Speed Kills

I worked and lived at the Multnomah County Medical Examiner’s office from 1976-1980. Those are the four years I attended dental school at The Oregon Health and Sciences University. It wasn’t easy toe tagging a body at 2 AM and then taking a neuroanatomy test six hours later. With my job experience you would have thought I would have done well in gross anatomy, but I passed with a 2.0. Of course, this was before grade inflation and a 2.0 was the class average.

I will never forget my first night on the job. The bell to the morgue rang about 1AM on a Saturday morning and I went down to check the body in. What I saw is etched in my mind. A motorcycle rider had hit a telephone pole head on at about 80 mph smashing his helmet through his head. Right then I knew I was not going to be riding motorcycles and I wasn’t going to speed. Speed Kills.

On Friday September 11, 2020 I went to the hospital to have my foot repaired. Over 40 years earlier I had blown out my left lateral peroneal tendons when I was tripped running to first base in a city league softball game in. I underwent surgery but my ankle had deteriorated over time. My general experience with surgeries are only do them if they are absolutely necessary. A general rule is if God made it then it will work better than if man made it. My appointment was scheduled for 1 PM and it was a three-hour surgery. At about 4 PM they finally came to get me. I told the doctor we should probably reschedule as being three hours late on a Friday would not be good. He insisted that he would not rush the surgery and that everything would be fine. went away immediately. Unfortunately, about a third of my foot is numb. It will take 6-24 months to see how much the nerve recovers.

How could the first surgeon not have seen the nerve and just botch the surgery? I think I know. He is supposed to be the best foot and ankle surgeon in Utah. I am sure he is normally really good. But when you are three hours behind schedule on a Friday afternoon, you tend to rush things. The nurses want to go home, the anesthesiologist wants to go home. The surgeon wants to go home. The hospital wants the surgical room. There is lots of pressure to get it done fast. He did my three-hour surgery in two hours. Everything turned into a nightmare.

I know that dentistry has a lot of stress. Maybe the biggest stress factor is keeping on schedule. Unless you have a practice that only sees one or two patients a day you are going to get behind. I hate being behind. Even for twenty minutes. But I must control myself and never lose sight of doing things right. Don’t short cut and don’t rush. It is a lot easier to reschedule a patient than it is to repair a damaged lingual nerve or a broken jaw. It is easy to perforate a root or overfill a canal. In your hurry to catch up you might look at an impression with a bubble on the margin and just let it go. Don’t do it! Dentistry takes a certain type of personality to survive and thrive. Never sweat. Never loose your cool. Stop and take a break if you need it. Hire good people around you. People who know how to stay calm. Just remember, Speed Kills—especially if you are on a motorcycle going 80 miles an hour at 1 AM in a rainstorm. That is how I feel when a pedo patient is screaming and I am an hour behind, but just put your mask on and slow down.

When I woke up at about 6 PM I had never been in such pain. My foot was on fire. For the next eight months the pain was unbearable. On a scale of 1-10, I gave it an 8 (intense, limited physical activity, even making conversation difficult). After visiting five more surgeons, two pain clinics, two chiropractors and five physical therapists, I was no better. I had tried almost every medicine I could find, but oxycontin was not a long-term option and gabapentin put me in a suicidal brain fog. After hours, days and months of searching for relief (pain will do that to you), I found a neurosurgeon who said he could help. No one else in the state could do peripheral nerve repairs. Unfortunately, he was booked out for 5 or 6 months, yet with some persuading, I was able to get an appointment in a few weeks. Dr. Mahan performed the surgery on May 26, 2021. What he found was the deep peroneal nerve had been completely obliterated by the foot surgeon. It looked like a chopped-up piece of cooked spaghetti. The deep peroneal nerve is the largest nerve to the foot, so it is fairly easy to locate and see. Dr. Mahan had to repair the nerve using a graft and suturing it with 9-0 suture. The pain Dr Drew Jones