myself with the patient and a young nurse. I grab a pair of gloves and
introduce myself.
“Henry, I’m Dave Schneider, I’m a medical student on the orthopedic
surgery team. I need to take a look at your hands. Is that okay?”
I begin unwrapping the makeshift dressing on Henry’s hands, gently
unfurling the blood-splattered blanket. When I untangle the last layer over
the right hand, Henry shudders in pain. Lifting the white cotton blanket I
see that the thumb is barely connected to the hand, dangling by a thin
bridge of skin to a gaping wound of crimson, serrated muscles, shredded
tendons, and pulsatile blood vessels.
Henry slams his head backward against the bed, screaming, “Oh my
god!” I silently mouth the same sentiment. I grab some 4x4 sponges
[pronounced “four by four”], vainly positioning the thumb back into
position, and while holding the digit in its precarious station, wonder what
will be my next move. I reinforce the temporary covering with a stouter
ABD [“Army battle dressing”] sponge and stabilize it with layers of cloth
tape. I like things to look tidy and organized; this looks like an 8th grade
science project, and my lack of proficiency must be obvious to everyone.
Before I can report to Joe, I know I must also examine the left hand.
Henry’s eyes are closed, and I assume that the fentanyl is drenching his
brain, finally relieving this poor man’s agony. I repeat the process,
carefully peeling open the onion of blanket layers, grimacing as I get down
to the left hand, discovering another dangling thumb—this one really
bleeding, obscuring my view of what is still holding the thumb to his body.
It is cockeyed and sickeningly unhinged, and despite the powerful
narcotics coursing through his body, Henry is snapped back into a hellish
appreciation of his predicament because of my intrusion.
I finish dressing the left hand, and make my way to the trauma bay to
update Joe.
In the ten minutes since we split up, another major trauma patient has
arrived, this one a young man who was run down by a drug dealer driving
a huge SUV. I glance into the room, and it’s the craziest scene I have ever
witnessed. Blood is everywhere. The young man is unconscious, and the
anesthesiologist is hurriedly placing a breathing tube while the trauma
team is cutting off his blue jeans with huge trauma shears. [Every medical
student and surgery resident dutifully carry these industrial-strength,
orange-handled scissors that can cut a penny and saw through any piece
marcin
(Marcin)
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