I Pricked My Finger and Smelt Putrid for 5 years

Majority of this article is written as a FICTIONAL STORY with FACTUAL ELEMENTS from the “Doctor’s perspective”.

 Here's my story…

Urr, yes Doctor it was quite a peculiar occurrence, nothing like September 1991, eh? 

Had I eaten anything rotten, you ask? No. Skipped a shower? Not at all -  I can assure you I’m spick and span. Is my home clean? I’d sure like to think so, Doctor. However, I do recall an event before I started smelling like this, Doctor. 

I was at work. 

Tending to chicken, raw chicken. 

“Ahh, you don’t say..” - Doctor 

Diary account of a Doctor ‘September 1991 - 1996’

(1) Erythematous Finger 

That’s what it said when I hastily searched through the plethora of medical documents.

‘Erythematous Finger’ that was the closest thing to what resembled the man’s swollen red limb..Frustrated, I slump into the chair, exhaling sharply. My mind races. Nothing. The words (2) ‘rare condition’ ‘burning sensation’ ‘hot skin’ ‘itching’ are what I ingest whilst skimming through the recorded symptoms of Erythematous Finger, written in the fragile, archaic NHS documents. Documents that should provide an answer and relief to my itching curiosity, but further leave my brain lusting for more scathing scratches..   

All these symptoms, but no sign of a ‘putrid’ smell. What am I missing? What are we missing? I need to schedule with this man again..

Treatment - September 1992

The swelling is worse, and the smell - even more so. I plaster on a smile at the man, whilst yesterday’s meal threatens to rear its ugly head on the blue medical floors. I take pictures of his swollen limb, I convince myself it's for future references, as opposed to morbid curiosity.

I beckon him to tell me more about his “event” at work. Surprisingly, he claimed that he (1) pricked his finger with a chicken bone that same month, September 1991. I grimace, not at what happened, but at the thought that an action so small, can cause catastrophic consequences. I relish it. 

As one of the greatest Doctors of my century, I work with what I know. I administer every kind of medicine (1) flucloxacillin, ciprofloxacin, erythromycin and metronidazole - yet still, no improvement. What a blow to my ego.

I dare not give up... not when the stench is worsening, not when my patient-centred decorum is breaking down, not when my nurses avoid his room. The foulness does not merely cling to the man; it seeps, insidious and greedy, threatening to corrupt my reputation—threatening to brand me a disgrace of a doctor. Its hunger is unimaginable. It dares to suffocate me—I dare not let it happen.

He becomes my newfound obsession. An itch I cannot quite scratch, a puzzle I cannot quite solve . When less intrusive methods prove to be unsuccessful, I resort to (6) surgical exploration… Nothing. No pus. No foreign body. No soft tissue damaged.  

I grudgingly settle with the assumption that it was the chicken meat that was causing the putrid scent, for rotting flesh, as we all know, can cause an unwelcoming smell. However, deep inside my conscious, I’m not convinced

I focus on the swelling, not the smell. But that does not satisfy me, for a smell can torment hundreds, while a swelling afflicts only one. I order a (1) skin biopsy to be done and wait for the results.

Revelations  - September 1992

I can’t sleep.

I toss and turn, still and shake, I can hardly contain my excitement for tomorrow’s result tests. 11:00 pm turns into 2:00am which turns into 4 then 6. It’s time. 

“Normal ey, doctor,”  The man shudders, “you’re the most renowned physician in town”.

I know.

"I suppose you want to know that this darned smell has made me lose my job and this stupid….”  The man blabs on. However, the once audible words turn into mush in my ears. Ringing. Throbbing. Pounding. 

Heat rises in my face. I feel the nurses' eyes on me as I grip the doorknob harder than necessary. I need air. I step out, the hallway tilting slightly. My hands tremble. No. This is impossible, my ears piping hot - frustrated. My balance is hazy, I bash into computers and trip over a crutch. Feral. 

Normal? I completely lose control, what about any of this is normal?

I recklessly skim through the result paper again and again, desperately wanting the answers to my nightmare, a nightmare masked as a daydream.

"Doctor, sorry for the mix-up. I gave you the wrong document—here." Composure possesses me... I snatch the results from my assistant and slowly, ever so slowly, I read carefully. I take my time. 

(8) Clostridium Novyi, Clostridium cochlearium and Clostridium malenominatum, I blink to keep  my rising emotions in check, could this really be the disease? Could this really be the loophole to my nightmares, the missing piece to my puzzle, my relief to my itch? 

A burst of laughter threatened to escape my throat, I don’t waste any time as I rushed back to the man whom I ashamedly abandoned. I treat him with (1) antibiotics, colpermin, isotretinoin, probanthine, psoralen ultraviolet light treatment - yet.. to no avail, the smell lingered. The disease is still pungent.  

There’s nothing new under the sun - September 1996

Questions we’ve had, have been said and done.

I gave up on that case, I gave up my honour, my pride, my right. The moment I had expressed my deepest apologies to the man, the moment when my medication didn’t work, his face etched with disgust and mine, sorrow.I sometimes wonder about that man—perhaps asking questions I shouldn’t. What new job does he have? Does he resent my clinical practice? Does his limb still.. Smell?

Not too long ago, I received a letter from my most trusted assistant—it was from the man, detailing how, after five years, the mystery of the smell had stopped. He thinks it was my doing, His appraisal tastes bitter on my tongue - an undeserved applause to a stolen performance. 

It was not me.

Craving to think no more about this case, I toss the letter in the bin on my way home, eager to forget. A sigh escapes me as I fumble with my keys. Finally, I step inside. The aroma of dinner greets me before my wife does.

“Thank God you are back dear, I’ve seemed to have developed a swollen red finger”

What happened to it, my love?

“I was dressing chicken. Raw chicken.” 

“Ahh, you don’t say..” - Doctor

END OF STORY

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1. Mills, C. M., Llewelyn, M. B., Kelly, D. R., & Holt, P. (1996, November 9). A man who pricked his finger and smelled putrid for 5 years. The Lancet. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(96)06408-2/abstract

2. Erythromelalgia. (2017, October 18). Nhs.uk. https://www.nhs.uk/conditions/erythromelalgia/

3. Clostridium novyi. (2023, December 14). Wikipedia. https://en.wikipedia.org/wiki/Clostridium_novyi