That Day I Fixed a Tendon

Day #2 started off a bit more quietly in casualty - by that, I mean there was no blood on the floor when I entered the department. Within about 20 minutes, though, a man entered the ED. He had stolen one of the boda-bodas (local, really dangerous motorcycle used commonly for transportation), been caught, had hot plastic dripped all over his entire body, and had been beaten. He managed to escape relatively unscathed compared to many of the stories I have heard, but he had severed his extensor tendon of his right index finger. I called over the attending physician and got a brief "Yes, that is his tendon. You can put it back together if you have time." Because this man was a thief, caring for him did not top the list of the attending's priorities.

Due to the nature of the injury, I had to create a T-incision to search for the tendon that had retracted deeper into the hand. The proximal end was somewhat shredded, so I had to improvise with the suturing to really bring it back together. It was SUCH an exciting moment when I told the man to extend his fingers, and where his index finger hadn't moved before, it extended along with all the others! I couldn't remember how to properly close a T-incision (because of the nature of it, the area where the skin meets can easily become necrotic). So I did the best I could with what I had, then moved on to the other less-severe lacerations the man had come in with.

On a brighter note, I was able to teach another student how to do some basic suturing. I asked about how they would learn otherwise, and the response I got was a shrug. For as much as I complained about the surgery skills course we had in school, I could not be more thankful that we had such great instructors for that course. Teaching is so grounding for me - in this chaotic hospital, it's a chance to totally immerse myself in someone's education. Seeing them take away a skill that they didn't have an hour earlier is such a gratifyig experience. Also, it reminds me that at one point I was just as unsure about myself and the skills that I have acquired, and it reminds me of the mentors who have been so patient with me in my education to this point.

We've been staying up late unpacking and talking the last few days, so I think I'm going to enjoy some extra shut-eye tonight! Good night!