Translate

The Oscar's stories # 4: The Thoracentesis


"Doctor Corsi, said Aunt Lea, this child has been really ill for days with a high fever of about 38 and sometimes even more. He has difficulty breathing, cough. Add that there is less than a month to go to the admission exam. to medium school... My mother and I don't know what to do. My father and my brother, Lalli's father, are prisoners who knows where ... The bombings on Florence continue ... And then there are the artillery duels between one bank of the Arno and the other ... Doctor tell us ... what we have to do! " 

Doctor Corsi was all effeminate. Everyone who saw him was convinced that they were dealing with a homosexual. Instead, this highly experienced pulmonologist, very renowned thanks to the word of mouth of former patients, was not only married but also the father of four children. 

He bent over the boy who had been in bed for days and invited him to sit down, helped by his aunt Lea. 

Stethoscope, lateral percussion to the chest, "Come on Lalli, tell me 33 ...!" 

"Dear Mrs. Lea, this child has got a nice exudative pleurisy with liquid that is reducing the already reduced lung capacity ..." 

"My Madonna, exclaimed Lea, and now what shall we do, doctor?" 

Doctor Corsi had come with his black bag, with a worn handle because he carried it with him in all his wanderings around visiting sick people. "It is not an easy thing, Mrs. Lea, but I think it is more appropriate than ever, considering the conditions of Lalli and also the next exam commitment, to practice a thoracentesis ..." 

"And what would this thoracentesis be, doctor?"

 

Dr. Corsi sighed deeply because he knew well in his long experience as a doctor that the greatest difficulty for a serious professional is precisely that of informing the relatives of the patient who generally want to impose their diagnosis and also the prognosis (so to speak). 

"Thoracentesis means inserting a needle between one rib and the other, piercing the pleura and extracting the fluid that has formed ..." 

 Aunt Lea turned her worried gaze to her grandmother Emma who was watching, petrified, sitting in a corner of the dining room. 

"If there is nothing else to do doctor, we are in his hands ..." 

"Well, let's proceed then. I hope I have everything I need with me. The boy has to be seated on the dining room table which seems sturdy to me. You Mrs. Lea has to take him by the shoulders and he has to lean slightly towards her. It is very important that during the procedure Lalli is absolutely immobile, otherwise there could be serious problems ... " 

The dining room, like all the windows of the apartment located on a mezzanine in Borgo Pinti number 31, overlooked the garden courtyard of the Geddes da Filicaia counts. 

And it was a great advantage because at least there was no contact with the reality of the road made of rubble, clogged sewers, the smell of dead animals but also of some civilians forgotten in the ravines of a stricken building. 

The large window - door was open, glass glued with paper to prevent them from being shattered by the crashes of bombs dropped by American planes. 

Lalli was taken in his arms by Doctor Corsi who did not make too much effort because that young man was reduced to skin and bones due to dysentery and the lung disease that had besieged him for a few weeks. 

His shirt and pajama jacket were removed. Doctor Corsi began to brush the boy's back with iodine. 

Not even to do it on purpose began to howl the anti-aircraft alarm sirens that required citizens to leave the house by slipping into the nearest shelter. 

"These children of bitches, Dr. Corsi rattled between his teeth, have found the right moment ... Madam Lea, if you want to go down to the shelter tell me right away ... 

In my opinion we should go ahead with the thoracentesis ..."

"There is nothing else to do, doctor" said Lea who was holding the shoulders of Lalli with energy, who had, in any case, placed her face against his cheek. 

Doctor Corsi had started a technical monologue to remember and go through step by step the procedure that he knew well but that at that juncture had to be changed. Better to say: simplified. 

“I was left with virtually no local anesthetic 1% lidocaine, these are the 25-gauge and 20 to 22-gauge needles and 10 mL syringe. The skin is that of a child and therefore, despite the long stay in bed, they have always kept it clean and there should be no problems with infection. 

Lady Lea, make Lalli maintain the position with the torso slightly bent forward and the arms supported and she will hold him firmly. 

Lalli show me that you are a real man and that you can bear a little pain that you will now feel in the right side of your body. " 

"Doctor what are you doing to me? - Lalli said in a faint voice, clinging to his aunt- I'm afraid, I'm afraid, doctor .." He couldn't cry because he was too weak. 

"Lalli, I know that you are strong, even if you are sick now. Trust me, we are at war, you are a soldier like your grandfather and your father .. Let me keep reminding what I learned in college ... see how important it is to study ... 

So: the intercostal neurovascular bundle is located along the lower edge of each rib. Therefore, the needle must be positioned over the upper edge of the rib to avoid damage to the neurovascular bundle. 

Yes, I know well, it seems strange to you Mrs. Lea, but it is better to repeat… before proceeding I must confirm the extent of the pleural effusion through percussion.

Now I select a point of insertion of the lake in the middle scapular line on the upper edge of the coast, an intercostal space under the top of the effusion ... 

 I introduce the needle and continue to make it penetrate piercing the pleura (Lalli was screaming in pain) and until the liquid is sucked in and I have to pay attention to the depth at which this happens in this little body ... " 

A roar reverberated in the room. "Certainly - said Dr. Corsi - they are bombing at Porta Romana, all the railway connections ... Poor ones that are left over there ... 

Here's Mrs. Lea: I took the liquid from the pleura, here in this syringe ... As soon as you can, come to my office where I have a latest generation X-ray unit to see what the exact situation of Lalli's lungs is ...

For any need, call me lady, provided that the lines are not lost .... Look, you don't insist on wanting to pay me, so much so that I can do it with the money now ...? All right, she insists ... We postpone everything to in a few months. Let me clean my hands and then say hello. Lalli I recommend now you are breathing better and you will see that the fever will drop too, see you in a few days if God wills…!" 

Doctor Corsi in his office subjected the boy to several X-ray examinations with his equipment that he had bought at a high price from the Germans before the outbreak of the Second World War. 

 

After a few years this pneumatologist went to the other world for the injuries caused by the X-rays of his extremely safe device.

No comments:

Post a Comment