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More than skin deep

A few weeks ago I tripped and fell on the sidewalk.  I went down on hands and knees and scraped my left knee pretty badly.  The onlookers pretended not to notice, I suppose sparing me the embarrassment of asking if I was ok.  I dusted myself off and bled down my leg en route to work.

Since then I kept the wound moist with neosporin and band aids, allowing the skin to heal with minimal scarring.  But as I marveled at how painful this little patch of road burn is, I remembered a young girl I met about a decade ago who had a much more serious burn.

Inga was camping with her parents in a synthetic tent.  They had spent the day fishing and canoing near a campground somewhere in Eastern Europe.  They were huddled together inside the tent in the cool of the evening, speaking animatedly about the day’s events and the beauty of nature when Inga accidentally knocked over the kerosene lamp situated near the exit flap.  The kerosene spilled out onto the tent and the fire ignited immediately.  The tent began to melt in the fire and the zipper got stuck in the hot plastic material.  The unimaginable screams of her dying parents as they burned alive, trapped in this tent, brought help just in time to save Inga’s life.

But Inga was horribly disfigured by the fire.  She spent nearly a year in the hospital, receiving skin grafts and fighting off infections.  She was eventually able to return to school, but was treated like an outcast.  Her former friends were too horrified by her appearance to welcome her back and she spent most of her days sitting alone in the corner, covering her face with a scarf, blaming herself for the death of her own parents.

Her story reached the compassionate ears of a plastic surgeon friend of mine.  He traveled to Eastern Europe to meet Inga and see if he could help her.  As it turns out, she had no living relatives and was dirt poor.  He could see that the medical team taking care of her had carefully covered the defects in her skin, but had not attempted to restore a normal appearance with modern plastic surgery techniques.

The surgeon knew that it would take many surgeries over many years to give her the best result possible.  After some debate and soul searching, he decided to sponsor Inga to come to America where he committed to taking care of her financial needs and to giving her a new life.

I first met Inga after she had been in the states for several years.  She looked like a burn victim, with tight facial skin and abnormal contours – but compared to how she appeared in the photos of when she first arrived (with no nose or cheek flesh at all) this was a huge improvement.  She was meeting with the surgeon to have a seroma evacuated from under her left cheek.  He had to remove the extra fluid with a large syringe.

As I watched him numb the area and sink a deep, large bore needle into this young girl’s face, I cringed internally but tried to appear unphased for her sake.  She didn’t flinch, but sat staring forward bravely, her grey eyes fixed on the wall in front of her.  I saw a tear well up and trickle down her disfigured cheek during the procedure and I instinctively reached for her hand.  The tears continued in silence.  This burn had penetrated so much deeper than the skin.

I haven’t seen Inga since, though I’ve heard that she’s doing well in school, has made some good friends, and is planning to become a nurse one day.  Her decision to devote her life to caring for others is a beautiful example of “paying it forward.”This post originally appeared on Dr. Val’s blog at

Smelling the flowers

There are cherry trees just outside my patio and 2 days ago
they decided to drop the majority of their pink petals on the ground.  It created a luxurious, 2 inch deep floral
carpet that surrounded my home.  It was so
beautiful and soft in appearance that I couldn’t resist scooping up fist fulls
of the flower bits and holding them out to my husband.  It was a sunny blue day and I giggled as I
asked him to join me in my child like glee.

“I’m not touching them,” he said, “It will make my nose

“Aw, come on honey,” I cajoled him, “these petals won’t be
here like this again for another year!
Touch them, they’re so soft!”

He glanced at me sideways.
“No, I don’t want to touch them.
They’re dirty.”

I was crest fallen at first, but then I started thinking
about how something so beautiful to one person, can look entirely different to
someone with allergies.  What a sad thing
to have taken away – the ability to truly stop and smell the flowers.  I count my blessings that I have no allergies
to anything.This post originally appeared on Dr. Val’s blog at

Thin workers woo investors?

