The Day I Found Maggots in My Patient’s Wound
The first day I met Howard, he kicked me out of his house. As a home health nurse, it wasn’t the first time.
I knocked for several minutes; I knew he was there.
I had called him prior to coming:
You don’t have to come here.
Your doctor would like me to come over today and check on you.
Grunt. Click.
—
He answered the door, pushing his wheelchair backward into the living room instead of turning it around, all the while commenting loudly about how he didn’t want me there.
You don’t need to be here. My doctor is a damned idiot, he shouldn’t have sent you.
At least I was inside and he was talking. Big win! I felt I’d made it into Howard’s inner circle and I’d be able to do my job. Instead, his litany of negativity and misery seemed endless. So I listened.
My useless kids live across the country. I never see them anymore.
They wouldn’t like you being here either. Especially if it costs money. I don’t have no money. They know that. That’s why I never hear from them.
You have Medicare, Howard. It’s paid for.
You should have seen the party they had for me at the power plant when I retired. I was there 40 years. Had to retire early because of this damn diabetes.
I’m sorry.
What do you know about it? What the hell are you doing here anyway?
Eventually, I spread out the disposable puppy pad— from the stash in my garage — on his living room floor as a clean place to set my bag so I could have easy access to my nursing equipment. His house wasn’t very clean but most weren’t.
After some convincing, Howard let me take his vital signs but refused to let me peek at his left ankle wound. Non-healing leg ulcers are common in brittle diabetics. This was his second wound in six months.
That leg is fine. I can’t even feel it. There’s no pain and no problem.
You can’t feel it?
If I could feel it, then I could walk on the damn thing.
If you let me look at your wound, you won’t have to find a ride to the doctor’s office this week. Save you some trouble.
That doctor doesn’t know shit anyway.
I took that as a yes and began undressing the wound.
It didn’t look too bad. No heavy drainage, only slight redness around the edges. As I looked closer at the holes forming caverns deep into his leg, I was thinking about the best way to clean and re-dress the area when a maggot popped out of the hole onto the surrounding skin wiggling frantically.
No way. That is not . . .
I looked up at Howard, hoping I hadn’t splattered the horror from my face onto him. But Howard had his head leaning on the palm of his right hand, his eyelids drifting downward. Oblivious.
I didn’t tell him . . . at first. I pulled out my phone and called the doctor. They told me to send him to the emergency department to be evaluated. That’s when I told Howard.
You’re full of shit. I’m not going anywhere. There’s nothing wrong with my leg. It’s fine. What’d you call the doctor for? You’re all full of shit. Every last one of you.
Howard, this is serious. You could lose your leg.
You’re full of shit. Get the hell out of my house. Now!
I left Howard alone in his house but called his son who lived in California. It felt like tattling, but I had no choice.
Maggot Problems
Howard is one of the reasons I love being a nurse. He’s also one of the reasons I love being a writer.
Life is full of maggot problems. The kind of messy issues that cannot be solved. The kind that lacks full resolution. They are often more complex than we can grasp and ill-defined on many levels. And the Howards of the world are the anchors that keep us centered in this truth.
It’s not that we can’t help Howard with his maggot problem, because we can. It’s just that the help is only better or worse. It’s not the type of solved that is a real solution.
Whatever fix we offer won’t make everything better. The best we can hope for is somewhat better and not worse. There’s always a trade-off. There are always adjustments. There is always a new messy issue rising from among the old messy problem.
The fact that there will always be maggot problems — without permanent solutions, lacking satisfying endings — is why I’m a nurse and why I’m a writer. We are a humanity of frailty and mortality and, at some point, we all face our own maggot problems.
My hope is to be of service as a nurse and writer to soften the unanticipated complications, to moderate what isn’t easily understood. And if I have to stick people with needles along the way, that’s the price I’ll have to pay.