One night last month, I was in the ED and one of my patients had this huge gaping forehead wound, open down to the skull, and he had even damaged his facial nerve and couldn't raise his eyebrow. He didn't seem bothered by it...until we tried to numb him up. Holy cow. I don't think I've ever seen a kid this upset. Intranasal Versed didn't touch him. It took the magic of the Child Life Representative (aka My Hero) and an hour and 40 minutes to stitch him back up without putting him under. It was my first layered closure (with the first two done by the attending) and my first running subcuticular (a more technical stitch than your typical simple interrupted, for better cosmetic result). It was EXHAUSTING. And when I got done, I felt like a total failure for how difficult the whole thing had become. I felt like I should have been able to somehow keep it from escalating into a screaming meltdown, and I should have sewn more quickly.
Well, fast forward to today, when I got a lovely email from the attending I worked with that night. She had gotten a call from the plastic surgeon who was following him up in clinic, who said that the wound had closed beautifully and he had even regained some nerve function. He was calling to say well done. Totally made my day. Like I'm not totally a failure at this doctor stuff after all.
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