Monday, August 27, 2018

Caring For Amputated Limbs

The brave new world of modern healthcare culture continues to dumbfound, agitate, and get stuck  in my old foolish, wrinkled up craw. The latest outrage?  I was reading an expert's answer  on Quora that amputated limbs are treated as "medical waste" and are disposed of by encasing them in a red sealed plastic bag marked with a biohazard symbol and sent on their merry  way to a landfill or incineration.

Self respect starts with caring for others in a dignified fashion.
Don't even think about tossing this in the trash!

Since everything in healthcare is governed by money, I suppose this is the cheapest  most cost effective means of limb disposable. Preoccupation with money when it comes to caring for people leads many in the wrong direction. Patients are never clients or accounts and caring for them is not an "industry."  That amputated limb was once a part of someone who is going to have a tough time, to say the least, of dealing with a new body image and learning a new lifestyle. An amputated limb is not an inflamed appendix or a gall bladder full of stones to be tossed in a kick bucket and tossed aside, it was part of someone and their identity. Who knows? Maybe an integral component of the patient's spirit was living in that limb. Treat body parts with the respect they deserve.

Alice, my favorite OR supervisor taught me how to care for an amputated limb many years ago. Alice could be a mean, cantankerous taskmaster, but I agree with her wholeheartedly about showing care and respect for an amputated body part. Despite their harsh appearances, old school nurses had and an innate sensitivity and were determined do-gooders.

When it came time to care for my first amputation patient in the OR, Alice was on hand for direction. "The first order of business is to line up 2 carts just outside the OR. One cart is for patient transport ant the other is used to transfer the amputated leg to the morgue. I don't ever want to see one of my nurses toting a large specimen through the halls like it was a suitcase. You will reap enough negative Karma to burden you forever with that trick." That last line said with Alice's all-knowing conviction made me shiver in my OR shoe coverings as I imagined an amputated limb coming back to haunt me. You better believe I conducted myself with dignity when showing respect to that amputated leg.

I carefully placed the amputated leg smack dab in the middle of the cart and carefully covered it with a white sheet. The trip to pathology was uneventful until I nudged open the door to the morgue and found the pathologist in the midst of an autopsy. He had just plopped a liver on the overhead scale when he noticed me and nonchalantly asked, "what can I do for you?" I stuttered and stammered that I was here with a large surgical specimen. He called  over to  a resident and advised , "Take aerobic and anaerobic cultures and some tissue for microscopy then show the nurse how to put the leg at rest."

One of the hospital  board members was a funeral director and donated a very nice metal casket to the hospital for one specific purpose; the dignified burial of amputated limbs. After the path resident obtained his specimens the amputated leg was wheeled over to the elevated casket in the back corner of the cooler. I gently raised the substantial lid of the coffin and gently nested the  severed limb inside. There were a number of other limbs resting comfortably in the ice cold  casket and when I was finished with the transfer I covered them all back up with a hand knitted shawl lovingly crocheted  by a dedicated member of the Ladies Auxiliary. The limbs were at peace.

The hospital purchased plots at a nearby cemetery where the limbs were carefully buried when the casket was full. I was curious how often burials occurred and was advised it was an annual event complete with a religious official and a few of the path personnel to show their respects.

Years ago I entertained myself with notions of working again as a nurse, but as I thought of the money grubbing corporations running the show my mind did an abrupt 180. My values come from a different place in time and although I failed many, I think my heart was in the right place. I plain just don't believe in nursing the way it's practiced today and the image of treating limbs like trash haunts me.


  1. I remember, very early on in my career, doing a dressing change on an old diabetic patient with a gangrenous foot...
    Sure enough, as I gently unwound the voluminous Kerlex dressing, one of the gentleman's toes came off with the dressing.
    No blood, no muss, no fuss.
    I remember being stunned and awed, and thinking "Now what the h*** do I do with it?!?!"
    You can be sure I treated it with respect!

  2. In my day amputated body parts were incinerated at the hospital - but now we actually get reports in the newspapers of amputated limbs being found at public council dumps. I'm with you & cantankerous Alice on this one OFRN & glad I'm long out of the hospital system quite honestly! Sue

  3. I suppose incinerating body parts in a dignified manner would be similar to cremation. I guess that would be OK as long as the limb is separated from the nasty detritus of other hospital waste. Just tossing something as significant as a limb in the trash stream really creeps me out.

    I sometimes wondered what conclusions future anthropologists would come up with if a dig in the next millennium unearthed a cache of interred limbs. Now that could prove interesting.

  4. Patients grieve over the loss of a limb, but I'm not sure they care about what happens to it once it's off.

    1. Feelings related to loss of a limb are probably diverse and vary from patient to patient.

      Treating severed body parts with respect did make old school surgeons and nurses feel a whole lot better about the messy business of amputations. Today, so many of the feel good aspects of healthcare have been derailed by dollar signs. I'm certain it's a lot cheaper to toss a severed leg in the trash than lease a cemetery plot and bury it. Times change, but not always for the better.