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The Old Testament book of Job is the story of a righteous man whose faithfulness God allowed Satan to test. He lost his financial security, family, friends and his health. The news of the loss of his children was delivered by the lone survivor of the massacre. “And I Only Am Escaped Alone to Tell Thee” — A Patient’s Experience With Excruciating Pain and Redemption is the title of an article just published online in Today’s Wound Clinic.

I asked Dr. Richard Maddy to tell the story surviving polyarteritis nodosa (PAN). I am sorry to say that it’s also the story of my own worst defeat as a wound care practitioner –- not because I didn’t identify that he had vasculitis, but because I could not get the admitting team of physicians to start high-dose prednisone immediately based on the clinical presentation -– but in the absence of biopsy proof. They didn’t get a biopsy because he was admitted for cellulitis, and it wasn’t their “area of expertise.” Ultimately, he lost both of his legs.

Dr. Maddy’s story is a plea for better education about “rare” conditions, which are a lot less rare than people think. It’s an indictment of a medical system that is focused on reducing length of hospital stay rather than patient care, and on physicians who forget they were doctors before they were specialists. However, it’s also a story about finding meaning and purpose, not in spite of, but as a result of our trials.

You may not know it, but the Biblical book of Job has a happy ending. In the end, Job gets back his health and wealth and even has more children. However, you can bet that after what he went through, Job never looked at life the same way again. Neither will Richard Maddy.


Dr. Fife sees patients at the CHI St. Luke's Hospital Wound Clinic in The Woodlands, Texas. For an appointment call (936) 266-2150.



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