I think at some point I remember mentioning that, as part of our residency training, we learn to work at "mass gathering" events. I had a chance earlier in the year to go to the Bills vs. Raiders game, and yesterday I worked the Bills vs. Browns game where I probably spent about 75% of my time sewing up drunk fans or fans involved in altercations with drunk fans.It's strange, but I don't mind it. I like to suture. It's almost like artistry. You take something that's torn, or cut or shredded and try to put it back together. Of course, the majority of the suturing occurred on people's faces which leads to the added pressure of making sure that cosmetically suitable results are achieved. And, it doesn't matter that the majority of my patients were so sloshed they wouldn't have noticed if I sewed their top lip to their bottom eyelid; my own pride and perfectionistic attitude wouldn't allow me to accept anything but my best.
Now, having said that, it's a challenge to work on someone who's heavily intoxicated while remembering my Hippocratic oath. If you've never had stitches on your face, or seen someone getting them, it's a pretty intimate situation. Especially when I had two patients needing sutures inside of their mouths because they had cut the inside of their lips.
Beer breath is nauseating. Stale beer breath with cigarette tobacco overtones even worse. Of course, the fun patient of the night was the majorly drunk patient in handcuffs who was jumping and fighting the two sheriff's deputies who had him under arrest. The patient needed just one stitch. On his lip.
Ever try to wash a cat? Yeah, the two sheriffs holding him down looked something like that. To top it off, we didn't have a suture kit, and I was using what I had available... a suture removal kit. So, here I was trying to hold the needle with a pair of scissors and getting a stitch into a moving target.
The sheriffs managed to hold his head but couldn't keep him from talking. I guess I didn't think about the possibility of him spitting or kicking out. He managed to stop talking long enough for me to swoop in, throw the stitch, step back and then take another step forward as I quickly tied my knots and then cut the stitch. No lidocaine for him, but given his blood alcohol level, I don't think he even noticed.
OK, that's it for tonight. I need to write about my last patients at Suburban before starting back at the excitement that is ECMC. Grand Rounds tomorrow, so I should have some time to write... cheers! Of course, always in moderation... :)
