The Power of Words: Senescence and Debridement

Words provide endless fascination for me, and I’ve encountered a couple of gems in the past month that seem to sizzle with relevance. So, here are my words of the week – and how they resonate:

Senescence and Debridement.

Both words I learned accompanying my 94-year-old Aunt Virginia to the Wound Clinic at Presbyterian Hospital in Dallas.  She is a warrior queen of remarkable grit and constitution, but a pesky wound on her outer ankle has refused to heal over the past few months. Since beginning our biweekly visits to see the perspicacious Dr. Moran and her choreographed coterie of clinicians, Virginia’s stubborn sore has much improved.

Debridement. It refers to the forced removal of unhealthy tissue from a wound to promote healing. Mon Dieu! It’s French – from débrider, to remove adhesions or to literally unbridle. Though the body possesses miraculous and mysterious organic self-healing capabilities, sometimes the process hits a snag. It stymies, and it needs a little help to progress. Debridement sends an urgent message to all the white blood cells and healing resources to galvanize the rescue mission – stat.  And, it hurts like hell!

Unfortunately, we don’t always know why we attract the excruciating circumstances we do or why healing pauses, but we do know why pain exists – to tell us something is terribly wrong. Pain  might be the most potent teacher. It’s just a matter of making the right connection.

Senescence. Debridement is a necessary protocol when a wound is senescent – another vocabulary word from the good doc. Senescent comes from the Latin senēscere, “to grow old.” In medicine or biology, it refers to cells that are still metabolically active – but are no longer capable of dividing.  Existing but not thriving. That’s why they need the jump-start.  Life is about living, not just surviving.

Thankfully, we have come to the right place. On our first visit to this chaotic clinic, I was overwhelmed by the number of “customers” – all seeking some sort of relief. There were not even enough chairs for everyone. There were babies, adolescents, grandfathers, society matrons and athletes. I saw one disturbingly gaunt man slouched in his wheelchair with his bandaged ankle plopped in the lap of a young man who looked like his son. He spoke with unconscious gusto. I think he must have been a teacher. “I believe in word economy,” he proclaimed. “I read that boy’s paper, and he used commas like he keeps them in a salt shaker.” I chuckled, but no one else in the room reacted.

“Ms. Thompson,” the out-of-breath nurse shouted as she cracked the door.

That’s Virginia’s married name. More accurately, her divorced name – an identity she’s maintained for more than fifty years. I grabbed the wheelchair she usually propels with her own two feet, and we were off down the hall.

“This is not uncommon,” said the chestnut-maned doc with an easy, warm smile. “But it’s a bear to heal. It’s a problem of pressure. I’ll bet you sleep on your right side, don’t you? We must offload the pressure. That’s all there is to it.”

Offload. There’s the lesson.

“This is gonna to hurt . . . a lot,” Dr. Moran warned as her nurse squirted the swollen, red ankle with lidocaine.

“This is what we call debridement,” Dr. Moran explained. “We have to remind the body how to heal. We need to remove the dead skin that gets in the way. This sends the body’s healing properties and enzymes to the wound.”

Virginia winced and closed her eyes tightly. Then, one glistening droplet ran down her wrinkled cheek.

“Are you OK?” I asked quietly. I have never seen her register pain, and she has endured much in her life.

“I know that hurt . . .  Uh, Ginny, more lidocaine here,” said Dr. Moran. “We need to rally all the resources we can to heal this bugger.”

Virginia began to breathe a little easier as the efficient tech team wrapped her puffy leg with focused precision. Moran gave us a list of instructions and pointed us to our next stop – radiology in the main hospital for an x-ray.

I was not here by accident. In addition to providing companionship and moral support for my only living senior relative, this experience held a lesson for me.  Sometimes the process of removing the dead tissue requires a seismic jolt – maybe two!  We can’t let unattended wounds just scab over – and pretend like everything is OK while the senescent tissue underneath remains.  Ignoring pain does not resolve it. And, the Universe keeps amplifying the intensity of our lessons until we finally get the message.

After all the turmoil, displacement and trauma in recent months (and even years), I know now it’s not my job to change or fix the mess and dysfunction all around me to feel better. That’s a no-win energy suck and likely leads to spiritual senescence. It’s about staying mindful, making higher-grade choices – and getting myself unstuck – not everyone else.

In medical terms, I guess the prescription is debridement – liquefying the icky eschar and slough. But, no more “liquefying” on my home front, please! I get the message! Thank goodness, Virginia’s choices are helping her heal, too. It’s been nice spending this time with her, too.

Let’s rally those inner resources . . . stat.

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