So once upon a time we had this young guy who came to us emergently from an outside hospital an hour or so away for an acute Type A dissection. Sucks for him because he was only 33 years old. But even 33 year olds dissect their aortas when they do a lot of cocaine. So our surgeons fixed it and we tuned him all up and he just looks peachy. So out he goes to the floor.
Where, on post-op day 4, his loving and doting girlfriend brings him everything he wants and needs. Including... you guessed it! Some cocaine. A nurse walked in on him doing a line off the bedside table. She appropriately freaked out, the girlfriend got arrested and the patient re-dissected his aorta. No worries. Our surgeons fixed it again for him. He spent a bit longer in the ICU this time because, well two sternotomies and two aortic surgeries in a week is a bit much for anyone. But never you worry, we fixed him again.
So he goes out to the floor again. And the girlfriend is in jail. And his visitors are restricted. So we figure we're good. And no one can prove it, but he re-dissected his aorta again. Either he's ridiculously unlucky, or somehow he got some more cocaine.
Wouldn't you think you would learn your lesson the first two times???
Don't worry. We fixed him again.
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