March 17, 2013 by drandmrso
On Saturday, Dr. O came home from morning rounds at the hospital. As per usual I asked him how it went. He pressed his lips together and gave me a sidelong glance.
“I’m not sure you want to know what we did,” he said slowly. I sighed. I was sure he was right: if he suspects that I can’t handle it before launching into the story it’s definitely going to be a rough subject. On the other hand, I am of course always trying to improve in my role as doctor’s wife, so I decided to be brave.
“Tell me! I can handle it.” I braced myself against the kitchen counter, just in case.
“We had to order leeches for one of our patients,” he said. My face, I’m sure, expressed something between sheer horror and overwhelming nausea. But I persisted.
“Leeches. Like, living leeches?”
“Right, like the things in lakes.” Now, I grew up in Minnesota. I spent many a glorious summer day at a lake and I inevitably went home with some combination of sunburn, chiggers, and leeches. I was familiar with the critter itself; I was not familiar with the medical application–at least not in the context of post-industrial revolution medicine.
“You ordered leeches to put on the patient?”
“Yeah. They attach and then drink the blood and then fall off.” He was looking at me like he expected me to keel over. But I was genuinely intrigued at this point.
“Wait, wait. Walk me through the whole process here. So there’s an order for leeches that you can bring up in the computer?”
“And the pharmacy sees this order come through and they…what, go back to the leech tank and pull out a few?”
“I don’t know exactly how they store them,” he said, seemingly amazed that I hadn’t run away and hidden under the bed. “But they send them up and then we put them on the patient.”
“How do they send them up? Is it like a prescription bottle filled with water and a leech swimming in it?”
“No, it’s like if you bought them for bait. They come up in a little bowl of water. They’ll crawl away if you don’t apply them quickly.” At this I clenched my jaw and swallowed hard.
“They crawl away?” Dr. O merely laughed and nodded. “Ok…so you have a bowl of leeches by the patient and then what? Do you put them on or does the nurse put them on?”
“We do the first couple. Dr. M and I showed the nurse how to do it so she could do the next ones. You basically just pick it up and put it where you want it.”
By this point my mind was reeling with images of dimly lit, dungeon-esque hospital rooms with blood lettings happening on the hour and a good dose of murky potion administered regularly. Could something like leeches really still be in common use? “Back up a second here. Why did this patient need leeches?”
“Her flap wasn’t healing well,” he said carefully. I know that when he uses a vague term like ‘healing’ instead of a more thorough description, he’s probably protecting me from some horribly disgusting reality. He had already explained to me that a flap was a patch of tissue harvested from elsewhere on the patient’s body and grafted onto a wound site. Eew.
“I see. So the leeches help?”
“They do,” he said. “It’s either that or re-do the flap. I don’t know if I should tell you this next part or not.”
“Tell me. I’m all in at this point.”
“Sometimes we have to do a flap inside a patient’s mouth…” his voice trailed off. I ran away and hid under the bed.
Not really, but I soooo wanted to. I regained my composure after a momentary lapse.
“So how do you take the leeches off?” I asked, remembering the somewhat skeevy feeling of plucking a leech from my ankle and watching it waggle around in remorse for the delicious meal that had just been stolen from it.
“Well, they just sort of fall off when they’re full.”
“So the patient’s got a bunch of leeches just sucking away and falling into the bed at random?”
“No, we only do one at a time,” he said. He was on the verge of tears from laughing at my bold attempt in this line of questioning.
A horrible realization hit me. “What about the patients that have them in their mouths?”
He chuckled. “They suture the leech on so the patient can’t swallow it or anything.” Having had quite enough detail for one evening, I dropped the subject.
Fast forward to tonight.
We went to a tap house in town with K, B, and A to imbibe a drink or two in celebration of St. Patrick’s day. B and A are fellow residents of Dr. O’s, and K is a nurse. Needless to say, they all tolerate blood and guts situations far better than I do. Naturally, I brought up the leeches.
“Guys,” I said. “Dr. O was telling me about using leeches on one of the patients yesterday.” They all nod nonchalantly as though using leeches is a perfectly normal thing to do (and maybe it is–but still, eew!).
“Sometimes we use maggots, too,” K said. I couldn’t help but recoil. “To clean out wounds. They only eat the dead tissue,” she added. I pondered this for a moment.
“But how do you know you can trust them?” After a laugh, we resumed the main topic of conversation: leeches.
“They’re way bigger than I was expecting,” B said. Dr. O had conveniently not mentioned anything about the size of the blood-sucking buggers.
“How big are they?” I asked. B held up his thumb and forefinger several inches apart. I gasped. “Seriously?”
They all nodded. “And they’re an iridescent green color,” he added.
“Whaaaaat!” I turned to Dr. O. “How could you not have mentioned that they’re green?”
A chimed in. “Are they green? They look kind of black.”
“The bigger they get the more green they look,” B said. For my edification he further explained that the leeches start out really skinny and eventually gorge themselves on so much blood that they bloat up to an inch wide or more. And he added one more juicy detail: you can see them peristalsing (fancy word for swallowing) after they latch on. He did a lovely impersonation.
“How fast do they drink?” someone asked.
“You have to change them out every couple of hours,” was the reply. Dr. O said, “My patient’s gone through 22 already.” And my mind couldn’t help but make the final leap.
“So, after the leech has had its fill, and it’s fallen off the patient, what happens to it?” I asked.
“You put it in ethanol to euthanize it,” Dr. O said diplomatically.
“It probably goes in the trash,” said K. Soon after, the conversation moved on to cheerier topics. This time, I was glad to let the story end before I learned any more about this weird, squirmy subject.