The day improved dramatically once we stopped rounding, and I could actually go take care of the patients, instead of talking about them.

Then we got one of the requisite holiday tragedies in the ER – child abuse, burns. A beautiful child, completely silent, shaking uncontrollably, not making a sound no matter what we did. After getting ivs and starting fluids, the women in the room thought that washing the child would be good, but as soon as we poured some saline out, the child started acting like a wild animal, grabbing for the water to drink. We could only conclude that it hadn’t been fed for days. 

After sorting out some other medical issues, we had time to clean up the burns properly (initial treatment having been to cover them with saline-soaked gauze, but once it appeared that the child would be staying for a while before transferring to a burn center, we couldn’t leave it like that). Surgeons are like the plumbers of the hospital: anything hands-on is automatically ours. This was one job I didn’t mind (compared to some frustrating Gtube consults) (plus I was standing there literally pushing fluids anyway). We warmed a lot more saline and washed everything down, and then put silvadene all over. Washing burns is hard because it looks like you must be hurting the patient so much, but once you get things clean, putting the silvadene on actually makes it feel better. And of course it made the staff feel better, to have things clean and wrapped up neatly. The aides brought juice and cookies, but by the time we had it cleaned up and covered in warm blankets, the child fell asleep with gingerbread in its hand.

The only problem is now I can’t get the smell of dirty burns off my hands. I slathered silvadene all over the child, and I’ve washed my hands a dozen times, and they still smell like burns that have been neglected for days. . .

The nurses and I discussed quitting work for the evening – and the next several days – and taking the child home with us to cuddle and nurse. The child didn’t even know it was Christmas, which struck the nurses as nearly as criminal as anything else that had happened. Everyone who saw it gave it presents – a very inadequate attempt to apologize for the injustice of life. It’s just as well for the parents that they were not in evidence, because I think they might have gotten hurt if they’d come around the ER staff.

(And no, the child is not an “it,” we’re having a try at anonymity.)

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