Things they let me do but probably shouldn't....

I’ve been very happy with variety of medical procedures I’ve gotten to perform at the prison. I haven’t done any pap smears (despite the fact that two of the inmates I’ve seen identify as female… one goes so far as to asked to be called “Glorious” instead of “John”) but I have been able to do some pretty fun things.

My most frequently occurring procedure is a toenail removal. For some reason, inmates have chronic problems with foot fungus and I have been designated as the person who gets to mess around with the red, swollen, infected big toes. It’s really a gruesome procedure. First, I clean the toe then stick a needle into both sides of the big toe at the base area and inject the anesthetic. That’s probably the most painful part for the patient because it burns and the web spaces in between your toes and fingers are pretty tender. But then comes the most painful part for me: I take specially designed scissors and insert them down the middle of the toe (one scissor blade in between the toenail and the nailbed) all the way past the cuticle. I apply pressure and the toe nail is clipped into two halves, right down the middle. At this point blood starts welling up and I can’t see anything more of the toenail so I blindly start digging around under the nail with a metal spatula device to loosen the nail from the nailbed even more. Thankfully they don’t feel this but I just keep thinking to myself “in many countries this is used as a torturing technique” and this causes me to make really grossed out faces as blood is running down the toe and I’m going to town with this spatula. Finally, with the nail free and clear (or as good as it’s going to get considering I can’t see much of what I’m doing through the blood and hey, they can’t feel it anyways!) I grab some plier-type device, clamp the nail, and yank. THANKFULLY my Dr. stopped me prior to the yanking and told me to use my other hand to cover the toe with some gauze so blood doesn’t spray across the ceiling & me—you don’t get style points for red racing stripes I guess. After the yank, a much bigger than expected nail comes out and wa-la! the wedge resection of a toenail is complete.



Other super fun procedures so far include: shoulder and knee steroid injections, knee joint aspirations, blood draws, sutures, assisted with casting, arm and wrist splints, lots of prostate exams, and liquid nitrogen treatment for warts (just feet and fingers so far… my timing has been such that I’m busy whenever the genital warts need to be frozen off…) All in all I feel that I’ve gotten do to a ton of procedures at this site. I’ve also seen a lot of interesting pathology like hepatitis, TB, multiple myoloma, sarcoidosis, MS, testicular cancer, hypertensive crisis, rhabdomyolysis, metal foreign body in an eye, blowout orbital fracture and lots of other acute and chronic conditions. This has been a truly amazing rotation and I’m sad to only have 1 week left.