I spent the majority of the last few nights in the children's emergency department sewing. I knew all of that knitting and crocheting I learned in some other old life would come in handy in this one. Except these nights, I sewed skin instead of yarn or buttons.
One three year old dare-devil blond
girl hit her chin on the tile floor; it wasn't until I put in the last tiny absorbable
stitches on her stellate
shaped gash that her mom revealed that she was an OB/Gyn
and she never sewed up c-sections that carefully. The chin would never look the same, but considering the injury, it looked much better.
Earlier a boy had been playing alone on the homemade swing that reminded me of our barn swing when he crashed to the ground leaving a sideways check shaped gash lateral to his left eye that required finesse and layering to repair. That one took me a while as his parents and little brother sat and watched, mourning the loss of the McDonald's toy and wondering how exactly
it had happened and glad he hadn't hit his eye.
I like sewing up skin lately. I find it satisfying to repair something so tangibly broken in a profession that often exists in shades of best guesses and protocols. Plus last night, I was utterly distracted for a while for various reasons and the quiet laceration repair rooms or corners forced me to concentrate on something physical and outside of my own concerns.
The other night I spent three hours sewing up an elbow. That young man had gashed his arm on a fence and torn a large triangle-shaped flap of skin away from his arm. The skin hung by one side of the triangle; the other two sides had to be reapproximated
with the point aligned carefully. Deep and superficial layers on that one, too. I lost count of how many sutures, but there were probably 40 deep sutures and between 40-50 superficial ones. I quietly stitched while the tired family joked good naturedly
with their son and teased each other about women and how he was going to look like Frankenstein when I finished. I stood the whole time and my bike wreck wounds started oozing serous fluid which I could feel drip down to my toes. Disgusting, but oddly fascinating
in the same way it was fascinating
earlier in the night to squeeze pus out of an abscess on a little girl's thigh.
Another chin laceration last night was the most straight forward of the evening--straight edges, easily matched, seven tiny stitches. This injury had been from a razor scooter crash into a curb. The mechanism sounded uncomfortably familiar to my bike wreck the other day. The eight year old boy twirled his hospital ID bracelet as I prepared the suture kit and turned my back so he wouldn't see me draw up the numbing medicine with the big 18 gauge needle, "Are you nervous?" I turned back to him, replacing the 18 gauge with a smaller 27 gauge and kneeling down to look into his down-cast eyes. "Yes," he glanced up at me briefly.
I took off the blue non-sterile gloves and touched his hand assuring him it would be alright and telling him that if it hurt, we could fix that, too. His mom moved over to him and took his hand. I changed the subject. He's in the third grade and studying division; he's on Spring break; he has a little sister. I told him a few stories from the farm and he started to relax a tiny bit. He stopped twirling his bracelet and started twitching his feet. His grandmother had just been to visit and he'd lost his previous razor scooter. She'd given him and his sister the choice of getting a razor or a bunch of other smaller toys. His mom said he was the more cautious of her two kids and had chosen the cornucopia
of smaller treasures, but his properly indulgent grandmother had bought him the scooter also. He made out well, except perhaps having to spend his Tuesday vacation night with me.
The three, seven and nine year olds
are not the only one getting hurt with the warmer weather and spring starting at 9:48 tonight. Colin teased me when he called the other night that I'm a 29 year old with skinned up knees from falling off my bike. It does sound funny. So far I haven't needed stitches, though. Just sunburned yesterday when I forgot to wear sunscreen during my yoga and writing at the beach. I look like Hera got into a fight with Apollo and the latter won. My feet are burned and bloody from the wreck and swollen from the fins I used while body boarding trying to give my knees a chance to recover (-ish
) from the crash.
I don't know why I'm pushing so hard again; it feels great to be out and active and not afraid anymore. Perhaps I'm making up for months of uncertainty. Doctors can really have an impact by telling people what they should and should not do. I'm supposed to wear a helmet all the time. I'm not supposed to be in the sun. I'm not supposed to get dehydrated. I'm not supposed to forget my medicine. I'm not supposed to work long hours. Blah blah blah. Doctors are the worst patients, perhaps, but who wants to be a "good patient" when all it means is restrictions. I eat well, I remember my medicines most of the time. I want to live my life. Patients do, too. Living well is a compromise--it's about making good choices. Sometimes it is on the edge of living. And people get hurt at the edges of life.
When I used to race on the ski team in high school my coach said that if I didn't fall sometimes, it meant I wasn't pushing enough. Without the occasional crash, I didn't stretch the limits of my abilities. Johnathon Livingston Seagull learned that, too.
I left my last shift last night in a funky mood. Oddly, I would miss the sewing and slight chaos and constant flow of the ER. And it means I'm switching back to medicine yet again, as a team leader for the first time, which makes me anxious. And I'll miss the peds
residents; they're a friendlier bunch over all than the medicine
ones. Or perhaps I just click with them better lately because I finally feel a bit more comfortable in this new (sunburned) skin again. Mom tells me, "Shine, by beautiful daughter." It sometimes comes easily when I stop trying to hard.
