The Vaudeville Suturing Experience
Many years ago I worked in a small rural hospital that had had more than its share of motorcycle accidents one summer.
I normally worked critical care but would occasionally work in the ER if it was busy. On this evening we got a call that an ambulance was bringing in yet another of the motorcyclists who seemed to have a way with running into things. That summer, among other motorcycle accidents, we had a man flip over the handlebars when a car cut him off. He went over the hood of the car and landed on both wrists, breaking both. Another woman had run headfirst into a tractor trailer and had a guillotine amputation of the leg at the level of the groin. This time all the nurses looked at each other. It was my turn to deal with this next motorcycle accident.
In he came with his helmet still on. It was split down the back. He missed a fatal blow to the head by the shear strength of his helmet. I say to myself,"OK, A,B,C, -all doing well. Leg was badly broken, in air splint, arm needing sutures. Ok, that is the physician's job. Call in X-Ray Tech. my job." We were doing neuro checks with the man, let's just call him Joe, who passed in and out of consciousness. Well, the doctor decides since we are waiting for the X-Ray tech on call to arrive, now is a good time to suture the arm. "OK, doc, what do you want?" He tells me the suture material needed and I set up the tray.
I got the wound cleaned and ready for suturing. The doctor tells me to put on a pair of sterile gloves and start suturing. I never sutured before. I told him so. His response was, "Well then it is about time you learned." I was game. I started to suture and the doctor gently taught me how to do the job. I was doing well. I was very proud of myself for working on this new skill. Obviously the patient did not know I was new at this. Joe would wake up and look at me suturing and ask, "What happened?" My response, "You hit a deer". Joe, "Hows' the deer?" Me, the suturing nurse replied, "The deer's dead." Joe, "How's my bike?" Me, "I don't know".
Joe would lose consciousness briefly. I would put in another stitch or two and Joe would wake up. "What happened?" "You hit a deer". "How's the deer?" "The deer's dead." "How's my bike?" "I don't know." Again he would close his eyes and drowse off. Soon he would awaken and ask again. In the mean time I had placed another couple of sutures and was getting more comfortable with my knots. Again and again we went through this routine. Open eyes, ask same questions, get same answers, close eyes, have sutures placed.
I began to feel like a bad vaudeville act. "What happened?, How's the deer? How's my bike?" The doctor watching me suture, the patient coming to only to ask the same three questions and me totally engrossed in my work answering the same way each time. "You hit a deer. The deer's dead. I don't know."
To this day every time I deal with someone who has a concussion and has that same kind of slippage in and out of consciousness I smile to myself and hear in my head again: "What happened? You hit a deer. How's the deer? The deer's dead. How's my bike? I don't know".
Joe had a compound fracture and was with us for many weeks. He recovered, but I doubt he remembered the suturing experience when I worried so little about learning to suture because I was living in a slap stick vaudeville act in the ER.Last edit by sirI on Oct 17, '08
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