The glaring wound stares back at me, and to my surprise, I cannot suppress a deep visceral reaction. A large, angry scar sears across her chest, engulfing the area where the right breast once lay. Only as I gently strip back the tenuous bandage do I realize that this is also her first time seeing the ravaging effects of her surgery. A quick glance and then she looks away, tears starting to form. Clearly, she was not prepared for this.
Nor was I.
The patient has just moved here and presents to the emergency department for her first follow-up after a mastectomy done three weeks ago. Naively, I thought I would be doing a simple wound check, perhaps ruling out infection and plugging her in with our oncologists. Yet as soon as I pulled away the dressing I realized I had opened a Pandora's box of emotions that could not be ignored. The psychological effects were so devastating that until now she could not build up the courage to peel back the small piece of tape and assess the damage.
Buckley B. Wound Healing. JAMA. 2008;299(14):1647. doi:10.1001/jama.299.14.1647
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