(By way of intro…I’ve written about some experiences and people over the last seven months. Since I’m serving in the bush, “Stories from the Bush” seemed to be the logical thing to call these sketches.)
September 8, 2018
Sandra’s dad carried her to the clinic on Saturday afternoon (my first one in the bush). Her brother had been cutting grass with a bush knife, and she walked up beside him. He never saw her. On a long swing, the knife sliced the back of her left ankle.
We (editorial “we”) got her foot unwrapped and cleaned to determine the severity of the damage, which ended up being serious. The knife had severed all the way through her Achilles’ tendon, calling for a surgeon and an OR. Wait, our room is the OR…and one of us is the surgeon…
I got to take in the scene with the eyes of a newbie. Sandra lay on the wooden exam table, quietly enduring the pain. Her dad stood nearby with arms folded, quietly observing. Chelsea and Mom A poked and prodded, quietly discussing the likelihood of suturing the tendon. Emma scurried around, not-so-quietly gathering supplies. I stood by the table, holding a flashlight and trying not to pass out.
Chelsea seemed reticent to begin searching for the two ends of the tendon. Though I didn’t understand why at that moment, I did about two hours later.
The first step was lidocaine. Emma was leading out, so she took the syringe Marie had drawn up and inserted it above and below the wound, numbing the entire area. I’m told it is painful at first, but then immediately puts everything to sleep (which is significant when you’re about to dig around inside a part of someone’s body).
Emma began the suturing process, with help from extra hands. She inserted the tweezers through the groove where the tendon used to be, searching invisibly for something that would feel different from the soft flesh and muscle. Blood is slippery, which makes the process more of a challenge.
After squeezing and slipping and splattering blood for awhile, feeling the tendon but struggling to clamp it, Emma switched out with Chelsea. She leaned in, picking right up with the squeezing-slipping-splattering. Emma (whose face was also in close proximity to the wound as she was holding things for Chelsea) kept jumping at every splatter of blood from the slipping clamps, which could have been funny in another situation.
Chelsea eventually found the tendon on top, clamping it and pulling it down into the opening. The end on the bottom proved to be more challenging, but she was ultimately successful. Once both ends were secured, Emma pulled the two together as Chelsea began to suture them with absorbable stitches. The process looked complicated, more so because of how tough tendons are. This was my first time to see suturing. Talk about total immersion…
Once the two ends of the tendon were re-attached, Chelsea tapped out and let Emma suture the flesh back together. I also switched out with Marie – her turn to hold the flashlight. It was day, but there isn’t great light in the clinic for that sort of job. The little light Landmark gave me has been a huge help for several suture jobs.
I was feeling weak in the stomach and mind. It sounds so simple – “just suture the tendon together.” It’s a two-hour job. At least, this one was. The pressure Chelsea felt was apparent. Tendons are apparently quite significant, if people are going to be able to walk. Having in your hands the responsibility for someone’s ability to walk – that is pressure.
When you walk away from a job like that one, there is just this nagging “What if?” What if we didn’t get it right? What if the sutures dissolve too fast? What if we missed something? If Sandra can’t walk right, is it our fault?
When I closed my eyes that evening, all I could see was her gaping wound and the blood (even after I cleaned the specks off my glasses). In another case, could I handle that kind of pressure with the poise and skill that Chelsea did? I can only hope, at this point anyway.
I went to talk with Chelsea after dinner that night. I was feeling like it may have been a bad idea to come here to work in the clinic, uncertain if I have the ability to respond to needs like Sandra’s. I feel so deeply for other people, but I can’t be immobilized by someone else’s pain if I’m going to help fix it.
That conversation encouraged me. Ultimately, responding to emergencies successfully comes back to a theology of sovereignty. At the end of the day, do I trust that God is in control? You do your best, you give your best, and you trust that God is God and you are not. He is in charge of healing. You do what you can, and you move on, doing your best yet not to let the worry of “What if?” cloud your ability to help someone else.
There is a place to weep with those who weep, but that isn’t the exam table. That is the place to fix what’s broken – with compassion, but with enough emotional detachment to do the job. Cry later, if you have to, but fix the problem that’s in front of you.
And every suture job isn’t like that one, for which we can all be grateful.
