First published in the Hektoen International Medical Journal. Hektoen International Journal is published by the Hektoen Institute of Medicine.
To view the story online visit the Article Here.
I saw two bright colored Polaroids: One pictured Rudolph, a burly coal miner with a white bandage about his left ankle. The second was a close-up showing a four-inch long festering ulcer overlying his Achilles tendon. Its crater floor appeared necrotic, slimy, and green. The margins looked chronically inflamed and rolled inwards. The lower edge was thicker and suspicious of an early squamous cell cancer—a classic Marjolin’s ulcer. As an oncology surgeon, I had only seen a similar photo in a textbook. I was certain of the diagnosis, although I had never treated one.
Tom and Dorothea, my next-door neighbors, casually showed me the photos during a gathering of distraught parents with teenagers approaching driving age. They congregated at our home on a gray Saturday afternoon, November 25, 1990, to petition our town of Manlius, a Syracuse community, for a traffic light at the top of our street. Another sixteen year old had died in a crash at its intersection on Thanksgiving.
“Is this something you could operate on?” asked Tom.
“Yes,” I said with assuredly, as if answering an academic question. “Where did you get the photos? And who is the person?”
Tom and Dorothea had visited Poland the previous summer, accompanied by Rudolph’s nephew, Jan, one of Tom’s students at Utica College in Upstate New York. Their visit coincided with the tumultuous sociopolitical upheaval. The anti-communist Solidarity movement, the Soviet-bloc’s first independent trade union, ended communist rule and saw its co-founder, labor activist Lech Walesa, form the nascent Solidarity government. Accompanied by Jan, the American couple traveled to Jaworzno, an industrial city of about 90,000, south of Warsaw in the Silesian Highlands where they met Rudolph. Jan had asked them if his uncle could be cured in America.
Tom continued, “One morning in 1965, Rudolph was riding his old motor cycle to the mine. Bumping over railroad tracks it overturned, pinning his left leg beneath him. The battery’s acid spilled onto his ankle, burning his skin, eating it away and creating a painful ulcer.” During the first few years his frequent wading in polluted water during his twelve-hour mining shifts constantly irritated it, preventing the wound from healing. When his political activity as a Solidarity union leader elevated him to a desk job at the mine, he had access to the best medical care Poland could offer—the ulcer still did not heal. Why had all the salves, creams, and medical attention not healed it? The situation could be more complicated than I understood.
“Would you be willing to operate on Rudolph if we brought him to Syracuse?”