Derek Vaughn, MD, checks in with Shade Tree Clinic patient Elizabeth Stebbins before he performs hand surgery to correct her Dupuytren’s contracture. (photo by Erin O. Smith)
It all started with a mole.
After Elizabeth Stebbins’ life changed “dramatically and traumatically,” according to her sister, Kim, she didn’t have access to health insurance. This became an issue when Elizabeth needed medical attention for skin cancer but couldn’t find a dermatologist to work with her on a sliding scale fee.
Kim called Vanderbilt Health Dermatology, who referred her to Shade Tree Clinic, the Vanderbilt University School of Medicine medical student-run clinic that provides high-quality care to uninsured individuals in Nashville free of charge. Elizabeth was accepted into the program and had life-saving Mohs surgery.
“It’s a reset for many of us, a reminder of why we went into medicine in the first place,” said Eric Bowman, MD, MPH, Associate Professor of Orthopaedic Surgery.
Skin cancer wasn’t the only medical support Elizabeth needed; it was just the top priority at the time.
For years, knots had been forming on the palms of Elizabeth’s hands, causing her fingers to curl toward the palm — classic symptoms of the hand condition Dupuytren’s contracture. Not being able to straighten her fingers made it difficult for Elizabeth to turn doorknobs, open drawers, dress herself and hold the reins while riding horses, which she has done since she was in kindergarten.
“It affects the palm of my hand, my fingers, even my knuckles and tendons, which hurt. When I pet a cat or dog, I can’t lay my hand flat,” said Elizabeth, 62, who grew up in Nashville and Columbia, Tennessee, and ran a horse farm in Texas for two decades. “Over the past year I’ve had about 40% more deformity and can’t separate my fingers. It’s become painful, and I know it will only get worse.”
Elizabeth met the criteria for Orthopaedics Outreach Day; a Vanderbilt Health event initially affiliated with the American Society of the Hand’s Touching Hands domestic initiative founded in 2016. In 2017, Vanderbilt Health became the second site in the country to host the event, in which volunteer surgeons, anesthesiologists, nurses and medical students come together to provide free surgical care to qualifying uninsured or underinsured Middle Tennesseans — and has kept it going over the past decade.
“Orthopedics Outreach Day is one of our team’s favorite days of the year,” said Derek Vaughn, MD, Assistant Professor of Orthopaedic Surgery. “Elizabeth had a very common problem with a relatively simple solution. Dupuytren’s contracture can be treated with a small outpatient procedure where we divide the cords in her palm and finger with a small needle.”
After a follow-up visit two weeks after surgery, Vaughn said Elizabeth “has regained full motion of the finger, no longer has the contracture and is back to full activity. I am thankful Vanderbilt supports us in taking care of patients like Elizabeth.”
Elizabeth said the free surgery on her left hand was “like a miracle” that gives her hope she can do the “normal, everyday” things she took for granted.
“I tell everyone how incredible it is,” she said.
‘More than just free surgery’
The 10th annual Orthopaedics Outreach Day, an example of interdisciplinary collaboration and service, was Aug. 29 at the Vanderbilt Surgery Center in Franklin. Thirteen patients received free orthopaedic surgeries including three sports medicine cases, such as knee and shoulder scopes, and 11 hand surgeries. But the patients weren’t the only ones who benefited.
“Orthopaedics Outreach Day is more than just free surgery,” said, Eric Bowman, MD, MPH, Associate Professor of Orthopaedic Surgery. “It’s a reset for many of us, a reminder of why we went into medicine in the first place. It restores purpose; providing care for patients who otherwise wouldn’t receive it. We are grateful for so many giving up a Saturday to help those in need.”
More than 50 Vanderbilt Health staff members donated their time this year — some of whom have participated every year since its inception.
“Staff comes together from all over the enterprise, and it works beautifully,” said Jen Neissen, MSN, RN, CNOR, Director of the Ambulatory Surgery Division. “It’s a great day to remember why I love patient care.”
Though the procedures and patient care are the same, the volunteer aspect creates a special atmosphere.
“Our surgery center teams provide amazing care every day, and I couldn’t be prouder of their devotion to our patients — especially during Orthopaedics Outreach Day,” said Wendy Monaci, MBA, President of Adult Ambulatory Services. “Their dedication and personalized care are truly second to none.”
The surgical team included Bowman; Vaughn; Douglas Weikert, MD, Division Chief of Hand and Upper Extremity Surgery; Peter Chang, MD, Assistant Professor of Orthopaedic Surgery; Chelsea Brown, MD, Assistant Professor in the Division of Hand and Upper Extremity; Rachel Windmueller, MD; Reagan Mead, MD; Jordan Newby, MD; Ryan Seltzer, MD; Katie Frith, MD; Andrew Bratsman, MD; and Travis Fortin, MD.
Anesthesia services were led by Jeffrey Clemmons, MD, Medical Director of the Vanderbilt Surgery Center; and Christopher Canlas, MD, Chief of Ambulatory Anesthesiology; with assistance from Lakshmi Damalanka, MBBS, Assistant Professor of Ambulatory Anesthesiology; and certified registered nurse anesthetists Donna Keeney, Michelle Thornhill, Theresa Gillespie, and Mary Kelley.
The surgery center staff was led by Maria Sullivan, MSN, MMHC, RN, CNOR, Perioperative Services Nurse Manager; and Christopher Fritts, RN, CNOR, Perioperative Charge Nurse. Spanish interpretation was provided by Fidel Moreno-Diaz. Patient referrals were coordinated by Stephen Chenard and Albert Cordoves, students at Vanderbilt University School of Medicine.
Partners supporting the event included Chick-fil-A, Costco Wholesale, Dragonfly Screen Graphics, KimKaps, Sova Catering, Moe’s Southwest Grill and Taziki’s Mediterranean Cafe.
