Wednesday, May 09, 2007
Hair's the Deal
Among my duties as an intern, back in those dark days and nights, was to order (and, not rarely, to do) the pre-op shave on patients. "Nipples to knees" was the typical order for vascular surgery patients. (Might be a good name for my next book, or for a rock group.) In addition to shaving hyper-extensively, we also generally did it the night before surgery -- now shown to be a bad idea, because the inevitable nicks became little soup bowls for bugs. The closer to the time of an operation the shave is done, the lower the incidence of wound infection from skin organisms. In fact, evidence suggests shaving not at all might be the best idea, even in the Tony Sopranoesque. Once in a while, in my practice, I had a guy (always a guy) show up for a hernia repair having hacked himself way more extensively than necessary, even into the, uh, saccular parts, leaving terrible tracks. Claiming only the wish to help, I guessed it was a matter of not wanting just anybody mucking about "down there."
But the most compelling argument against shaving is it itches like crazy when growing back. Having more complaints about that than about pain when I'd see people post-op, I came to shave less and less over the years. More than that, I generally shaved my own patients, because I could rarely get others to do it as minimally as I did. My aim was to keep hairs out of my way when working and to leave room for a (small as possible) bandage.
I think some OR nurses thought I had some sort of fetish for shaving. Not so. If others shaved people as minimally as I did, I was fine with it. Once I came in to shave my sleeping patient, heading toward the pubes for a groin hernia. To my surprise they fell away en mass; a well-intentioned aide had shaved already, and when the anesthesiologist noticed, he said "Oh no, you shaved Sid's patient!! Put it back! Put it back!!!"