quarta-feira, 26 de dezembro de 2007


Alfred Velpeau was a French surgeon that lived from 1795 to 1867. He was a professor of Surgery in Paris and many scientific papers of his have been published.
The Velpeau immobilization for shoulder lesions is quite well known.
It is also ascribed to him the observation of a phenomenon called 'Velpeau's Law', when strange or rare facts occur repeatedly in a short period of time.
I have had the opportunity of testing this law during my years as a doctor, but one occasion always comes to mind, that I intend to relate below.
I have never slept easily at the hospital, when I am on night shift, with fear of not waking up properly. Having to deal with emergencies and determining medical procedures are attitudes of responsibility and one has to be wide awake not to commit mistakes. So I have always tried to sleep with an eye half-open.
In the wee hours of a certain morning, a young subordinate of mine came to my dormitory to tell me that a man had been admitted to the Emergency Room, bitten by a lion.
I was certain that my colleague was teasing me, so I turned over and tried to sleep again, but I was interrupted by him urging me to go and see the newly arrived patient.
I got up and went over to the Emergency Room. A thirty-year-old man was lying unconscious on the examining table, with a severe gash of the upper arm. Briefly explained, his forearm and hand were hanging by threads from his upper arm, of which there was only the bone (the humerus); skin, muscles, arteries, veins and nerves were all gone. Obviously, he was a candidate for an amputation, for there was no question as to the possibility of saving that limb.
"What is this smell?" I inquired of the nurse, for an unpleasant stench pervaded the room, a mixture of wet towels and rotten meat. I wouldn't know how to describe it any other way.
"Doctor, it's the lion."
"How so?"
"As far as we can tell," said my colleague, "this man was cleaning out the lion's den and the animal escaped and attacked him."
The nurse pointed to the blood-stained sheet upon which the patient was prostrated.
"Look there at the lion's fur." she said.
The sheet and his clothing were covered with hundreds of yellowish-white hairs, each about half an inch long. I was obliged to accept the fact that a feline had had a mouthful of the patient.
He was operated on, the limb removed at the shoulder joint.
About two weeks later, I was awoken during the night to see another patient bitten by a lion. This time, as soon as I received the news, I ran as fast as I could to the Emergency Room, all the while remembering Velpeau and his well known observation.
I was certain of the diagnosis as soon as I entered the room, for the stench was quite the same as in my previous experience.
He had been brought over by a police car from a close-by circus. He was so drunk that his breath at times rivaled the lion's stench.
The lion had helped himself of a large chunk of the patient's forearm, with no hope of recovery for that part of the right limb and had bitten his other arm as well.
I took the patient to the Operating Theater and amputated him just below the elbow. Our plastic surgeon operated on the other side. Skin grafts were sufficient to save the left limb.
The following day I went to visit him. He was in a six-bed ward. I found him surrounded by patients from other beds and by nurses from that floor.
He was proudly showing off the stump with its dressing. A smile had brightened up his face with bloodshot eyes.
"I made a bet with a friend of mine" he was saying "that I would dare put my hand in the lion's cage to caress him."
He had already seen that lion in action at the circus and was quite sure that he was tame.
So he slipped his arm between the bars and the lion went at him. Even though the pain was intense, he put his left arm in the cage to release the other. The animal let go and thrust his teeth into that arm too. This time, the drunkard was faster and was able to set himself free.
"And what happened after that?" his audience wanted to know.
An idiotic expression appeared on his countenance.
"I can't remember anything else until this morning."
Poor devil!
I turned my back on him and went away, hoping never to have to confront myself with Velpeau's Law again...

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