[Warning, there’s some gross-ass pictures below. I’d give them just a 6 out of 10, with 10 being a snuff film, but that’s me.]
While America hyperventilates into the world’s largest paper bag over terrorism, I’d like to draw your attention to a much more sinister boogyman. It doesn’t hate our freedoms. It craves flesh, and it’s the closest thing we have to a real Walking Dead nightmare. I know, because I got bit, and though I lived, it’s coming for you.
They say that to call it a “flesh eating bacteria” is a misnomer. Methicillin-resistant Staphylococcus aureus or MRSA, an increasingly common drug-resistant “super bug” doesn’t actually “eat” you, and instead “destroys” the nearby tissue. But I call that semantics. TomAto-TomAHto, it eats you all right! The fact is, if I’d lived in the Indian bush, or was off-grid on some round-the-world trek, I’d be dead already, if not from the infection than from jumping off a cliff; the pain was incredible.
It started out as something as innocuous as a pimple. One on the jaw, where you might scratch your beard, and then another on the abdomen over my rib cage. On day three it looked like I was hiding a gumball in my cheek, and as a general rule, if a growth is changing the shape of your head then it’s time for an intervention.
Unable to sleep from the pain, I lanced them in front of the bathroom mirror. I squeezed out the abscess in my jaw and to my horror, a cavity remained. I could stick the lance inside 1/4” in any direction and feel no pain. There was nothing left. Just a hole. I tried the same with my stomach, but to my surprise the nerve endings were still intact, and the pain dropped me to my knees.
In the morning my roommates recoiled at the sight of me. During the night I’d grown a beard of blood and puss as it drained all over my cheek. And the pain didn’t stop. As I walked to the emergency room I reminded myself that I’d gotten a full STD screen after Burning Man just six weeks ago and been on my best behavior ever since, so so tertiary syphilis it is not! But then Jesus Christ! What is it? This is not a pimple. This is a tumor. This is cancer! (Oh my god, what if it really is Cancer?) My last thought walking through the door was that if this is some kind of incurable skin cancer then I’m just going to off myself. This is why doctor-assisted suicide is a thing. All those bible thumpers going on about the trials of Job and the beauty of Christ can go fuck themselves. And let’s be honest for a moment: If there is a god, how shitty must he be that He would strike Job with festering boils all over his body just to settle a bet with Satan over whether one of his hoes really loved him. (True story–or not.)
Lancing a boil is not like popping a zit. They are similar, but similar in the way that six-year-olds playing pee-wee hockey look cute next to NHL players who get checked into the boards and spit out teeth. It’s the big leagues, and has to be treated as such. First you sterilize the area, then you slice. In the ER, the doctor held up a scalpel and said she would try to keep the scarring on my face to a minimum, because, you know, “it’s your face.” I told her to give me the full Tom Berenger. While you cut, you should remember, you’re not just poking a hole. The skin at the top has been corrupted, so you have to lop it off like a blown volcano.
Then comes the squeeze. There will be lots of pain, so if you don’t have a local anesthetic like lidocaine, knock them them out with propofol or a large rock. After squeezing out as much as you can, you’ll need to “manipulate” the infection, which means to get in there and dig around, dislodging any remaining corruption to give the body’s immune system a fair shot. Scraping out the infection leaves a cavity where the patient’s flesh used to be.
Because the body will continue to fight the infection, there’s going to be more puss, and it will need to drain, which is why we “pack.” Take a spindle of gauze about 1/4” thick and start cramming it in there with some forceps. Really get it in there. The wound should be as swollen with gauze as it was before the lancing. Leave a little hanging out the top for easy removal later, and patch up the job with a good size bandage. I walked into the ER with two pimples and walked out bandaged up like a car crash victim.
Oh, and don’t forget the pain medicine. Whereas before the patient suffered from tenderness, you’ve just stabbed him in the ribs and stuffed his injury full of course fabric that’s going to clot and tear at every bump and breath, so only the best will do. I walked home stoned on Oxycontin. And this being the first time I ever got high on opiates, I’d like to take a moment to issue an apology to every junky I ever cast judgment on. (You are not weak. It really is that good.)
Save for one bandage-clad excursion to a strip-club for a friend’s birthday, I spent the rest of the week wasted on legalized heroin, playing Fallout 4 all afternoon and then sleeping until noon before taking more pills.
A few days later I returned to the ER to get “unpacked.” That was supposed to be it, but when the bandages came off, the sight was horrifying. This half-inch cavity was a swamp, and in it was some engorged worm that turned out to be the gauze swimming in puss. With one look she could tell the antibiotics weren’t working.
Then she yanked out the string of packing like she was starting a lawnmower. Next was my jaw, but without the element of surprise. Bent over my face to inspect the wound she turned my head and touched it with her latex fingers, then gave it an agonizing squeeze and I struggled not to cry out. “Just one more.” She said and when she finished I relaxed. Then she did it again. “Just one more.”
I hissed at her. “I don’t think that means what you think it means.”
The lab results confirmed her suspicions. It was MRSA. All I knew was that that’s bad, even for modern medicine. It can be deadly, but it remains treatable. Some strains keep an achilles heal. It might be resistant to all but one super-class of drugs. So they cultured the infection in several different petri dishes and introduce different antibiotics to each sample. Penicillin and amoxycillin had done nothing to kill it, but lucky for me, mine was still vulnerable to sulfamethoxazole (whatever that is).
After my beating and repacking, they gave me a week of super-antibiotics and enough Oxy to last until my next followup (again, so great!) It worked. The pain was subsiding. I got stronger, and after getting unpacked at my followup, it was clear I was going to heal up just fine.
But it remains a cautionary tale. With each passing year, doctors are reporting MRSA to be more and more prevalent, and more resistant to best drugs we have. It could get to a point where this increasingly common infection becomes so resistant that it has to be treated with chemotherapy, like cancer. I’d read about this “war” being fought against superbugs, but never took it seriously. Now I’m going to see the scars from it every time I look in the mirror.
Whenever you take a seat on a park bench, or ride on a subway car, or swipe your credit card, you’re some distance from an invisible assassin. So the next time you feel the urge to scratch your face or rub your eyes before washing your hands, remember: it’s out there, and the race to invent new antibiotics faster than MRSA can evolve is far from a sure thing.