Indexing Title: RJPeralta’s Medical Anecdotal Report 08-10
MAR Title: Accidents
Date of Observation: November 2008
During one ER duty, I was able to attend to a 45-year-old male whose left hand accidentally
got stuck under a car he was repairing after the jack give in. Wound flushing
was done and upon inspection, the distal third of the 3rd digit of the left hand was avulsed and was hanging merely
via a piece of flesh. I informed my senior about the case and of my plan of action
which was to disarticulate the said digit after clearing other injuries of the said hand.
Radiograph of the left hand was taken and revealed comminuted fracture of the distal third of the 3rd digit
of the hand, left with associated soft tissue avulsion of the distal third of the 3rd digit of the hand, left. After explaining to the patient his condition and my plan - its risks, and benefits,
he agreed and consented for the procedure. Disarticulation was done. ATS and TT were given. While patient was being prepared for
discharged, he seemed lost and not hearing any of the instructions given. He
kept on looking at his bandaged, newly disarticulated digit, I could feel his pain.
He was at work, doing his job for his family and this happened. I said
I’m sorry but I have to do what I have to do. I told him that he can still work as long as his wounds – physically
and emotionally heals. Accidents do happen.
Some survived unscarred others lose their limbs others lose their lives. No matter how hard we try to avoid this, it can
still happen. What is important is what do we after it. I told him be strong for himself and for his family and he is not a lesser person because of this. He smiled and I could feel hope emanating from him.
I repeated his home instructions regarding wound care, oral medications and reiterated his follow up schedule. A few minutes later, he approached me and thanked me with the promised of being
compliant all of my instructions.
Insight: (Physical,
Ethical, Psychosocial)
(Discovery,
Reinforcement, Stimulus)
Accidents, whether we like it or not, do happen and we, as residents of surgery, must
be equipped of the knowledge and the skills to help a patient recover. But part
of the recovery is the emotional aspect of it. Yes, we are helping them by offering
medical/surgical management of their case but do we stop there? I mean, they
are people who at the start of their days are all apparently well and now this. Try
placing yourself in their shoes. What would you feel now that you have 9 and
a half digits?
Thank you and
good morning!
