stitch it, stitch it good

Ok, seriously I spent an inordinate amount of time trying to upload pictures to my next blog post, which actually shows more of what we were doing medically while in Belize.  But this *&%#$ host site sometimes drive me up a wall with it's frustratingly annoying quirks that include (but most certainly are not limited to) choosing to upload only certain photos and not others for no particular reason, freezing on the photo load page, and in general being a wonky pile.  Never fear folks, my computer programmer fiance is swooping to my rescue and together we are designing a new updated webpage that will hopefully solve all my first world problems. IN ANY CASE, while that is in the works, and while blogger slowly figures out just what exactly I want it to do in my next post, I have a story for you.

So, ED yesterday, day two, still settling in.  Finding my grounding, cracking very innocent, tentative medical jokes with my new preceptors to ease the awkwardness, and sucking up like mad to all the nurses and techs.  Towards the end of my shift I picked up a chart for a patient needing a stool disimpaction.  This is like par for the course in the ED, but somehow I have managed to miss all those cases thus far, so I signed myself up.  Confidence is key, Walsh! Anyway, as I ever so confidently strode towards that room I passed the trauma bay.  Literally did a moonwalk style double take so I could adequately take in the gaping leg laceration on the table.  And yes, I do know that people probably hate it when they are referred to as the body part in which they have come to the department in complaint of, but get there.  And by there, I mean get to me with my double take.  Seriously, when he flexed his leg there was muscle bulging out.  I stared for a cool three seconds, didn't want to appear too weird guys, and in my head I said. YUP, I'm gonna sew that.  I'm gonna sew the hell out of that.

So, meanwhile I had the disimpaction patient, and I have a seriously funny story that I would love to tell you about that, but, it's the kind of story that cries out for real time facial expressions and wild hand motions, and I am just not sure I have the literary prowess to capture it adequately in word form.  But if you see me in real life, please ask me to elaborate and I will indeed.  Add it to my top three ridiculous medical stories.

Back to the leg lac.  Of course I am standing in the middle of the swamped ED, plotting how to snag the case.  Picture the real life adult version of the anxious toddler potty dance, and I was doing a metaphorical one of those.  I still have some hesitancy in grabbing charts out of order, which is actually a totally encouraged thing to do when you are a student, but the OCD in me feels weird cutting in line like that.  So I just potty dance hovered until room 2A was next in line, and then real casual like grabbed the clipboard and flipped to the intake form.

Case thus snagged, I tromped myself into the trauma bay to introduce myself and assess the situation.  I know it's the past CNA in me that makes me stop before undressing wounds or deciding a patient's NPO status, or making a variety of decisions, because I always hesitate and think I need to get an adult, but then I remember that I am actually the person that I would have gone to get, so I force myself to at least appear comfortable doing those things and making those decisions.  In any case, I did the things, assessed the wounds, ordered the xrays, and presented to the attending.

He of course asked me if I had sutured before.  To which I promptly and gamely replied oh yes.  And while technically that's not a lie, it is also technically true that I have thrown more stitches on dead animals than I have on live humans.  But still, I have done it before.  Six stitches on three seperate occasions say yes, so yes, of course I've done this before.  Old hat and all that.

Side note here, it's remarkable how much I feel like being in the ED is 'fake it tell you make it' as a student.  My classmates tell me the same things.  Have I done injections, well, does a troll doll count? Cause if yes, then yes.  It's exhilarating and terrifying, and awesome, but bizarre. 

So, we anesthetized the wound, which in itself was something I hadn't yet done in real life.  It was awesome.  Needle, meet jagged wound edges.  Repeat.  Yet another time in my life that I actively thought, thank god this doesn't make me want to pass out, because, cool.  

And then I safety pinned my engagement ring onto my shirt and asked for a size 6 sterile glove and got to work.  And I sutured the crap out of that lac.  24 stitches later I had literally quadrupled my previous human number!  While I tucked that muscle back into his calf we talked about his three grand kids, and the crazy cold weather we've been having, and how dry it is all the time in Denver, and what it's like in MN in the winter, and how incredibly nice small town parades are.  The whole time I tried to channel the spirit of my amazing seamstress of a grandmother, and I think I did her proud. 

When I left that shift all I could think was, holy crap it's awesome that I get to do this for a living.  And then I took this picture, and blogger miraculously uploaded it. Case closed.