Giving Last Rites To Failed Equipment

By John H. McCord, DPM

   I do not care much for equipment failures. If you take good care of your stuff and do not abuse your equipment and instruments, they should last forever or at least for another three years until I retire. Tell that to my cast saw.    A patient of mine fell off her horse and broke her lateral malleolus. Since the fracture was slightly displaced and the patient was a real macho cowgirl, I felt that a fiberglass walking cast with a couple of extra rolls was the safest way to go. She griped and complained while I was putting on the cast. She said she wouldn’t be able to remove it so she could ride her horse. I said, “Yep.”    A week later, she called and confessed that her cast needed some repairs. She had bent a spur to fit around the back of the cast and went for a ride. The spur kind of ruined the back of the cast. I told her to drive to the office (not ride) and I would repair the cast.    It was a wreck. The spur had torn part of the back of the cast off and the cast smelled like horse poop. I decided to cut it off and start over. She promised to stay off the horse for a few weeks. I did not believe her for a second. I have had my old cast saw for 25 years. It is made by a reliable company and has had the same design since 1949 when the company invented an oscillating bone saw for taking the top of the skull off in autopsies and discovered that it was also good for cutting a cast off. My trusty saw had never failed me.    I put cotton in my ears and had the patient do the same. I explained that the blade only vibrated and did not spin, and therefore could not hurt her. I always have visions of the same tool being used to whack the tops of the skulls off the poor dead folks.    I plugged the saw in and turned it on. It emitted a deafening 120-decibel roar. It sounded like a ruptured grizzly bear. The saw, the patient and I shook like wet dogs. I carefully cut down the lateral side and noted that the saw was making a funny sound. As I started down the medial side, the sound turned from a roar to a screech. Smoke bellowed out of the end of the saw and the blade quit vibrating or oscillating.    I turned it off and stared at it. The patient asked, “Am I screwing up your day, Doc?” The cast was half cut off but would not budge. I regretted putting the extra two rolls of fiberglass on this cast.    When office instruments or equipment break, I can seek replacements, call for service from a medical equipment repair specialist (very expensive) or I can take it to Willie’s Gun Repair Shop. Willie is a hell of a metalsmith and can fabricate anything. I also take broken parts from my airplane to him. I was planning to run my cast saw over to Willie after work but horse lady still had her cast half on. The day was warm and the cast smelled.    I called the hospital ER and arranged to borrow one of its cast cutters to extricate my patient. This cast saw was like nothing I had ever seen. It was smaller and had an ergonomic grip handle. It also had a vacuum extractor that connected to the saw with a plastic hose.    I passed out new sets of cotton balls and turned on the cast cutter. Nothing seemed to happen. I felt the blade vibrating and then took the cotton out of my ears. The room was quiet except for the gentle hum coming from the saw.    The blade cut easily through the fiberglass and the vacuum extractor sucked up all the debris so I was not covered with my usual patina of 5-micron fiberglass dust.    I stood back and marveled at this wonderful tool. I made up my mind not to take the old saw to Willie. I plan to bury the noisy, shaky old piece of crap next to the rest of the obsolete, antiquated medical equipment I have tortured myself with over the past 32 years.    I ordered a new cast saw and extractor online. My old computer crashed and fouled up the order. It is next on the list of things that need to be replaced. Dr. McCord (pictured) is a Diplomate with the American Board of Podiatric Surgery. He practices at Centralia Medical Center in Centralia, Wash.

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