Why today?

The hospital that I work/study at services a lot of indigent people and those without insurance. Many of them are uneducated, unemployed, drink a lot, smoke a lot, don't have great hygiene and in general don't take great care of their health. That means that we see a lot of things that are downright disgusting. Take for example two people I saw today. One of them had scraped up their knee and now had a bacterial infection. That's not great, right? But it's just an infection you say, what could be that disgusting about that? And you would be right, except for the fact that the lady is only 5 feet tall and weighs over 350lbs. This person's calves were so big that my hands would have only gone half way around it. The best/worse part though, was that she was embarrassed about not being able to shave her legs!! Seriously woman, that's the least of your worries. She needs to lose 225 lbs and she's worried about not shaving her legs.

Another guy that came in had something called "woody edema" or "crocodile skin" (see picture on right) and a necrotic lesion on his foot. Now when I say necrotic lesion many of you may not know what I mean. Essentially the blood backs up in the veins which causes the skin to not get enough oxygen and if this happens for a long time eventually the skin, fat, and muscle there will just die and decompose while still attached to someone's leg. This guy actually had maggots infecting his wound. Yup, that's revolting.

Both of these people made me ask the question, when is enough enough? Is this lady just waiting to pass 400 lbs before making serious changes in her life to lose weight? Was the guy just waiting for the necrotic lesion to get to his ankle before coming in to have it looked at? (incidentally he's going to have his foot amputated half-way up his foot). It just baffles the mind.

Moral of the story; Don't wait until it's disgusting, smells, and has maggots growing on it.