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What you can learn from my bum leg


Will you be ready if you or one of your partners becomes disabled?

I didn't exactly feel the earth move under my feet, but there I was, with something obviously very wrong with my right leg and a very startled-looking telephone repairman looking down at me. I hadn't felt anything break, so my initial thought was that I had dislocated my patella. But when I reached to pop it back in place, I realized it had headed south. I had slipped, fallen, and completely ruptured my quadriceps tendon.

Four hours later I found little comfort in my cheerful orthopedist's comment that the torn retinaculum "looked as large as Julia Roberts' smile," as he surgically reattached the tendon. Nor did I find his advice to take two or three weeks off very useful. Like most of us in small groups, I had patients to see, bills and staff to pay, partners planning vacations.

I also had disability insurance with a 90-day elimination period-the length of time one must be disabled before the benefits kick in. The brace on my leg would be ready to come off just about then.

I ignored the advice to rest

My two partners and I were busy, our appointment schedules filled for weeks ahead. Having me take most of a month off, with no advance planning, would cost us tens of thousands of dollars.

So I compromised. I took the weekend off. I was back in the office Monday morning-in a wheelchair. Much to my dismay, I discovered that only three of our seven exam rooms could accommodate me in the chair.

I soon figured out it was easier for the majority of the patients to come to me while I stayed put in my office. The nurse took their vitals and ushered them in. I often spoke to patients in my office after their exam anyway, so I'd kept an otoscope and ophthalmoscope in a charger on my desk, for the "Oh, by the way . . ." questions. I also kept tongue depressors, throat swabs, and other supplies at the ready. I couldn't multitask the way I might have, dropping in on patients in multiple exam rooms, but the nurses kept the stream of patients steady. I wouldn't starve.

I did well in the office, but my hospitalized patients posed a bigger problem. My group uses two hospitals. One is nine miles away and has hospitalist coverage, so I was spared any 2 a.m. admissions there. The other, closer to home, has a suite I was able to use for my nights on call, so I bunked down there rather than trying to get back and forth. Did I mention that you can't drive with a locked long leg brace? But you can sure roll a wheelchair up and down the halls. One late-night admission said, "It was a pleasure to have a doctor in worse shape than I am."

Since I couldn't drive, my hospital administrator found me a street-legal golf cart with headlights that let me go back and forth at a blazing 24 miles per hour, driving with my left foot while my right leg stuck out the side. It's not always practical to expect a spouse to play limo driver, and in many small towns like my own, taxi service is hard to come by. I'm sure I was quite a sight, chugging along the side roads in a golf cart, but how would you get around if you couldn't drive?

The mishap taught some valuable lessons

What did I learn from my accident? If I were solo, I'd look long and hard for insurance that would cover my office overhead and living expenses a lot sooner than 90 days. Among other things, if your disability is such that you expect to return to full practice in a reasonable amount of time, you'll want to be able to keep paying employees, so your key staff can be in place when you reopen for business.

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© National Institute for Occupational Safety and Health