I had an eye-opening conversation with Dr. Jim Hill
today.  He told me that Denver’s
Metro Mayors (Denver’s
metropolitan area is actually composed of 37 cities and towns!) are competing
with one another to see who can get their inhabitants the most fit and thin.

Why would they be so aggressive about fitness and good
health?  Because they say that large
corporations considering investing in Denver
(where they’d build factories or large office buildings) know that setting up
shop in areas where the population has a lower BMI means that health insurance
costs will be lower.

That’s right my friends.
Being thin can lure investors!  It
makes sense that a corporation seeking to avoid the skyrocketing costs of health
care would want to create facilities where new employees are likely to have
fewer medical issues.  And BMI is a good
surrogate marker for health… so there you have it.

Do you see this approach to wooing investors as a form of discrimination
or just good business sense?

Either way, I’m going to get on the treadmill later.

This post originally appeared on Dr. Val’s blog at

A little medical humor

I got a good laugh from a few sarcastic posts lately.  This first one (via Graham) is about the
medicalization of modern life (where every symptom must have a diagnosis):

Consumer: I get
very moody if I don’t eat in the morning. If I don’t eat until 3-4pm I get
headaches, drowsiness and feel nauseous… I think I’ve always had this. Since
I usually eat enough it doesn’t really bother me. I’m 21, male, and a
vegetarian. What do I have?

Physician: You have a condition
known as hunger.

The good news: it is easily treatable

The bad news: there is no permanent cure

This condition can be treated at a specialized clinic, the one you want is
known as a restaurant. This condition can also be treated at home, but you will
need specialized supplies from a grocery store. Most sufferers find that
several treatments per day are necessary.


And this conversation was pretty funny (though I can’t for
the life of me find where I read it – sorry I would certainly love to give
attribution here):

Physician: we’re
going to need to get an MRI of your teenager’s head since he had a seizure.

Mom: why are you
going to get an MRI of his head, it was his body that had the seizure!

Have you heard any good jokes lately?

This post originally appeared on Dr. Val’s blog at

The great unveiling

A psychiatric nurse once relayed an observation to me that I
have been pondering for the last decade.
We were working together in an inner city “dementia unit,” populated
with patients with end stage Alzheimer’s, vascular dementias, and brain
disorders of unclear etiology.
Individuals were parked in geri-chairs in institutional hallways, others
were in bed in 4 point restraints for their own protection, still others were
muttering to themselves in wheelchairs.

We were discussing the case of a particularly unpleasant
– he would swing at people as they got near him, trying to hurt them –
scratching, punching, even biting if you got close enough.  His favorite thing was to grab nurses’, or
other female staff’s, breasts or crotches.  He rarely succeeded at this, since most staff
were aware of his tactics, though he sat in his chair nearly motionless, like a
Moray eel in a reef cave, small eyes and snaggle teeth, mouth open slightly at
all times, taking slow deliberate breaths as he waited for an unsuspecting ocean
dweller to wander inadvertently into his reach.

I asked the nurse how she thought he had gotten to be so
rotten.  She replied simply, “When people
get older they become more like themselves.”

That one sentence has fascinated me ever since.  Could it be that as we age (and our minds
lose their ability to maintain the social graces we were taught), we slip into saying
things in an uncensored manner, and behaving the way we truly want to?  Or is the difference between “sweet little
old ladies
” and “mean old biddies” a matter of how much damage there has been
to their frontal lobes?

The scientist in me would like to explain away all agitation
as an organic brain disorder.  But I just
don’t think we can reduce human behavior to neuroanatomy.  The complexity of a lifetime of circumstances
and individual choices – and their interaction with personality – are soul-defining.

Perhaps age brings wisdom and life experience… or maybe it
unveils the truth about who we’ve been all along.  Either way I have a feeling that when the time
draws near for our bodies to give up our souls, we can catch a glimpse of what people
are “made of” in their final words and deeds.This post originally appeared on Dr. Val’s blog at

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