The patient: “Katrina,” an American patient who had returned to her native Austria, wanted a video consult with me

Why she came to see me: On a vacation a few years ago on St. John in the Virgin Islands, she had slipped on a wooden staircase leading down to the beach from her villa and a wooden splinter penetrated her right forearm. She pulled out what she thought was the entire piece of wood out and the point of entry healed over quite well. Recently, she noticed that a swelling had developed near the place where the splinter had been located.

How I evaluated her: My appointment with Katrina was “virtual”—via the secure telemedicine platform doxy.me. Here’s how we successfully diagnosed and treated the problem successfully! After exchanging pleasantries and fumbling with my few words in “Austrogerman,” I had her “show” me her forearm via the camera on her smartphone. I then had her probe and gently squeeze around the area of the swelling and describe any symptoms that this evoked.

How we addressed her problem: I noticed that the tissue where the splinter had entered a few years ago looked incompletely healed and somewhat scarred. I had her roll the tissue between her fingers until the skin began to open and serum (a mixture of non-infected fluids) began to emerge. I counselled her to imagine that we were going to revisit the event of the accident but in reverse and “coax” the remaining splinter—which I was certain was creating the lump—out via the same path through which it had entered. After a few minutes of focused massaging and squeezing, a blacken point began to emerge. Eventually, a piece of wood which measured about one inch long by ¼ inch wide was “birthed” from Katarina’s forearm.The patient’s progress: I must admit that I was as surprised and relieved as she was that my assumptions were correct. Two weeks later, both “mother and baby” were fine. Katrina’s forearm appeared to be healing well with no residual lump, and the splinter now holds a place of honor on her mantle and will be the subject of many fireside chats with friends once the pandemic has passed!