“Can I have something for the pain?” I say, to no one in particular in the throng around me.
“No one’s given you anything yet?” a nurse responds, surprised.
“No.”
The nurse asks how I’d rate my pain on a scale from one to ten, one being mild discomfort and ten being “the worst pain you could ever imagine feeling in your life.” I can imagine pretty unbearable pain—say, that induced by surgery before the invention of anesthesia, or by being boiled alive like that miserable sod in the novel Shōgun. My pain is intense but bearable, so I rate it a four.
The nurse disappears momentarily and returns with a big syringe of morphine.
“This is going to pinch a little,” she warns, clearly from habit, as she can’t possibly believe a shot could be worse than a hole in the arm, “then you’ll feel a cold sensation in your chest.”
Sure enough, a frigid wave rushes from my left shoulder, through my chest, and down my right arm. It’s bizarre, and amazing, to feel something inside that part of the body, like when a hot drink burns down the esophagus, calling attention to the organ’s existence. Suddenly, I don’t care about the pain. It hasn’t gone away; I just don’t care about it. Rather, I feel the same quietly joyful “there’s no place I’d rather be” contentment I have felt lingering in the arms of someone I love. I believe I finally understand the reason people abuse narcotics. It must be because the feeling is just that good, worth risking a whole lot to experience. I’m none too happy a mere hour later, however, when the morphine wears off. The pain has proved itself a screaming seven at least, which the nurse doesn’t seem surprised to hear when Erica tells her.
Enjoying a second, healthier dose of morphine, I note that the crowd of staff around me has dissipated, leaving two young men in scrubs.
“I’m Dr. Goldstein, and this is Dr. Schwartz,” the taller, dark-haired, blue-eyed one announces. “Ha. Sounds like a Lower East Side comedy team,” he adds under his breath, chuckling. “Anyway. So, what happened here?”
I tell the story, which Erica hears for the first time along with the doctors, and can’t help laughing as I do. It’s impossible to talk about an exploding toilet with a straight face.
“Seriously?! That’s incredible!” Dr. Goldstein says. He’s clearly the more senior physician, as he leads the conversation while Dr. Schwartz sits to the side, listening. “I’ve never heard anything that crazy, and believe me, we see it all here. Well, I knew something big was gonna happen tonight because I couldn’t sleep in the on-call room, and now here you are. So let’s get you taken care of.”
Dr. Goldstein’s jovial manner makes me think there might be cause for optimism about my prognosis, so I muster the courage to ask about it. “Am I . . . going to lose my hand?” I look back and forth between him and Erica, who encourages me with her eyes. She wants to know, too.
“Definitely not,” he says.
“Oh, thank God. Will I need a blood transfusion?”
“Nope.”
“Really? But there was so much blood . . .”
“Body has five liters of blood in it, and you gotta lose more than one before you need a transfusion. Believe it or not, you didn’t lose enough. Must’ve looked like it, though. Arteries really spray.” They sure do.
Erica and I look at each other with relief. The worst-case scenarios thus off the table, we interest ourselves in the long process by which Dr. Goldstein, with Dr. Schwartz assisting, assesses the extent of damage to my wrist. Only, I stare straight ahead to avoid glimpsing the gore, having seen enough already.
First, Dr. Goldstein cleans the wound by placing my right forearm in a square plastic receptacle he’s rested on my stomach and dumping a gallon of some liquid over it. “Oh, ewwww!” I moan, seeing a rusty red wave surge against the sides of the container with my peripheral vision. When will the nastiness stop? Erica and Dr. Goldstein laugh. “That’s not blood, it’s iodine!” they assure me, nearly in concert.
Next, a technician using a mobile unit brought to my bedside x-rays my hand and wrist in several awkward positions, checking for broken bones. Then Dr. Goldstein performs a Doppler ultrasound of my hand’s arteries to determine whether the artery thought to be severed receives any blood flow. The amplified sound of my blood pulsing through the vessels—WHEE-ew, WHEE-ew, WHEE-ew, WHEE-ew—resembles that of a fetal heartbeat, at least as I’ve heard it on TV. The poignant irony that I am hearing this sound for the first time at the age of thirty-nine as a result of an accident, not a pregnancy, does not escape me.
Erica stays with me during these disgusting procedures—fighting nausea, she later admits—despite several invitations by Dr. Goldstein to step outside the curtained bay until the worst is done. Finally, he sits in a chair next to me and asks me to make a few simple gestures with my hand, as he’ll get some indication of which tendons in my wrist are severed by whether I can execute his instructions.
“So,” he says afterward, leaning back in the chair. “Would you like me to tell you what we’ve learned so far?”
“Please,” I reply.
He speaks just a few sentences, then pauses. I hear the words tendons, artery, severed, but can’t glean the larger implications of what he’s said, though he has taken care to speak in layman’s terms. I ask him to repeat what he’s said, then turn it over in my head again. Still, I understand little. The foreign context provides few clues, and the morphine can’t be helping me follow them.
“Would you like to hear more right now,” Dr. Goldstein asks, “or do you want some time to absorb what I’ve said so far?”
I hesitate in responding. What do I want? “Yeah—I could use a little time to think about that, thanks.” I can’t remember even one instance when I haven’t wanted more information on a topic that concerned or interested me, but clearly I will need to learn a lot more about my injury before I understand even a little about its impact.
“OK, we’ll pick it up a little later, then,” he says, smiling. He stands and turns to Dr. Schwartz. “Let’s have the chief come take a look at this.”
