In my line of work there’s a litany of mundane duties. Though routine to us in the field, most would find them bizarre. One such day started innocuously enough with a routine ‘morgue check’: which involves verifying all the cadavers we should have in stock in the morgue are in the morgue and not absconded to become a brick in some mad man’s mile-high corpse pyramid or put to work as a cheap farmer’s smelly scarecrow. This day, however, I was quite surprised to open the morgue door and see a blood and…something… stained portion of a couch. This desecrated sofa was accompanied by a pair of amputated legs and the decedent owner of it all. As this is a hospital and not a CSI laboratory, this raised many questions. Questions which proved to be a strange, sad story of the couch this patient belonged to.
Now most medical findings are a mix of facts and speculation, but one definitive element that came into play in this case was extreme morbid obesity. To surmise, our patient had literally merged with their couch due to extreme immobility, which caused bedsores to develop. Bedsores which would burst and as they healed caused flesh and fabric to became one. This is far from the first occasion of unintended negligence leading to such horrific results. Similar stories have occurred before with the same outcome. In this particular case, the family or loved ones attempted to take care of the patient, at least in terms of feeding, until their health began to drastically diminish (slowed heart beat and/or labored breathing) and EMTs were finally notified. At that point, there was nothing that could be done, amputations and emergency skin removal could do little to combat years of unintended negligence. Such as what happened with this patient – a slow and painful passing.
“Tell me more about bedsores!” you ask? Alright! You got it buddy! Bedsores, AKA ‘ pressure ulcers’, are caused by staying in one position for a prolonged period of time causing a complete or partial obstruction to of bloodflow to the epidermis and muscle. Those that are typically afflicted suffer from paralysis or immobility, including the elderly, coma patients, or the frail and immobile. These sores have four stages: (1) a reddish painful mark, (2) a wound resembling a cut or lesion, (3) a large crater like opening, and (4) a deep abscess where layers of bone and muscle become visible. Nurses and health practitioners are trained to move bedridden patients to prevent too much accumulated pressure on any one point of the body, lest they become some Cronenberg-ian furniture-person.
Fun fact! Stage 4 pressure ulcers have had a history of being treated with ‘maggot debridement therapy.’ Disinfected (sterilized and germ-free) maggots are placed into the open wound and feast on the necrotic and damaged tissue while secreting natural anti-bacterial molecules. Non-healing necrotic skin provides the perfect warm and wet wounds for this type of therapy. The hungry lil’ critters can clean out a rotting wound in as little as 2-3 days, provided they are properly localized and contained with special dressings to prevent migration. This practice fell out of favor with many doctors – perhaps for being a bit too maggoty? Although it seems incredibly antiquated, maggots are actually available by prescription and considered a ‘medical device’ by the FDA. This, of course, was approved a very long time ago. Possibly while listening to Usher’s hit single “Yeah!” since medical maggots were re-approved in 2004 following decades of approving studies.