A Full House

Open wound, you said? That took me right back to my days “on call” at night for the Operating Room of a good-sized city hospital in the Boston area. We saw lots and lots of open wounds on a good night. On a bad night, it was knife slashes to the throat, almost severing major arteries, emergency abdominal surgery – lots of causes. Little compares, in my memory, with a spaghetti wrist. What’s that? The National Library of Medicine describes it like this:

“The idiom “spaghetti wrist” refers to a deep laceration of the distal volar forearm. Because structures at the wrist are tightly packed and thinly covered, lacerations of tendons, nerves, and arteries are likely. Exposed tendons on a red background resemble pasta noodles in a bed of tomato sauce. Despite the term being more colorful than scientific, it is accepted by hand surgeons. The expression “full house” is also occasionally used.1 There is, to our knowledge, no alternative, more formal descriptor.”

So there it is—a Full House. The drunk comes into the EW at 2 AM, and you are prepping a room for surgery at 2:30. At three, the anesthesiologist is through expressing his doubts about the patient to the surgery, and the choice of anesthesia method has been made. The surgeon explains that Mr. Smith, in a moment of rage, put his fist through a plate glass window. His hand and wrist now need a relatively comprehensive series of repairs. You will be there for the next three hours while the hand guy, a pair of residents, and an intern sort out the bits and try to shuffle everything into proper order. 

At about 4 AM, the circulating nurse sticks a straw into your mask, and you suck down a cup of lukewarm, overly sweet black coffee – gratefully.

At 6 AM, you break scrub and head to the break room for an hour’s nap. The OR supervisor takes pity on you and allows you to nap until you wake up for an 8:30 case.

Yes, I could have posted a picture of a Full House, but some of you might have been disturbed.