DYNAMITE ROCKET

While in the family practice office I had the opportunity to do a physical examination on a 55-year-old male whose name was Jim. I quickly looked at the information in his chart before walking into the exam room. I lightly knocked on the door before entering the exam room. I walked in the room to see a middle-aged male who smiled at me as I entered the exam room. He was sitting on the exam table with a paper drape over his lap and in his underwear and socks. I introduced myself as the nurse practitioner student. He nodded his head in acceptance of me doing his exam. I looked at his chart to see his medical history. He was on no medications and had no significant history that was listed in his chart. One of the first things I noticed was he had a prosthetic left lower leg. I knew I would address this during the examination.

I started my exam by listening to his heart and lungs. While doing this I noticed a large scar on his right chest.

“What is this scar from?” I asked touching the scar on his right chest.

“All of them are from the same accident,” Jim replied.

I thought about what he said while assessing the rest of his skin on his upper body. I noticed he had several large scars on his chest, neck, and both arms. They did not look like surgical scars. Before I could say anything he responded to my curiosity.

“All of my scars are from when I was 12-years-old,” Jim said.

“Really? What happened?” I asked in curiosity. I continued to count the numerous scars of different sizes on his torso. Jim continued to smile.

“I was in an explosion when I was 12,” Jim said.

“Really?” I responded. I could tell he enjoyed talking about his childhood wounds. I picked up the otoscope to look in his ears. I first looked in his right ear. I noticed old scarring on his tympanic membrane. Quickly after I took the ear piece out of his right ear he looked at me.

“What did you see?” he asked.

“I saw old scarring on your ear drum,” I responded. I went to the left ear and saw the same type of scarring on his tympanic membrane.

“Good. I got that in the explosion,” he responded with a smile. I watched him. I had to know why a 12-year-old was in an explosion.

“What kind of explosion were you in?” I asked.

“I built a rocket and it exploded,” he responded. Well, I remembered when I was a child there were kids who built those rockets from a kit that went up in the air with the assistance of some sort of guide. Also from my memory I did not remember any explosion in the process. There was maybe a little extra smoke, but no big booms. Jim continued to smile.

“What exploded? I remembered rockets when I was a child and there were no big explosions,” I responded.

“I used dynamite with the rocket,” he smiled. I thought about that for a while. My thought at the time was how did a 12-year-old get dynamite?

“Dynamite? How did you get dynamite?” I asked. This physical exam was getting somewhat interesting.

“I found it on the railroad. I found several,” Jim told me. I looked at him. I continued my exam. It was time to look at his lower extremities. It was obvious he did not have a lower left leg. My gut instinct told me it had to do with the rocket explosion. As I looked at his lower extremities I noticed what looked like old graft scars on his upper legs.

“It fell between my legs when it exploded. It took off part of my left foot and burned my lower legs,” Jim told me. He continued to smile. I continued to do my skin examination.

“What happened to your right leg?” I asked. He still had his sock on his foot.

“It was also damaged pretty much from the dynamite. Do you want to see it?” he asked.

“Yes I do,” I told him. I could not tell if it was more curiosity or doing a complete physical exam. He took off his sock. There I saw a severely deformed foot. I knew he was able to walk on it with no problem. I assessed his pedal pulses and they were strong.

“I also had skin grafts on my foot. That is where these scars are from,” he told me as he pointed to his right thigh. I looked at the scarred skin graft on his right thigh.

“Yeah. They could hear the explosion four miles away,” he said. He was still smiling. I knew although he was probably lucky to still be alive from his childhood curiosity of dynamite he was proud of his battle scars.

“How did your mom react when this happened?” I asked. I was curious.

“Well, she was many different things that day. I remember Bonanza was on T.V. that afternoon. I did not want to watch it so I decided to fly my rocket,” he told me.

“You know the rocket never flew,” Jim told me. I looked at him.

“Was it worth it?” I asked him. He smiled and did not say anything.

I finished up my exam by doing his inguinal hernia, testicular, and rectal examination. Everything was normal. Considering the impact of the dynamite rocket, I bet he was glad his genitals were intact.

I charted the rest of my exam and told him he could get dressed and I would be back into the room with my preceptor. I told my preceptor about Jim and his wounds from his childhood. She looked at me as I told her about his dynamite rocket.

Jim walked down the hallway after his exam. He was still smiling. I could tell he liked to talk about his scars and wounds. All I thought about was how lucky Jim was to be alive and/or functioning normally today. It was a bad combination for a young boy to find dynamite and use it with his rocket at 12-years-old. Apparently Jim turned out alright because he had married and had a daughter. He was functioning well and had a good disposition. He was a very pleasant man who endured life with his disabilities and loved his life. This was because he did not see himself as disabled. This was definitely a male exam I would not forget soon.