White Girl in the OR

Tuesday, March 27, 2012

Every day I see things that amaze me more than the last. Today was my first day to go into the OR to actually perform a procedure and I realized first hand the shortage of materials and limitations to what we can offer. It was quite surprising yet still very fulfilling.

A 14 yo girl came hobbling in on one leg. They got her onto an OR table and called Dr. Tom. I’m sitting on the couch not even changed from work yet when I hear through the window “Angela?”

At first it startled me a little. I still haven’t completely gotten used to the open slatted windows yet. “Yes?” I reply, recognizing Dr. Tom’s voice. “There is a new case in the OR. A girl came in from a motorbike accident with a laceration on her leg. I want you and Phillip to repair it.” We quickly gather our things and head down to the hospital to meet him.

When I walked in, there was a very frightened girl atop the table. My attention immediately turned to her leg. There was an open wound starting from behind her left knee and making a jagged turn down the inside of her leg. Impressively, she was crying on a little. The wound was covered in dirt and debris and the edges of her skin were torn very unevenly.

We quickly get to work. Dr. Tom leaves to go get supplies and the nurse starts to work on her IV. Soon she is sleeping peacefully as if she didn’t even know how badly her leg was injured and how lucky she was that she could still walk. WE irrigated the wound and dug out dirt and debris for over an hour until finally Dr. Tom brought in suture. Phillip started suturing on her left side. The needle was not a cutting edge needle (the kind you typically use at home) so it was VERY difficult to penetrate the skin. The wound edges barely matched up as they were and there were several time that Phillip had to pull so hard on her skin to get the needle through that I was most certain he would tear the skin more. But, thankfully, he did not. After several sutures on the top of the knee he rolled her leg outwards so that I could try to suture the inside of her leg. It was getting dark and we have no electricity. My eyes were beginning to hurt from all the straining. The dark blue suture was nearly impossible to see against her dark skin. Finally Dr. Tom agreed that we needed the lights to continue further.

I look over at Phillip and he has been concentrating so hard in the hot stuffy room that he hasn’t even realized that there is sweat dripping down his nose. I quickly motion for the nurse to get a napkin. He wipes Phillip’s head and face just before the sweat drips into the wound. My scrubs are soaked and I feel faint so we take a short break while we wait for the generator.

Eventually it cuts on and Dr. Tom returns. While we were waiting I noticed that the wound started bleeding again. I turn to Dr. Tom and ask if we have any gauze to dry the area for better viewing. “We don’t have any,” he replies. So, without gauze or a clear picture of what we had already sutured and what exactly was left, we continued on in perseverance.

After over 24 wide spaced sutures (we had to conserve) and 2 hours of working on a wound that should have taken less than one hour anywhere else, I again look at Dr. Tom and ask, “Do we have anything to clean her with before we bandage her leg?” “No,” he says “but here, try this.” He hands me a large paper like material that is normally used as a drape to cover areas where you aren’t working to keep them clean. I glance at her leg, now covered with dried blood and sitting in a pool of blood/iodine/sterile water mix that was also slowly dripping onto the floor. Reluctantly I scrubbed her legs with the tough scratchy paper until I got it a little cleaner…not clean by any means.

As she was becoming aroused, we began to pick up the drapes and instruments. I asked if I could bandage her leg (still bleeding somewhat) and was handed a roll of Kurlex- a loosely woven stretchy gauze type material that normally is used to only hold a bandage in place. It is non-absorbent, but it’s all we have. I know she will bleed through it in a matter of minutes but I wrap her up and send her back to the ward where she will stay for a long recovery. I hope she knows how lucky she is to have her leg and most especially to still have full function of her leg. I’m certain she will have much suffering during her stay at KWH but I’m also very hopeful she will walk again with no complications. I praise God for that.

They bring in the mobile bed and begin to roll her from the room. I offer to hold the door for them and after such a long period of time in the hot, stuffy, sweat-box of a room, when the hot night air hits my face I let out a big sigh. “Ahhhh, AIR!!!” I yell and they laugh at me. Silly white girl…