DIY Surgery
September 13, 2013
Here's how you perform your first surgery.
After getting the call you stroll into the house. You’re thinking, a few beers, a few rounds of Call of Duty, maybe rip the bong—but your buddy says, No, you gotta see this shit. He shoves you in front of the computer. ‘Check it out,’ he says while pushing in the chair.
‘But I thought we—’
‘Just watch.’
He clicks the mouse, enlarges the YouTube screen, and for ten minutes you endure the most grisly montage of quivering flesh, suctioned blood and squid-like guts. Without realizing it, you’re gripping the desk. Licking your chalky lips.
Look over your shoulder. Green medical paper drapes the kitchen table. And glinting in the fluorescent light, a silver bowl beside a syringe and a scalpel.
Every sport has its pitfalls. Surf long enough and no doubt you’ll wipe out so hard a fin will gouge your wetsuit and nearly sever your jewels. Skate and you'll eat it on a rail, fracturing your wrist. Train Mixed Martial Arts, you might end up with ‘bitch-tits.’
Here’s the thing with MMA—the kids are beasts. Wrestlers straight from high school, or worse, a Division I college. Muay thai prodigies that train two, three times a day.
But your buddy, he’s in his early thirties. Works in the accounting department at Boeing. No, he never plans on fighting in the UFC, but this isn’t about belts or records, he explains, this is about mortality. This is about the twilight of youth. Everyday he sees the sand slipping through his fingers and fuck if he’s ready to hang it up and spend weekends tending the garden.
Hell no, for at least a few more years, he wants to bang with the kids.
So he tells you, ibuprofen isn't enough. BCAAs don't cut it. To keep up with these animals he needs the magic sauce that’s giving them b’acne and more wile than wits.
Brazilians call it bomba.
Pharmaceutical reps call it Oxandrolone, Methandrostenolone, and Stanozolol. And you can procure it in just about any sports locker room, for any athletic endeavor, around the world.
Seize your destiny, son.
Great maxim, you tell him, but as per Fu Manchu, No one rides for free.
If only he’d researched the side effects of steroids on Wikipedia:
Gynecomastia /ɡaɪnɨkɵˈmæstiə/ colloquially known as man boobs, is the benign enlargement of breast tissue in males... gynecomastia may arise as an abnormal condition associated with disease or metabolic disorders, [or] as a side-effect of medication.
We’ve all witnessed this condition at the beach, perhaps even this past Labor Day--the elderly Don Juan smoking his cigar, scoping the girls from behind those gold aviators. Barrel-chested and high-waisted trunks. Sweat pouring down his neck and droopy boobs.
Gross, but natural. As we age testosterone production declines and estrogen seizes the throne, and as the feminine is wont to do, she starts remodeling the castle. What’s not natural is a non-elderly athlete upping his testosterone via weekly injections. It’s a jolt to the system, and to balance the hormonal soup the body increases estrogen production. Which leads to mood swings, insomnia, and gynecomastia.
Now, leaning near the desk, your buddy lifts his shirt and palms his breast like a streetwalker. There it is. A golf-ball size lump moving under his left nipple, turning white when he pinches.
ER personnel will tell you that every year hundreds of Americans perform surgery on themselves. Pulling teeth. Lancing boils. Scraping warts. There are plenty videos on YouTube. It’s a byproduct of a health-care system that frankly, doesn’t care.
One of my cringe-inducing favs features Dwain Williams, who removes a ‘knot’ from his forehead with box cutters. Even Orphan Black, the critically acclaimed BBC television show, based an entire episode on the self-surgery phenomena.
It’s the new DIY craze, and the reasons vary: Convenience. Challenge. Mental Illness.
But mostly, money. Or lack thereof. Those endless monthly bills with their cryptic charges—'EST PT/LVL 3,' 'IMMUNIZ ADMIN,' 'ANCILLARY CHARGES'—they’re the number one cause of bankruptcy in America.
