Wound Care Karma

A recent radio talk show addressed the topic of karma. Callers were debating whether people who do good deeds should expect good things will happen to them in return. I listened for a bit to the whines and complaints: why couldn’t anything just once go their way? There were deserving. They were entitled. 

I immediately thought of our readers. I cannot think of another group of practitioners whose deeds more deserve works in kind. Not only is providing health care in general an often challenging and thankless pursuit, but when you add in the demands of wound care — gory, unglamorous, and tedious, with victories frequently years in the making — you have to wonder what attracts folks to this niche. 

Working in wound care is not without reward, but it seems mostly to be of the selfless kind. I have not yet met a practitioner who pursued wound care for the prestige. Basically, wound care people express satisfaction in helping others, many of whom have suffered with medicine’s most sensorally (gruesome, odorous, painful) offensive “gifts.” The articles in this issue of OWM underscore the selflessness of wound management and research. Beitz tackles medications and their impact on healing; her overview of the ways drugs can impede or enhance healing includes numerous graphic photographs that might off put anyone with a less than staunch interest in compromised skin. Danne et al examine options for pilonidal sinus healing that involves overcoming infection, abscess and discharge, and pain. Farid et al take a forensic look at the evolution of pressure injuries. I highly doubt these authors conducted their research for personal fame or gain. I suspect their intentions did not include the notion, If I heal this wound, something good will happen to me. 

This is not to say the wound care arena has not received its share of recognition. Numerous Nobel Prize winners in Medicine and/or Physiology have wound care connections. The 1909 Nobel Prize for Physiology was awarded to Theodor Kocher, who practiced and published on the antiseptic treatment of wounds using weak chlorine solutions, the Listerian approach to surgery and wound dressings, preparing antiseptic catgut, healing wounds without drainage tubes, gunshot wounds (including the mode of action of small-caliber missiles with high initial velocity), acute osteomyelitis, and healing by first intention. 

In 1912, the Nobel Prize in Physiology or Medicine went to Alexis Carrel, whose research included studies on infection and wounds. He wrote Treatment of Infected Wounds in collaboration with Georges Debelly and was intrigued by experimental surgery and transplantation involving tissues and whole organs. His publication, the Lyons Medical, described a technique for the end-to-end anastomosis of blood vessels and cold storage blood vessel preservation for use in transplant surgery. While Carrel served as a Major in the French Army Medical Corps from 1914–1919, he helped develop the Carrel-Dakin method of treating war wounds. In addition, he devised methods for whole-organ transplant; in collaboration with the Charles Lindbergh, he created a machine for supplying a sterile respiratory system to organs removed from the body. Carrel addressed these subjects in his books The Culture of Organs and Man, the Unknown.

In 1986, Rita Levi-Montalcini and Stanley Cohen won the Nobel Prize for their discovery of nerve growth factor (NGF) and epidermal growth factor (EGF). Their research showed how the growth and differentiation of a cell is regulated; the discovery and characterization of NGF and EGF would subsequently increase understanding of delayed wound healing.

Drs. Furchgott, Ignarro, and Murad won the Nobel Prize for Physiology in 1998 for their discoveries concerning nitric oxide (NO) as a signaling molecule in the cardiovascular system. Their research enhanced understanding of the amino acid arginine, which is solely responsible for producing NO in the body, and described its utility in protecting the skin from damage and quickening wound healing.

Despite the recognition a Nobel Prize affords, I highly doubt these esteemed winners, or wound care’s own Braden, Winter, Pecoraro, and Jeter (just to name a few), ever set forth on their professional journeys with the thought, What will this get me? If I had to guess, like you, they had 1 ultimate goal in mind: to improve patient care. Like you, a patient’s smile of gratitude is all the karma they needed. 

I am mildly obsessed with the musical Hamilton. I will leave you with this final thought from the show: History has its eyes on you. Look to the recognized among you who have humbly achieved greatness. Look to the up-and-coming members of your profession who can inspire and be inspired. Look to your own motives … and be proud. If there is such a thing as karma, you will be well-rewarded. 

S ince 1987, we
Y early make wound history
M eeting up to gather knowledge 
P oints they just don’t teach in college
O pening Exhibits: grand
S essions packed with info: planned
I ntellectual and fun
U nanimous: we’re Number One
M ay there be at least 30 more
     There’s so much wound yet to explore! 

This article was not subject to the Ostomy Wound Management peer-review process.