Surely There Must Be a Way!

Many times, we face frustrating challenges in wound care. There are patients with challenging, difficult-to-heal ulcers and wounds who do not adhere to the agreed upon treatment plans. Additionally, we face challenges when dealing with insurance companies, trying to secure coverage for the treatment we feel will benefit the patient best. At times, we may get to a point where we want to walk away, but we know that will not help our patients. What are we to do when there do not seem to be any solutions to the problems? Surely there must be a way to solve the problem.

There was a story about a man in a small Italian town many years ago. He owned a small business, but his debt to a loan shark continued to increase over the years. The loan shark was old and “unattractive” (to say the least). He was infatuated with the businessman’s daughter, who was young and attractive and had no interest in the older man. In an effort to win the young woman’s attention, the loan shark offered the businessman a deal. He would forget the loan if the businessman allowed him to marry his daughter. The businessman summarily rejected this offer, so the loan shark returned with another offer—he would place one black pebble and one white pebble in a bag and the daughter would draw one from the bag. If the pebble was white, the debt would be forgiven, and the daughter would not have to marry the older man. If the pebble was black, the debt would be forgiven, and the daughter would have to marry the older man. The loan shark picked up two pebbles from the pathway covered in pebbles and put them in a bag. The young woman did not trust the loan shark and watched him carefully. Sure enough, the loan shark picked up two black pebbles and put them in the bag, which meant either pebble selected would result in her having to marry the older man. What was she to do? The obvious things she could do would be to refuse to pick a pebble, to take both pebbles out and expose the cheating, or to choose one, knowing that she would help her family but sacrifice her future happiness. 

As she stood there making a decision, she had an idea. She reached into the bag and withdrew a pebble, but before anyone saw the color, she dropped it on the ground covered with pebbles. She looked all around and suggested they check the color of the pebble remaining in the bag. That way, they would know she had chosen the opposite-colored pebble. When it was revealed that the pebble in the bag was black, it suggested the daughter had chosen the white one, which meant the loan shark had been outsmarted. If he protested, it would have exposed the cheating. In this story, the young woman found a solution to a seemingly hopeless situation. In the end, the loan shark showed the black pebble and said she had chosen the white one. Her father’s debt was forgiven, and the daughter did not have to marry the older man.¹

This story illustrates that if we use our ingenuity, we can often find solutions to difficult problems, even when dealing with wounds and patients. Remember, the obvious approaches to the issues may not be the only ones. If a unique solution is discovered, consider sharing it with others who might be struggling with a similarly challenging problem. 

Terry Treadwell, MD, FACS

Senior Clinical Editor, Wounds
woundseditor@hmpglobal.com