Saturday, September 09, 2006

Anatomy

A lot of television things are about other things on television.

Your life probably is not one of those things.

Thank god, or whatever.

Try discussing Anselm's Proof with an 8-year-old. You will be happy you did.

"Perfection."

Pink Floyd. Anthony Braxton. Dan Hicks and his Hot Licks. The 2nd and 3rd string quartets by Elliot Carter. Switched-On Bach. All at the same time?

Lisa was a bit more busy than I was so I asked her what she had going on, and she said I could hold up Mr. Beaver's leg while she changed the dressing. She dashed off to the supply room while I went into Mr. Beaver's room and started to unwrap the gauze from around the entire length of his lower left leg.

Though never assigned to Mr. Beaver, he recalled me because I'd held his head still and encouraged him a couple days ago when one of the other nurses sunk a duotube down his nose to feed him Jevity or something, because he wasn't eating enough on his own.

I unwrapped the dressing and asked him "So, what happened?" and as I continued to peel off bloody 4X4 after bloody 4X4 gauze he said "I fell off my bicycle and nicked my leg and it got infected." After I'd peeled off several packages worth of messy 4-inch-square gauzes the wound appeared in its perigee, resplendant as the recent full moon.

Impressive. Staring at an exposed length of 10 inches of tibia is impressive. There's gotta be another word for it but the shock of seeing so much exposed bone on a living appendage sent most other words right out of me. That just tells you that I am not an emergency department nurse. They'd be making dog-bone jokes.

His foot was pink. A little "x" mark cued me into the dorsal pulse, which was easily palpable and non-obliterating. Unbelievable. The foot was basically fine. When the dressing and wrap were in place it looked as if he had a regular lower leg. But he didn't. The shin and calf above it were both debrided away, leaving a bit of calf muscle to fill out the ghost, somewhat imaginary, of a human lower leg. Shin bone exposed. Story at 6.

There was no skin nor muscle tissue covering nor accompanying either side the tibia. It was exposed for its length from the knee to the ankle. I swear I could have rounded a gloved finger behind it, only to have my finger clear the back other side of that expressionistically-exposed length of leg bone.

An awful image, though the patient talked and went on as if this were a pimple on his priest-white butt. Or rabbi-white butt. Or Imam-pink butt. Butts are butts. We had best accept that principle lest our differences lead to a violent self-immolation of all mankind.

3 comments:

Sid Schwab said...

A well-rendered picture of a wound that's gonna be big trouble before long, odds are. Might be time to see a plastic surgeon to swing something in there. And the way things are nowadays, it's not hard to see how you took the sight beyond the singular into the reality of our world.

may said...

like you, wounds always impress me...in an eerie way, it is amazing how things happen. and much more, howthey eventually heal, irregardless of time.

hope your week is less crappy this week :)

DisappearingJohn said...

Actually, the ED people all have our own things that get to us. Wounds are actually pretty cool, they don't bother me a bit.

Now, lung butter, that's something else... I just can't deal with sputum...