Surgery with an “Appy Ending.

A narrow beam of light lights the play’s final scene. Clarence Darrow’s character Henry Drummond grabs a copy of The Origin of the Species, Darwin, and the Holy Bible with one hand. He hefts each book in his hands, arms extended, and briefly compares them. Then, he slaps the books together and drops them side-by-side in his briefcase. This is a great theatrical moment. But what does it mean?

The Appendix: Why?

While I have great respect for the Bible and do not intend to be blasphemous but there is no comparison, in my opinion. If man was created in God’s exact image, many things must be explained. Why is the appendix there? My strong opinions on creationism and evolution by natural selection are based on my experience as a physician who spends a lot of time anesthetizing patients for appendectomies.

Appendicitis: History

Claudius Aymand (a French surgeon) performed the first appendectomy in 1736 on an eleven-year-old patient. He had an appendix that was perforated by a swallowed straight pin. An attack of appendicitis caused Sergeant Charles Floyd to become the last person to die during the entire Lewis and Clark Expedition in 1804. There was no reliable intra-abdominal surgical procedure at that time. Also, there wasn’t any surgical anesthesia available. Appendicitis was only possible after the introduction of general anesthesia in the late 19th century.

My wife and I both had appendicitis that was followed by emergency surgery. Dana, our only and youngest daughter, had hers in her first trimester during her third and final pregnancy. At the tender age of four, she had appendicitis.

The Three “D’s”

These three “D’s, ” as with many doctors’ families, are crucial in identifying domestic medical issues that might arise. The first is to “downplay” the complaint. Are you sure that you are sick? Because a lot is. And you don’t look that sick to me …”. This is a common phrase in my house and other doctor houses. I am certain my family is sick of hearing it.

The second letter, “D,” stands for denial. Although Dana’s symptoms were briefly considered appendicitis for a second, I was more concerned about an ectopic pregnancy 6 because that was possible given Dana’s gestational age (ten weeks), which is a typical time for such a problem.

The final and third “D” stands for “Dummy”, which I used to be when Dana was diagnosed with an appendix that had nearly burst several hours later. I was too busy working on my patients and long gone to the hospital.

Hindsight

Instead of trusting my medical instincts and instead relying too heavily on my personality, which always looks at the positive side of things, my wife, who was pregnant, became ill, and I left her at home with my two young boys. This was not my proudest moment as a father and husband.

We are blessed to have Gina, a wonderful friend. We call her Saint Gina. She is a nurse, a super-mom and as practical as they come. Dana called Gina shortly after I left work to take care of our boys. She was too sick to stand and needed help. Gina looked at Dana as soon as she arrived and said, “You’re going straight to the hospital!”

Kate

We decided to go to the local theatre to see Harry Potter and the Chamber of Secrets when she was just four years old. She was feeling unwell most of the day and becoming irritable. Kate was irritable because she smiled less often than usual. I suggested a movie to cheer her up.

While she watched the movie about young wizards, witches, and “spellbound”, I remember her noticing something odd. Her hand felt warm to my touch, and she moved around in her chair as if trying to find a more comfortable place. She also seemed to stiffen and grimace a few times when she moved. What caught my attention was her refusal to accept a popcorn and candy offer. She was unusually quiet as she walked up the aisle towards the movie’s end. When we arrived home, I could see that she was feeling sick.

The ER

It was late at night, and the emergency room at the local hospital was empty. Crickets. We sat on the hard plastic chairs, under the bright fluorescent lights, for what seemed like an eternity.

The Surgery

A quick urine test proved negative for infection, and a blood sample revealed a high level of white blood cells. The diagnosis was confirmed by ultrasound. Kate was a strong trooper, enduring the straight urethral catheter and a needle poke to collect blood samples without a single complaint. Our local hospital did not have dedicated pediatric anesthesiologists or pediatric surgeons.

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