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.
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In August 1978 we moved to Los Angeles. The van had barely left when Zan padded across our cul-de-sac, shirtless in knee-length shorts, concealing a bulging large mass he called “my benign sliding inguinal hernia.” At sixty-five, he was a tall, stocky man with a crop of wavy white hair.
In fragmented pieces, revealed casually and interspersed with daily political news, Zan gradually painted his life as a gentleman farmer in Orange County. In a moment of bravado he said, “I’ve had it for so many years and it hasn’t bothered me, it’ll probably be all right, Doc.” After a swig of his beer, he added, “If you’re willing to fix it I’ll let you do it someday. I don’t trust doctors, but you’re different.”
Eventually Zan made an appointment. His hernia reached his left knee. Elsa, my resident, had not seen anything like it—I had, in India. He lay back. I successfully reduced it.
“An operation will fix your problem.”
“It doesn’t show,” he argued. “Why fix it?”
“If you aren’t willing to fix it under controlled conditions, will you be willing when it’s strangulated and a life-threatening emergency?”
His operation was my first of the day. Backing my car out of our driveway, I failed to note signs of inactivity across the street, riveted by news that Iranian Revolutionary Guards had stormed our embassy and taken fifty-two hostages.
My usual surgical team, including my scrub nurse, and the operating room (OR) were ready. We hung around in our blues, expecting Zan at any moment. We continued to wait. I grew frustrated, believing Zan would turn up, then incensed at being let down.Still smarting, by 9:30 I called for my next case. My team disbanded and a different nursing team turned over the OR while Mr. Nazari was wheeled in. A new scrub technician what was unknown to me at the time kept irritating me by asking numerous questions about what instruments and sutures I was going to use. It was more efficient and safer to work with my familiar team.
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