Three

After today, I only have two more times scheduled to be in the ER. Funny how when I first began this Internship I thought it'd be very hard to get enough hours in, let alone complete the program. And yet, here I am....counting down the final times that I will get to have this hands on experience.

Today started off well. I got to see a man get his shoulder put back into its socket. Apparently, it's been an issue he's had for three or four years now--his shoulder just comes out way too easily and sometimes, try as he might, he cannot get it back into place. He was accompanied by a friend, and the moment I entered the room, I had that crowd pleasing effect of all the guys automatically adjusting their behavior, words, everything. (Note: this change is as evident as the light of day--there's no hiding it, unfortunately)

It took a bit of work on the behalf of the Doctor, Physician Assistant, Nurse and I, but we all got his shoulder back into place. The patient, so pumped up on Propofol was saying all sorts of silly things, but once he came to, he turned out to be quite normal, but still needed his vitals monitored.

And so, I was left in the room with two very silly, very much trying hard to impress me guys. One kept telling me how he and his friends are a "tough crowd" and his friend (the patient) relayed to me how his shoulder just popped out of socket--he was reaching for a glass of water, coughed, and out came the shoulder (?!?!)

Come discharge time, Mr "I'm from a tough crowd" comes up to me as I'm trying very hard to look incredibly busy staring at a computer screen and asks me for my number....in front of some of the other staff members. It generated many laughs, jokes, and high fives, and...a very red face from me.

The best story of my day came when I was ushered into an exam room, not quite sure who was there but based upon the urgency of the tones, I knew it was something serious. Lo and behold, there was a young man with a hand drenched in blood. It was funny--my first thought was "Hmmm. Good special effects". Nice to know my mind is geared towards false movie injuries instead of real life...

So, he's freaking out, his hand is gushing blood and I'm quickly filled in that he was cutting foam with a table saw, was guiding the foam through with his left hand when it got caught in the saw. The end result was partial amputation of three of his fingers, the worst being his pinky finger. It was not only mangled, but his bone was sticking through. I got the task of putting him on oxygen and cleaning up his non injured hand. Try making small talk with someone whose hand is falling off right in front of you.

At one point, the Doctor comes in to examine the hand and give the patient some injections, and Mr. Patient asks "Is there anything I can put into my other hand just to squeeze it?" And suddenly....everyone is looking at me. So, I glove up, hold hands with this guy and he squeezes the hell out of my hand while I try to console him.

Last I saw of him, he was being admitted to the OR, but according to the ER staff, it wasn't looking so good for his hand...the nail beds of his three injured fingers were destroyed, and the x-ray of his pinky showed incredible more than likely un-reparable damage. According to a Paramedic, due to the severity of damage to his pinky finger, it would be un-wise to just amputate that finger--there's a high chance of infection spreading to the rest of the body, so....this poor kid just may wind up losing his hand. Just like that. Word to the wise, don't use a table saw. The damage it can do is incredible.