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Let me tell you about my most horrifying surgery. Actually, let me tell you about my three most horrifying surgeries. Maybe you'll spot a common theme.

One heroin addict had blown out just about every vein, so she injected directly into her muscles. When she came into the OR, her leg had swelled up to twice its normal size. We sliced it open, and 3-4 liters of blood and pus plopped down into the basin below her. Afterward, the hole in the leg was so big I could put my whole hand in it. Instead of sewing the patient up, we filled the cavity with betadine-soaked sponges so the wound would try healing from the inside out.

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Another addict got his toe amputated, and that was just the start of his adventure. He then went home with a sponge on his wound to vacuum up the pus and an IV port for pain meds. He put some of his own "meds" into the IV bag at home and suddenly concluded that he didn't need the sponge, so he removed it. He then further concluded he didn't need all that dead skin on his foot, so he cut it off. He finally returned to the hospital, where the ER staff found his foot now infused with live maggots. Assuming maggots don't grow overnight, he'd hung around quite a while with his extremely smelly dying foot.

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We chopped off both those patients' legs. But that's still not my worst surgery, which was on a meth cook whose brew exploded all over him. His shirt melted into his back. The surgeon used a high-pressure water blade to strip all the dead skin until we could watch the blood flow through his vessels. We then used a nitrogen-powered blade to peel healthy skin from his legs and buttocks. I put these strips in a "meshing machine" to increase their surface area (to minimize the amount we have to remove) then we all played hours of skin Tetris, covering his exposed muscle with the grafts. By the end, everything around the OR table was covered in blood and bits of dead, slimy skin. I felt like no shower could rid me of the burned-skin smell.