And I awoke to my pager reminding me of Grand Rounds this morning (and reminding me that I should have turned it off last night). Awoke thinking of people who don't think of me and forcing myself to turn on NPR for the distraction of hearing it's the five-year anniversary of starting the war in Iraq. And remembering all the people who do think of me and thinking of Pop in the hospital and Bryce after his hard game yesterday. And thinking of the waves.
I went out for the first time on my own today. I figured out how to fit the board into my car without much trouble. And I found my Harriet Lane book in the process. I turned up the music and drove too fast, "go out beyond the white breakers, where a man can still be free (or a woman if you are one)/my my my it's a beautiful world/ i like sleeping with marie
/ she is one sexy woman."
When I found my book (which I'd been fretting over losing for the past few days), I remembered
also that my bike chain had fallen off the other day--right in front of the store where Mike had bought the bike for me for my 28th birthday
. The brakes went out, too. I stopped with my feet and rolled it into the store where they fixed it for free. Best place for it to break. I went to the beach still and wanted to write in my journal, but had forgotten a pen. A man sitting in his car watching the waves gave me one. I saw him later setting up to go kite surfing; I'd finished writing and gave his pen back.
like this reassure me.
I tried a new break today; much less rough than the one Bernie and I have visited the last few days. The one where I saw the dolphins play the other day. The one where I scamper out on the rocky pier to watch the waves. I jumped in today. It was easier to paddle out without the rip tide; and the waves are higher and more rhythmic
; I can read them better. They still smooshed
me a few times, but I'd come up sputtering and laughing to myself. I made it out "beyond the white breakers", caught a few back in; still hard to stand for me (hurt knees plus inexperience). Being out there distracts me better than sewing skin.
It is beautiful. I balance on my board and paddle around, watching for waves to catch. Sometimes I catch one. Sometimes one catches me. The seaweed makes shadows beneath the water. I play with in between my toes as I straddle the board and feel the sun on my back; it is easier to look west in the morning. My feet bleed beneath the waves but I don't notice this until I'm back showering and pleasantly weary, changing into dry clothes under the towel behind my car, still watching the ocean. I'll be back, for lifetimes I will be back.
I drive with wet hair to the thrift store where I have been meaning to drop off things that make me feel old. The man at the Frosty Freeze lets me park in his parking lot while I drop things off. The Spring Breakers who vacation where I live have not yet awoken and the streets are empty compared to the past few afternoons when I have navigated them on my repaired and well-oiled bike. They will be full later in the day and likely into the night. As I drop off the old clothes and worn out clocks, I'm peaceful from the ocean but still obscurely pensive.
And then I laugh out loud
, with very little provocation. I see a razor scooter in the drop-off bin. I remember the boy smiling after I'd finished sewing up his chin and saying he was going to get rid of the scooter as I give him the syringe to use as a fancy water gun against his sister. And this tiny thing makes me laugh. Seeing the abandoned scooter, I think of pushed edges and repaired breaks and getting back up after falling; and this makes me feel that the universe is unfolding as it should. This pushes me over the edge and make me fall back into joy.
Go placidly amid the noise and haste,
and remember what peace there may be in silence.
As far as possible without surrender
be on good terms with all persons.
Speak your truth quietly and clearly;
and listen to others,even the dull and the ignorant;
they too have their story.
Avoid loud and aggressive persons,
they are vexations to the spirit.
If you compare yourself with others,
you may become vain and bitter;
for always there will be greater and lesser persons than yourself.
Enjoy your achievements as well as your plans.
Keep interested in your own career, however humble;
it is a real possession in the changing fortunes of time.
Exercise caution in your business affairs;
for the world is full of trickery.
But let this not blind you to what virtue there is;
many persons strive for high ideals;
and everywhere life is full of heroism.
Especially, do not feign affection.
Neither be cynical about love;
for in the face of all aridity and disenchantment
it is as perennial as the grass.
Take kindly the counsel of the years,
gracefully surrendering the things of youth.
Nurture strength of spirit to shield you in sudden misfortune.
But do not distress yourself with dark imaginings.
Many fears are born of fatigue and loneliness.
Beyond a wholesome discipline,
be gentle with yourself.
You are a child of the universe,
no less than the trees and the stars;
you have a right to be here.
And whether or not it is clear to you,
no doubt the universe is unfolding as it should.
Therefore be at peace with God,
whatever you conceive Him to be,
and whatever your labors and aspirations,
in the noisy confusion of life keep peace with your soul.
With all its sham, drudgery, and broken dreams,
it is still a beautiful world.
Strive to be happy.
, Desiderata, Copyright 1952.