"It just happened..."

A patient was sitting in the ER grasping his hand, trying to stem the oozing bleeding with some drenched gauze. As the gauze was completely saturated, it didn’t do much and the ground was splattered in blood. He had been hanging out with some friends and somehow “it just happened”. A knife had sliced through his 3rd, 4th, and 5th finger. After waiting an hour for an ambulance, he ended up in the ER to await some sutures.

The intern tapped each finger, checking the function and movement. Both the intern and the patient looked surprised, when they got to the fourth finger, and… nothing happened. While I couldn’t see any tendon beneath, I could only assume that the knife wound had knicked it (flexor digitalis longus! Thank you, anatomy class). After the intern consulted with another doctor, they decided to go ahead and suture it together and then have him return for a consult.

I’ve seen a lot of blood and accidents after working as an EMT, but it was so hard for me to watch as the patient got prepped for sutures. The intern gave him a dose of Ketorolac into his arm before beginning. But, it didn’t seem to do much. As we started on his fingers, we cleaned the wounds with alcohol to better visualize it. He was being physically restrained by his friend as he groaned through gritted teeth. Every single time we touched his fingers, he was sent into more pain. I was getting really worried because I didn’t know if he would get any more anesthesia (And I think he was too). Fortunately, he did. Whoever invented local lidocaine is a genius. He went from writhing in pain to waiting in boredom for us to finish the sutures.

“Secalo.” Dry it. “Cortalo.” Cut it. It felt like I was back at my own job as a medical assistant to surgeries at the Family Dermatology of Albemarle. Déjà vu. Different country, but the same routine. Sterile gloves on, cut with the blunt side, nonexistent tails for the deep sutures, and short tails for the external sutures.