Warning: Not For the Squeamish

Well, I can't seem to get caught up with my blog entries. I've got 3 more road trips to gloat about (all with beautiful accompanying photos). But with dial up it takes so long to load photos that I may just skip ahead.

In the meantime (in between fantastic weekends), I've been doing the usual clinic, hospital, ER coverage routine. I think I'll relate some noteworthy stories (in broad generalities to avoid any conflict with HIPPA regulations) that occurred while I was covering the ER during the last few weeks.

When covering the ER, most of the time it is fairly boring. Most of the problems are straight forward, and many could be handled in the clinic if it was open 24 hours a day. However, you just never know what could possibly come through those doors. I've always been a little nervous about massive trauma - you know, the combine thresher versus human type injuries. Well I've had to deal with some similar accidents over the last few weeks.

Where I'm working there are two main industries - agriculture and logging. Both tend to cause some rather nasty injuries. Particularly the logging industry has quite a lot of risk. I've had a few loggers already who have had massive trees fall on them or roll over them down a steep mountainside or swat them to the ground after the rope snapped that tied the tree onto a logging truck. Each injury usually involves broken bones. A few had deep puncture wounds where a branch or knot penetrated the back or a leg. All of the loggers are usually covered with dirt, pine needles, rocks, and other debris when they are brought in.

With each injury, it is important to not miss anything that might be lethal or result in a needless bad outcome. Consequently every puncture, gash, or skin laceration has to be explored to make sure there are no foreign objects still within that could cause infection later on. In one case, I could feel some splinters of some sort about 3-4 inches deep down the end of one of the puncture tracts. I wasn't sure if this was pine splinters or splintered rib, so I had to send the patient to the surgeon for further exploration and eventual closure.

Then there was the hand versus wood grinder incident. The backside of the fingers still had skin, even fingernails. Unfortunately the front parts of the fingers were all gone (bone and flesh). About all I could do was give high doses of pain meds, apply a pressure dressing to the bones sticking out of the end of the hand, and send the patient to the hand surgeon.

Through it all, I'm getting less squeamish than I used to be. Repeated exposure to all sorts of unpleasant things tends to dull the shock. This is good as it lets me think more clearly in emergent situations (without feeling the need to vomit or pass out). The downside is that as I lose the ability to be shocked, the repeated suppression of natural emotion bleeds over into other areas in life (where suppression of emotion is not necessarily a good thing).

I think this is why I'm drawn towards the splendor of creation. When I see snow dusted fir tree forests, hear water trip over river rocks, feel a bracing wind sweep down majestic mountains, and experience a fiery sunset lapping against the cobalt sky; my emotions are reborn. Not that I become more distressed by gory ER situations, but rather that I am able to stay connected emotionally in other areas of life. Hence my philosophy: Road trips are to be enjoyed as frequently as possible. After all... All work and no play makes Doc a grumpy boy.