TWO
Paper, Prophet, and Printing Press
I struggle to remember what day it is. I came to the medical center
Saturday morning, preparing to meet my fellow residents in the hospital
cafeteria, and to “run the list,” where we review our patient registry and
assign the scut work for the day. As the junior-level resident, I knew most
of the “dirty work” would be done by me over the weekend, and because
the orthopedic hand team was on call for the trauma center, I knew I was
at risk for a brutal sixty-hour slugfest. All it takes is a little bad luck for a
call weekend to go to crap, and as soon as I sat down with my pancakes
and my list, my trauma pager beckoned me to the trauma bay.
The first trauma patient had been in a motorcycle accident, and most of
the bodily destruction was centered on his right arm. His right hand was a
jumble of open fractures, exposed tendons, pumping macerated vessels,
and dog-eared skin flaps. I knew at a glance his surgery would take hours,
and the day was just starting. Additional hand-injured patients steadily
arrived in the emergency room, and as day turned to night, there was no
abatement of suffering. By Sunday morning, there was almost a chance I
could take a quick nap, but someone’s bagel knife mishap mandated that I
descend down to the emergency room for a consult. The waves of
traumatized patients, in a never-ending flow, pulsed through the ER, and
my job was to stabilize, evaluate, and prepare the wounded for surgery
and, if not otherwise detained, report to the operating room to surgically
assist.
Late Sunday night, at my wits’ end, not having slept all weekend, a
twenty-four-year-old Central-Pennsylvania lumber mill worker was flown
in on an air ambulance helicopter. Four fingers on his right hand were
sawed off where they attach to the palm, and the giant saw blade had
mangled all the digits into oblivion. All we could hope to do was surgically