Joseph Epstein

The unexpected was never a problem
Joe is always there to take calls and provide help or advice.
Many years ago, minor surgical procedures were booked
from Surgical Outpatients and performed in ED. One
such was a patient with a ‘sebaceous cyst’ on the scalp
for excision. On infiltrating and injecting to the base
of the lump with local anaesthetic, the needle went in
all the way to its hub without striking the skull despite
being perpendicular to the skin. The X-ray – it was quite a
while ago – showed multiple lytic lesions of the skull.
Joe, then also a member of one of the inpatient surgical
teams, was called. He came in immediately, provided
support and accepted the patient for admission. No harm
was done to the patient from the procedure and the
underlying lesion proved to be metastatic renal cancer.
1Patience and attention to detail
In theatre we were performing a laparotomy for bowel
perforation in an elderly patient. Surgery went well up until
time to close. Joe had chosen to use a paramedian incision
and this was being performed less frequently at the time.
Wound closure took an extended time due to a combination
of the bowel being distended from the nitrous oxide used
by the anaesthetist and the thin, friable tissue of the patient,
with sutures frequently pulling through. With patience,
a considerable time later skin closure was achieved.
Michael Bryant | Emergency physician and
former registrar, Western Hospital
n We were going through
a period of budgetary
constriction. Joe said, ‘The
total amount of money
spent on health will always
go through contractionary
periods. That is really of no
concern to us in emergency
medicine. The size of the cake
may be smaller: we just have
to argue for a larger slice.’
He did this most effectively.
Peter Cameron | emergency
physician, Melbourne
n Thanks for your great
service at Footscray ED over
the years Joe. I loved hearing
your trauma stories, the
insights into how to fix the
Victorian Health System, and
all about the helicopters
used in trauma retrievals.
I also miss the weekly order
of Turkish bread and dips.
An icon of the ED, already
greatly missed.
Vicki Catchpole | emergency
nurse, Footscray Hospital
Thanks for your great service at
Footscray E D over the years Joe.
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