black finger

01/06/2009 at 10:19 AM Leave a comment

A normal busy day until man calls and says that his finger hurts. It hurts alot. Turns out he cut off the tip and the surgeons tried to graft it back on–gave it a 50/50 chance. That was 9 days ago! No one has checked it since, he has not removed the bandage since.

The question I asked was: Can you come over now?

The question I didn’t ask: How bad does it smell?

Turns out it was a patient I have known forever and we can give each other a hard time. Makes it a lot easier and much more fun. Carefully I removed the bandage and the graft was black. Not kind of black, but deep dark black, almost melanoma black. The good news was that it did not smell, and the rest of the finger was perfect. Interesting, one side of the sutures pink and healthy, other side black and dead.

He will lose the tip, but that was likely anyway. He will have a shorter finger to remind him of what not to do.

It brings up one of the difficulties in medicine. The surgeon told him to come back in 5 to 7 days. Later when the patient makes the appointment they have nothing less than 12 days. The surgeon is somewhere else by then. The surgeon is busily doing his clinical stuff the front staff doing their appointments stuff and the two don’t coincide. In a small office the staff comes back and asks the doctor if it can wait, in a big hospital like place–the kind of place that sews fingers back on–not so much.

They aren’t being incompetent, it is just very hard to coordinate this kind of stuff. Forty or more doctors simultaneously deciding things on their own. The scheduling people doing their best to accommodate. Like converting a third down and 8 yards, doable but not every  single time.  Part of my job is to look out for the occasional dropped ball.

Domingo

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