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This Experience "Sticks" With Me
Paul S. Koch, M.D.

Ouch!" I remember thinking as the needle punctured my right forearm. At the time, I was an intern in a large city emergency room running a code on a dialysis patient who came in with total body failure. When we successfully stabilized her, I recall in amazement because I have long ago forgotten those skills, I went to my attending to get a gamma globulin shot to ward off hepatitis. "Not so fast," he told me. "We don't give those out willy-nilly. Let's see if she has hepatitis first."

So we checked her chart, found a recent negative serum test, and I was sent off, untreated. I remained worried because even though my case was "academically correct," I knew hepatitis could lie dormant for several months before becoming manifest.

Two months later, while admitting a patient, I fell asleep in the chair while conducting the interview. Joe Ciabbatoni, my senior resident and angel, found me an hour later and sent me off to bed thinking I had exhaustion. He did all of my work as well as his own for 2 additional days while I slept at home. When I woke up I had white poop and yellow skin and knew that I had serum hepatitis. My liver enzymes climbed from very high to dangerous levels and then to terrifying. My doctors became afraid that my liver was not going to recover and that I would become their first needle-stick fatality.

Fortunately, while in college I had subjected my liver to a rigorous program of insult and recovery by dosing it regularly with Ripple when I was flush and Thunderbird (89 cents a quart) when I was tapped out. My liver lads did not let me down. They eventually crawled to their feet, shook off the cobwebs and pumped out the toxins. I lost 5 months in recovery and graduated from internship with 7 months served, which, considering my modest aptitude for internal medicine, was probably a good thing.

Fortunately, We're Better Off Today

Since my unfortunate accident, needle technology, sharps disposal, and post-puncture protocols have improved immeasurably. Needle sticks are much less common, and when they occur they are treated more aggressively than mine was. Still, because of the deadly and transmittable viruses that are so common today, we need occasional reminders of what a simple accident or a dumb mistake might do. It's OK to share my "confidential" adventure with your staff members. I keep a HIPAA waiver on file.