“He’s got clinic starting at one this afternoon. I’ll book her in on the early side,” Dr. Schwartz offers.
“I want him to see her sooner than that,” Dr. Goldstein counters. “We can pull him off rounds at seven this morning.” Dr. Schwartz confirms the plan, and the two disappear behind the bay’s curtains to attend to some other unlucky arrival.
For the next several hours, a continuous stream of people parades past my bedside—Miles the paramedic coming to wish me well on his way out, nurses checking on my morphine, and surgical residents (four or five of them, I lose track) checking out my “spaghetti wrist,” as Dr. Goldstein has told me my injury is called, due to the numerous severed, strand-like structures involved.
The string of surgical “consults” makes a great parody of speed dating. Each resident initiates the same conversation: “Can you do this, this, this? Feel this, this, this?” he asks. “Yes, no, no. Sort of, no, no,” I reply. Within seven minutes he’s decided whether my case is sexy enough to warrant follow-up, while I’ve admired the beginnings of a talented clinician, or written the guy off for lousy bedside manner and cowardice in the face of icky wounds. Then we never see each other again.
As time drags on, I begin to think that each new resident stopping by must be the chief, and I am disappointed each time I’m proven wrong. Then I see him—it has to be him—crossing the emergency room toward my bed. His compact runner’s body cuts cleanly through the zigzagging people and rolling beds in his path with no extraneous motion, no drag, and a momentary hush falls over the room while everyone seemingly tracks his progress.
Still loath to look at my wound, I watch from the corner of my eye as he settles himself on the edge of the chair next to my bed. Confirming my guess that he is indeed Dr. Vargas, chief resident of the hospital’s esteemed hand-surgery team, a handful of junior residents quickly clusters around him, presumably waiting for him to speak. He does not. Instead, he remains silent for a long time while, I imagine, he reviews my chart and contemplates my wrist. Stealing a glance at him, I am confronted by an expressionless face, bookish glasses, and a penetrating stare. I turn away.
Without sharing his conclusions, he turns his attention to the question of tendon function, repeating the tests Dr. Goldstein performed to form a preliminary diagnosis.
“Make a fist?” His voice is quiet but assured, a bit nasal with a hint of New York.
I flex all the right muscles but don’t know if I’ve succeeded because my hand is numb and I’m still not looking at it.
“Touch your thumb to your little finger?” I wonder what happens when I try. Eventually the positions he wants to see become too difficult to describe. He needs to show them to me from where he sits, so he can keep his eyes trained on my hand and register its slightest movements.
He asks softly, “Do you think you can look?”
I steel myself, then spend the next ten minutes attempting to copy his gestures, watching the pearly ends of the cut tendons in my forearm reach in vain for their lost mates on the other side of the deep, burgundy wound. The sight is disturbing, yet perversely intriguing.
His exam completed, Dr. Vargas explains that an artery, major nerve, and numerous tendons enabling finger contraction have been severed in my wrist. They must be surgically “repaired” to the extent possible. He also coolly informs me that because the tendons have been severed near the point in the forearm where they become muscle, some of the ends (or stumps) nearest the muscle may not be strong enough to hold sutures. If not, multiple stumps from the hand will need to be stitched to fewer stumps in the arm, depriving me of independent finger motion in my dominant hand.
“Meaning . . . I’d have a paw,” I guess.
“Basically . . . yes,” he replies. He offers no reassurance or sympathy, nor any clue as to how he feels about what he’s telling me, which makes it hard to know how I should feel about it. Only a wedding ring and a dark, artfully shaped goatee betray any desire on his part to be known.
Dr. Vargas rises, confers quietly with Dr. Goldstein for a moment, then leaves. Erica and I look at each other but say nothing. Concentrating hard on the information Dr. Vargas has conveyed, I conclude that it should upset me, but it does not. Significant loss of hand function seems inconsequential, given that just a few hours ago I feared bleeding to death on my bathroom floor. And morphine inures me to anxiety the way a big, fluffy down comforter locks out winter cold. Under its influence, I just can’t get too upset about anything.
Dr. Schwartz returns to the bay, and Dr. Goldstein explains to us all that I have been scheduled for surgery at 3:00 p.m.—nearly eight hours later.
“She’s stable, but we can’t admit her yet,” Dr. Schwartz says to Dr. Goldstein. “So I guess we send her home to wait.”
Erica and I shoot “What the fuck!” glances at each other.
“She’s been through a lot already—I think that’s a little too much to ask,” Dr. Goldstein says. “We’re not too busy; we can keep her off to the side till then.”
Erica and I heave sighs of relief.
Dr. Goldstein sits down and leans over my hand to close my wound for the long wait, halving it with the first suture, then halving each resulting gap again and again until my insides disappear, twenty-six stitches in all. I watch, no longer disturbed by the sight.
“So, what made you choose orthopedics?” I ask as he works.
“C’mon!” he exclaims, gesturing to my wound with shrugged shoulders. “That’s so cool!”
I laugh, perfectly happy to be the subject of a surgeon’s fascination. Surely it’ll help him do his best. “Yeah, I guess it is,” I reply, considering the matter in a new light.
Finished suturing, Dr. Goldstein applies another sterile dressing, then instructs me to keep my arm constantly elevated—until the surgery, and for weeks after—to facilitate drainage of fluids out of my grotesquely swollen hand. Finally, he arranges for some porters to wheel my bed to the quietest part of the emergency room—a dimly lit corner lined with locked supply cabinets.