to do.
In my career, medicine has evolved into a bloated, dysfunctional
bureaucracy. Each day we are confronted with EMR issues, feuding
health systems, insurance preauthorizations, and treatment denials.
We come to work on Monday only to find out that our passwords
no longer work. The health care i.e. health insurance issue has not
been solved by either political party. Instead of spending face to
face time with our patients, we stare at computer screens. Our
patients spend their time looking at our backs. It is so easy to
become cynical and forget why we all went into this field, to relieve
human suffering. Our patients can be so appreciative of what we
do for them. What other field can offer that?
I would be remiss if I didn't mention some of the other items
given to me over the years. This partial list includes fishing lures,
deer bologna, a turkey call, religious incense, several first edition
framed prints, cigars, white liquor in a mason jar, many bottles of
wine, a wooden statue from Zimbabwe, a monogramed anthracite
desktop pen set from Frackville, a keychain made by a girl born
without arms, and most recently, another afghan. All were received
with gratitude. I've kept each and every one of them.

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Central PA Medicine Summer2020

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