The Very Last One

I read in Wednesday’s paper where Florence Green died.  I didn’t know Florence Green. I don’t even know that I know anyone who knew Florence Green. I'm pretty sure I don't. Nonetheless, I felt a twinge of sadness at her passing. And a twinge of guilt.

Florence was born in London in 1901. Her death was reported as that of the last surviving World War One veteran. She entered the Women’s Royal Air Force in 1918 and enlisted in time to spend the last month of the war serving food.

My guilt stems from an episode my first year in practice as an orthopedic surgeon, 1990. I was fresh out, eager to work, but lacking the robust confidence and pure guts to simply dive into the most difficult cases. And so, wouldn't you know it, first month while on call I get a phone call from one of the really busy and cool family docs. He tells me that one of his patients has broken his hip and he wants me to take care of him. “And take good care of him. He’s a World War One vet. He even has a dent in his forehead where a German soldier hit him with the butt of his rifle. Don’t kill him!” he finished with a laugh. 

As you might not guess, with a lead in like that, I operated him without a problem. Unfortunately, about three or four days later the repair failed after I had already left the state for a beach trip to Oregon. My partners re-operated him a day or so after I had left. When I returned after a week-long trip to the Oregon coast I learned that he had, indeed, died a few days after the second surgery

As awful as that story sounds it is not a bizarre or entirely unexpected outcome. There was nothing lacking in his care. He was in his late eighties, poor quality bone, and the risk of death with hip fracture at that age is not insubstantial—even more so 20 years ago then perhaps now.

The hard part in all of that was the fact that this old barnacle of a veteran, a guy who survived a terrible war and survived getting bashed in the head with a rifle, lived long enough to break his hip and die after this newbie surgeon laid hands on him.  I couldn't help feeling I failed him as well as having failed in my duty. To this day I feel a little sadness in that sorry ending. It’s not an uncommon end for many elderly people but this one was an especially frustrating, sentimental, and sad demise.

I'm over it. Sort of. But reading about the passing of Florence Green kind of brought it all back once more. I wish he'd lived to be 110 as well.