Recently I watched one where one of the residents missed a step in a procedure due to confusion and chaos around them. I suddenly remember once when I did the same thing.
It was several decades ago, in an improvised ER, actually a bunker made of sandbags. I had a young man with a deep laceration on his arm, perhaps 4 inches long and over an inch deep, in one place the bone was visible. I put out the tray and gloved up, in front of me I had all the necessary implements, syringe with lidocaine, scissors, kelly clamps, sutures with a couple kinds of thread.
I decided to use a mattress suture, one where an anastomosis of both the sub-cutaneous and the derma can be closed with the same stitch.
I frankly don't remember whether or not the young Marine had been given any pain meds, I doubt that he had. As I was getting ready to start all hell broke loose. Helicopters came in carrying several wounded soldiers. I was busy for several minutes doing triage, trying to give order to something very disorderly.
I got back to the Marine with the laceration, sat down and started suturing. With all the noise and activity around, I dimly noticed the Marine was visibly wincing and jerking with each suture. I kept on, I'd guess it took several minutes to finish and put on a dressing. Then I cleared off the tray, and saw it....the unused syringe with 10ml of 1% lidocaine under a dressing. I'd just done a fairly major repair of a laceration without even giving the poor kid a bullet to bite.
I promise this'll be the last medical post for a while, spring is trying to get here, and there are fish in the river.
Thanks for serving. I was there in 68 & 69, then returned in 70 to 71. Came back healthy. Another time, another place.
ReplyDeleteBack at you, Steve. I was there 66-68, attached to the 3rdMarDiv. Glad you made it back to the world too.
DeleteAs a former CorpsWave (they're just corpsmen now), I'm loving your medical posts.
ReplyDeleteBut, I get that the fish are singing your favorite tune and you must heed their siren call.
PS: when I first saw your post in the list, I thought the image above was a carrot.
DeleteDoes kind of look like a carrot.
DeleteSpring, at least in the temp, might just be here for a few days. The snow is rapidly melting, now less than a foot in the front.
Cheers, Martha.
Whoever said Marines aren't tough?
DeleteThanks for your service, Mike.
Some of the most-deserving people I've ever treated.
DeleteI dated a future Marine, when I was in high school. He was this type. I'm glad to know all of you. Thanks.
ReplyDeleteI'm sure all of us whom were lucky enough to have known you thank you also.
DeleteOoh! That bites for the kid. An old boyfriend who has deployed several times still complains about a root canal he had to have in a ten on the side of a mountain in Afghanistan.
ReplyDeleteReally did bite for him. Lack of concentration on my part caused him a bit of pain.
DeleteImagine the dentist/orthodontist....scared out of his wits, hoping he lived till he got on the chopper. Takes a weird type to get out there, and think 'huh, this is kinda fun'.
Long ago my dad sat with a family friend who had a bad leg gash the doctor was sewing up. When she asked why it was taking so long my father said 'He's not just sewing you up, Clara, he's knitting you a pair of socks'.
ReplyDeleteWell, I'm not a Renoir, or Van Gogh (imagine that for a moment), but these guys never complained about scars.
DeleteThe wife and I keep sutures in our bug out bags and get home bags. You never know when you'll need to stitch up a wound while out in the wild. Of course, I don't know if I'd have the guts to sew myself up....Heh...
ReplyDeleteYou see that bit of nonsense in movies, but I'd not care to try it.
DeleteThanks for stopping by my site. I am going to have to read more, but this post made me wince and be amazed at the same time. Can't imaging operating under those conditions. No wonder you forgot the lidocaine!
ReplyDeleteI always had a kind of mantra: 'do one thing, do it well, then do something else'. This time it got left by the wayside.
DeleteHoly cow.
ReplyDeleteI had a tumor (benign) removed my my shoulder a couple months back, sitting in a chair -- with lidocaine. I cannot image that done without drugs.
What memories you must have...
Pearl
Tough to get to my age without a few, Pearl. Something about having many more years in back of you than are in front....brings about a kind of introspection.
DeleteI've had a lot of stitching done in my life and I'm happy to say that none of it was done without painkiller! My tour in-country was also 1968-69. I was with the 1stMarDiv. Seems like it was in a former life...
ReplyDeleteIt was a former life, pal. The only remnants that exist in my conscious is a liking for Nuoc Mam.
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