A Voice in the Wilderness:
I Know What To Do
The explosive combination of young people and alcohol has kept medical
providers gainfully employed since the days of Hippocrates. Michael Discenza.
Our hero was a gigantic Popeye-looking kid with massive forearms. He clearly was no stranger to the gym. He presented to the clinic on a Saturday afternoon. Saturday afternoon was when the good stuff invariably slithered in.
He had been attending a rocking frat party the night before and was three sheets to the wind. In a fit of playful stupidity he had scooped up a handful of ice and thrown it at a friend. In his sordid state, the ice ball obviously missed its mark. His buddy scooped up the discarded bolus of ice and threw it back. My new pal reflexively raised his forearm to protect his face — ultimately preserving the kid’s striking good looks.
His friend had inadvertently scooped up a generous piece of broken beer bottle and hummed it back with the ice ball. This big shard of jagged glass tore deep into the lateral aspect of Popeye’s elbow, severing a sizable artery along the way. The wound began pulsing blood like Dracula’s garden hose.
The collective of drunken college students immediately and vigorously came unglued. A few in attendance of both genders were unaccustomed to human blood, particularly in such prodigious quantities, and reacted poorly. There was honestly only one solitary example of sound judgement exercised throughout the evening: no one drove to the hospital.
Somebody generously donated a t-shirt to the cause. This altruistic gesture didn’t do much good. Things were looking bleak. Then a voice in the wilderness spoke up. “I know what to do. I saw it in a movie.”
Nothing transforms a good day into a great day at work like a little gratuitous gore.
This ersatz practitioner of the healing arts somehow produced a butter knife and propane torch. They further lubricated the victim with distilled spirits to dull the pending undeniable agony and then liberally doused the wound in tequila, something that also likely stung a bit. They then proceeded to physically restrain the kid for his own safety.
Once they had the butter knife heated cherry red they pressed it deep and hard onto his flesh. The patient lost consciousness. Their healing work now complete, the kid’s buddies relocated him to a couch in the frat house to sleep it off. He proceeded to sleep the sleep of the dead, bleeding vigorously and with enthusiasm all night long.
The following morning someone thought to check on the kid and was shocked to find that the couch looked like something out of a slasher movie. At least by now they were all sufficiently clear-headed enough to drive safely. His friends bundled him up and brought him to me. What greeted me when I pulled the blood-soaked t-shirt clear was memorable to say the least. I did, with the benefit of hindsight, wonder what ever became of that couch.
The lateral aspect of this poor kid’s elbow looked like something you might obtain in a sack from the drive-thru at Cap’n D’s. The wound was maybe an inch and a half long and was still spurting with some vigor. I cleaned everything as best I could, numbed it up, and went exploring.
Addressing traumatic wounds is great fun once you get past the obligatory aversion to gore and the invariable associated human suffering. Every example is just a little bit different. The basic techniques are the same, but the specific application is unique to each circumstance. I appreciate that this sounds terribly ghoulish, but nothing transforms a good day into a great day at the clinic like a nice chainsaw to the thigh.
This pumper was fairly deep. So deep in fact that all the ad hoc high-temperature emergency therapy had not come even remotely close to the source of the bleeding. I isolated the severed artery and tied it off with a figure eight Vicryl suture before closing the wound by layers. Approximating the exterior skin was like trying to sew broiled fish.
I dressed the carnage and educated the now thoroughly sober kid on proper wound care. I gently inquired as to whether or not he planned ever to do that again. He answered in the negative. Never underestimate the capacity of the young human male for unfiltered stupidity. It’s a wonder any of us survive.
