A man gingerly supports his hand while sitting in an emergency department of a hospital. A thick nail is sticking out of his index finger due to an accident with a nail gun.
The man is being filmed by Dr. Larry Mellick, vice chair of emergency medicine at the University of South Alabama (USA) College of Medicine and division chief of pediatric emergency medicine at USA Health. Another doctor prepares to remove the nail from the man’s finger. X-rays show it pierced the bone.
Mellick moves the camera closer as the other doctor begins pulling the nail from the man’s finger with sanitized pliers. He slowly twists the nail back and forth until it finally comes loose. He pulls it out.
Later, Mellick will sit down and edit the footage into a tight, three-minute video, complete with music, pictures and a title card, before uploading it to YouTube, where it will receive over 23 million views.
“The truth is, I’m kind of a mini YouTube rockstar,” he said.
Mellick said his YouTube channel, which is simply titled “Larry Mellick,” is supposed to teach doctors how to help their patients in uncommon medical scenarios, whether that be a stiletto heel impaled in someone’s face, a dead cockroach burrowed in someone’s ear canal or a thick nail stuck in someone’s finger.
“Every, every, every week, I get comments from all over the world from either patients, parents or doctors or medical students or nurses,” Mellick said. “I was just looking at some of them today, who basically say, ‘Thank you so much for this. I’m so much more confident and I’ve learned so much from this channel.’”
Learning from watching someone else do something, he said, is always better than learning how to do it from a textbook or a lecture from a teacher. He’ll use his videos to teach his students in the USA College of Medicine how to perform a proper procedure.
Sometimes, when Mellick hasn’t done a procedure in a while, he said he’ll rewatch his videos to re-familiarize himself with the finer points.
“Doctors do this all the time, and it’s like, ‘You heard this from YouTube?’ ‘You bet I did!’” Mellick said. “I’ve had doctors up in rural Alaska and in rural hospitals, and they said, ‘We don’t have specialists. We have to do the procedures ourselves and we have no way of knowing how to do them except in a textbook. But we use your videos all the time.’”
For many doctors, Mellick said, performing these uncommon procedures is the only way their patients can receive care without being sent somewhere larger and much farther away.
“That’s what happens the vast majority of the time,” Mellick said. “Like, ‘I need to do this uncommon procedure. I can read about it in textbooks. I’ve seen it done in medical school. I have never done it myself, but the patient needs it. Otherwise, if I don’t do it, then they’re going to get sent 200 miles to the big city to have the procedure done and be evaluated in another setting.’”
The educational value of his channel has helped more than just doctors, he said. Over the years, he’s received comments on videos from parents who saved money on hospital visits because of his videos on ailments such as nursemaid’s elbow, which is a partial dislocation of the elbow common in young children.
Others have expressed their gratitude for his videos as well. Medical, paramedic and nursing students, from as far away as Iran and Iraq, who haven’t been able to see patients during the COVID-19 pandemic have called his videos a lifesaver.
He started making these videos in 2010 when he was at the Medical College of Georgia, which is now Augusta University. He was treating a patient with an uncommon hand injury and he realized how valuable it would be as an educational tool. He asked the patient if he could take a video of the examination and the patient agreed, so Mellick started filming and put that video on YouTube.
His first few videos received thousands of views, even though he only meant them to be used for local training.
“This was over 10 years ago, when there really wasn’t a whole lot of medical procedure educational things on YouTube,” Mellick said.
He said this is because many hospitals are fairly rigid in their rules on photography and videos, due to privacy laws. Once he realized his channel could become fairly popular, he took extra precautions by improving his vetting process for videos.
“It was immediately obvious very early on that there was some real potential here and some real interest and that it could potentially become a lot bigger than we had expected,” Mellick said. “Partly because there was just not a huge amount of material like ours.”
Each video he makes goes through a peer review group of emergency medicine physicians, a legal review, a compliance review and even an assessment by the hospital public relations team. Patients also sign a release form, which allows them to revoke their consent at any time and have their videos taken down.
“I’m very sensitive to the fact that these videos are made in sometimes the most vulnerable times of people’s lives,” Mellick said. “I work real hard to make it real clear to the patient that the intent is not to take advantage of them when they’re stressed or when they’re in need.”
When a woman came in with a stiletto heel impaled in her face, Mellick got her permission to start recording. It was the perfect video for the channel, but he worried she hadn’t fully considered the implications of agreeing to it.
A few days later, he reached out to her and asked if she wanted the video taken down.
“And she said, ‘No, I’ve already got 100 — I don’t even know how many — comments on that video, and people are loving it!’” Mellick said.
Mellick blames cavalier attitudes about privacy on the social media age. Even on what he imagines to be one of the worst days of these people’s lives, he’s amazed by how open these people are to their situations being used to potentially help others.
“A lot of it is flat-out altruistic,” Mellick said. “It’s not like, ‘Hey, I want my 15 minutes of fame.’ A lot of the time it’s like, ‘I’m helping other people. I mean, I’m having the worst day of my life, but I might as well use it to help other people.’”
He said most people agree to be filmed, so he’s surprised whenever someone says they’d rather not be filmed.
In another video, where a young boy lays down on a medical bed with a dead cockroach stuck in his ear, a medical professional hides her face when Mellick points the camera at her. He said coworkers often make remarks when he is about to film, saying they’d rather not be in it, but he said they’re just pretending.
“Pretty soon you look up and someone’s walking right in front of the camera,” he said. “Like you didn’t need to do that. You did it on purpose!”
Over time, he said, people warm up to it. They enjoy being a part of something that’s bigger than a hospital, something that can reach a large, diverse group of people.
People will see him and say they were in one of his videos years ago. In medical meetings, some people will ask for his autograph.
That’s not why he does it, though. He said what’s important about the work he does, including the hours at night he spends putting the videos together, is the ability to have a positive impact on people’s lives.
In YouTube comments, people will often ask for medical advice, and he said he’s been able to convince people with serious injuries to go to the emergency room. A doctor messaged him to say he used one of Mellick’s procedures in a video to save a life.
Mellick said he also values the channel as it lets him focus on his artistic side.
“Making these videos is really very artistic,” he said. “I mean, just having a sense of timing, having a sense of what people like, having a sense of how to make transitions, how to keep people’s attention, because attention spans are so short … It’s learning how to deliver quick and fast and trimming out the excess.”
He said he comes from a family that’s a mix of artists and scientists.
“We always say medicine is a marriage between art and science,” Mellick said.
Though the channel was designed for medical professionals, its popularity has spread in other circles as well. As YouTube has grown over the last decade, other channels have emerged that focus on medical procedures for a general audience. He has no problem with some people including his videos in that circle.
“I fully recognize that a lot of the videos are simply human interest,” Mellick said.
His videos show professionals what needs to be done in abnormal cases, but he doesn’t worry people will take their care into their own hands. He said he thinks one could sit down and think about reasons the channel could potentially cause harm, but he can’t deny the good it’s done either.
“We’ve gone through this exercise with the hospital lawyers back in Augusta, and when you really kind of sit down and figure out the positive — I mean, I’ve had patients’ lives saved because of this channel,” Mellick said.
This page is available to our local subscribers. Click here to join us today and get the latest local news from local reporters written for local readers. The best deal is found by clicking here. Check it out now.
Already a member of the Lagniappe family? Sign in by clicking here