So I called Doctor Greg Hsu, the UFC’s backstage ophthalmologist/stitch-doctor, about this so-called movement.
“Are you crazy?” he said, “that’s the dumbest thing I’ve ever heard. That’s like me cutting my own eyes so I can avoid the cost of LASIK—and that’s what I do for a living... or worse, having you operate on my ear!”
Which is about the response I expected. Sanctioned MMA events are highly-regulated affairs, staffed with a dozen medical personnel and emergency units. UFC fighters must pass a full exam—blood work, eye assessment, full physical—to receive a license. They’re evaluated at the weigh-ins, and immediately after the bout they’re hustled into a medical tent for more poking and prodding. Forms are filled out and logged, and if stitches are required, the fighters strut (or mope, depending on the outcome) down the hall to Doctor Hsu.
Like I said, highly-regulated.
But if you’re reckless and revel in tempting fate you can fight MMA in New York where legislators refuse to sanction the sport, and as a result unscrupulous promoters stage events with zero medical staff.
Or, if you’re feeling even braver, jump on Ebay and order yourself a DIY surgical kit.
For roughly $29 here’s what you’ll get:
Scalpel
Forceps
Scissors
Tweezers
Iodine
Saline
Syringe
Swabs
Gauze
Lidocaine
Before we dive into the actual surgery, I have to confess I’m no fan of DIY medicine. Yeah, I’ve super-glued gashes in my forehead, cuts in my palm, even glued my gushing eyebrow. But that was on the beach, miles from the road. That was last resort.
Your buddy’s now lying on the table, wearing just his boxers. With a red marker he’s drawn a line just below his right nipple. He lifts the syringe and slowly pierces the spot, injecting the Lidocaine to the hilt. Then he shoots another load, just to be safe.
Lest there’s any doubt, as he hands you the scalpel, you drive, he navigates.
‘No fucking way,’ you say.
‘Dude, you watched the videos, it’s simple.’
‘Simple? What if I cut too deep. Fuck this, I thought we were gonna play that new map. No fucking way.’
‘Remember last month, when you hit that curb and blew out your front wheel? Who was there in twenty goddamn minutes?’
Ughhhh. Gripping the scalpel, you gently prod the skin. The things we do for friends. Close your eyes and breath deep. Try and still your trembling hand.
This can't be as bad as it seems... can it? In the scope of history, you think those nomads had hospitals when they crossed the bearing straits? You think Butch Cassidy, shot up and bleeding, waited in his cave for the family physician? The ice caps are melting. Five, ten years, this house of cards comes crashing down. Get with the program.
‘Come on,’ he whispers, ‘you got this.’
You push. The skin is tough. Tougher than you imagined. But you’ve watched every episode of Dexter, seen countless mutilations. This is your one chance to really play doctor.
So do it.
Do it now.
‘Oh my God, I’m freaking out,’ you say.
He grabs your wrist and stares up at you. ‘Bro, you think surfing makes you a man? You think that’s any sort of test? Fuck that, it’s facing shit like this that defines us. Go!’
If you weren’t trembling and trying to catch a proper breath you’d laugh. His pep talk is ridiculous, and it’s not why you bear down and sink the blade half-way under his nipple.
No, it’s the earnest look in his eyes that says, if you don’t pull this here and now, I’ll forever remember—just as you will—that in the heat of battle, you turned tail and ran.
So you press until the skin flays, just like the videos. Inside it’s clean and white, like peeling apart calamari strips. Which causes you to pause. Reflect. Until blood spurts up your hand and forearm. Sprays and spills down his chest, flowing onto the floor.
A flesh fountain. He’s a goddamn flesh fountain.
You step back, searching for help. A nurse. A paramedic. Someone, anyone, help.
But it’s just you.
And him.
Only now his earnest eyes betray a tinge of fear. He needs you. Like it or not, the test has actually begun.
Tick, tick, tick.
Every day 150 species of plant, insect, reptile, mammal vanish from the Earth.
