One Thumb Down

One Thumb to Go

It was 6:00am and things had calmed a bit in the ER. I knew that it would only be a short while until the morning rush began, so I took advantage of the moment of silence to pour a cup of coffee. Somehow coffee is soothing to the soul, at least to my soul.

I saw a young woman escorted over to one of the laceration beds. There was a group of 3 beds that were primarily used for patients who needed stitches. Sometimes they were used for whatever we needed but cuts and gashes were normally in these beds. I looked at this woman and something in my heart felt very sad. She was bone thin and so unhealthy and unkempt looking. She wore very tight dirty jeans and a very faded t-shirt that said “AC/DC” on front. My thought was how did such a thin person find jeans that tight. Her hair was light brown and appeared to want to stick out in every direction with little control. She seemed to be very nervous as her big brown eyes darted about as though she was being tracked by a tiger or something.

My attention was turned to the telephone as a call came in from Cardiology Associates for Dr. M and I got him to the phone. It was for a chest pain patient we had been holding all night. I was certain they would be taking him to the Cath Lab this morning.

My mind and eyes quickly turned back to the young woman in the laceration bed. She was sitting up on the bed even though her nurse had left her laying down. She was rocking back and forth with an erratic rhythm and I was fascinated with her demeanor.  I knew from her chart that she had something wrong with her thumb on her left hand. Unlike most patients who had lacerations, there was no blood dripping nor bleeding through a make shift bandage. 

Dr. M. picked up her chart and headed her way. She didn’t seem to be cooperating with him as he tried to get information from her. He was trying to determine how her thumb got injured and she refused to answer. The thumb was in really bad condition, so much so that Dr. M. asked me to call the on-call surgeon. 

When the surgeon arrived, he was familiar with this patient. He had taken care of her about a year earlier. He talked blunt and boldly to her. He said, “so you are at it again I see!” She peeked up at him then ducked her head down like a small child who was being scolded for jumping in the mud puddles.

The surgeon asked that we call the operating room and get things set up for this patient.

He was going to have to amputate her thumb. I stood there in shock. Amputate her thumb, was he for real?

Then I heard him say, "Gina, I know how you burned that thumb so bad". "Holding that hot crack pipe", he added. "I told you this was going to happen the last time you came in, didn’t I?”  She sat there meekly staring at the floor and nodded in agreement with his words.

I had the Operating room staff on the line and the surgeon came over to speak to them. I walked over to her bedside and asked Gina if there was anyone she would like me to call before she went to surgery. She just shook her head and her hair covered her face down over her eyes but she made no effort to move it. I looked at the thumb and it looked really bad. It had black spots on it and looked almost shriveled. I stood there for a moment and then asked, “Are you sure you don’t want me to call a friend or relative before you go to surgery?” She never looked up again but she said, “No, they wouldn’t care and I ain’t got their number anyway”. I noticed she had pimples or bug bite marks covering a lot of her face, arms and legs. It looked like she had slept outside and mosquitoes had just stung her for hours, yet I was not sure how these marks were made. It was painful, of that I was certain.

I have to tell you I felt so sorry for this young lady. Not because of the situation of her surgery, not because of the marks on her, but for the sadness and emptiness I felt coming from her core. Perhaps she brought it on herself. She may have had wonderful, caring parents but chose the wrong path in life or more likely she may have had no one who really cared to teach her right from wrong. At this point in time how she got here did not matter that much, the fact that she was in this situation was very sad.

When my shift ended and I headed out the ER doors I thought of her. When I showered and headed to my waiting bed, I thought of her. I tried to fall asleep after that long night shift; yet Gina’s sad eyes and poor health disturbed me. Equally disturbing was the fact that nobody cared about her, or at least that is how she viewed it. 

Eventually I convinced myself that this was one of those situations over which I had no control. She was a lost soul whose life was valued by no one, not even her.

I can only hope that Gina healed well and turned her life around. I can only hope that she found safety, sobriety and joy in her life. I have a difficult time believing it ...yet 

I can hope.