You step up, hold your breath and lay into the scalpel, sawing across the entire line. One, two inches. The spoiled-peanut-butter stench, it’s overwhelming. You backhand sweat from your eyes. ‘There,’ you say, whatever that means.
He pinches the ends, opening the hole wide as a quarter.
‘Can you see it?’ he asks, trying to angle his handheld mirror for a view.
‘No. It’s too dark in there. I don’t—’
‘Keep cutting.’
So you stab under the skin, slicing away, every ten seconds flushing the gash with saline.
Tick, tick, tick.
While we sleep, teams of pathologists, microbiologists, epidemiologists—all in hooded yellow suits—descend on rural villages throughout the world, trying to thwart the next pandemic.
SARS, Ebola, Rift Valley Fever.
Tick, tick, tick.
‘Wait! A white tip, I see a white tip,’ you exclaim.
‘All right, now cut around it.’
That lump pressing against his nipple, you always thought it was a fatty-marble floating in flesh. And once you exposed the thing, just a squeeze and it would pop out like a pimple.
Hah!
You lock the tip of the fetus with the forceps—you know, the scissors with the roach-clip end—and when you tug, his entire pectoral lifts. Up, down. Up, down. But at least this plugs the gash and staunches the blood.
‘Cut, you gotta keep cutting it out,’ he says.
Pulling the forceps with one hand, you carve around the cyst with the other. Slicing here, spearing there. After a few minutes you lose yourself in the work. Time ceases. The world falls away. You so missed your calling.
But when you finally free the growth, Oh shit, the hole is too narrow. So you tug.
‘Pull—’ he grits his teeth ‘—pull harder!’
So you yank and the gap tears like a taint during childbirth, which is somewhat funny/peculiar, because holding the peanut-shaped nodule covered in slimly blood, the nodule that you birthed into the world, how you feel is like a proud papa.
You.
Your first surgery.
You gingerly place the peanut on the table, then turn back to the patient. I mean doctor. He’s covered in sweat, grinning stupid.
Tick, tick, tick.
It's not just environmental crises. Four years ago a cabal of big-banks nearly brought down the entire house of cards via their gambling with financial derivatives. And how did our elected leaders respond? By enacting stiff regulations to prohibit such malfeasance? By breaking up the too-big-to-fail institutions? Hardly. At the first sign of peaceful ‘Occupy’ protests, Congress passed, and Obama signed, the 2013 National Defense Authorization Act, which now permits the military to round up American citizens without warrants or due process, and detain them indefinitely.
Tick, tick, tick.
The top nine banks are again parlaying the toxic instruments. Bank of America's current derivative exposure is over $50 trillion, as is Citibank's. JP Morgan Chase is on the hook for over $70 trillion. That's the size of the entire world's economy. All told, the derivative exposure of these banks exceeds $220 trillion.
Tick, tick, tick.
After washing your buddy’s wound with iodine and saline, you clumsily stitch him up. Then goop on Neosporin and adhere two butterfly bandages.
‘We did it,’ he says.
‘Yeah,’ you say, ‘now I’m ready for the floods.’
Afterword: This is a true story. It’s been two years since the operation. Six months after healing, our patient/surgeon started taking an over-the-counter anabolic precursor to speed his training recovery. The man-boob returned. This time, he caved-in to his girlfriend’s pleas and sought out a licensed physician. Here’s what might pass for a Yelp review of the second procedure: “That dude butchered me. I’m serious. First he lectured me about how stupid I was, then he dug into my chest like it was an autopsy. Some doctors don’t give a shit. We spent like fifteen minutes prepping and sterilizing my chest, carefully drawing the incision—but this quack, he dove in and carved me up like it was Thanksgiving. Look at this scar [he reveals a jagged Frankenstein line that nearly rings his entire nipple]. Do I have any regrets? Yeah, I do—not doing the second surgery myself.”
LINK:
Dwain Williams cuts out knot with box cutters
http://www.youtube.com/watch?v=_sR3Ob8s4oc