The Girl With Kaleidoscope Eyes

Tuesday evening my left lateral  malleolus (the bony protuberance at the bottom of the fibula on the outside of the ankle) was fractured as a result of a blow from a hard and dense flying object. My left cuboid (a small bone in a cluster of bones just above the metatarsals) also endured an evulsion fracture, which would have happened when I fell to the floor following the initial impact of the flying object.  My anterior cruciate ligament was also partially torn. Mild displacement of the malleolus was present. I was initially given a soft cast and told by an orthopedic resident to see an orthopedist on Thursday, but the attending physician supervising me for my gastroenterology rotation called me very early Wednesday morning because the orthopedist and radiologist who had reviewed my x-rays recommended surgical setting of the bone (open reduction internal fixation, or ORIF, it's called, meaning that the bone is put into place, then a plate is attached, usually with screws or pins).  Concern about possible damage to dorsalis pedis artery dictated that surgery needed to happen sooner rather than later. My brother drove me to the hospital at 4:40 a.m. on Wednesday, and I was immediately prepped for surgery.

My surgery went exactly as planned, I was told. I somehow thought in my drug-induced haze that I had a boot over my injury, but the area has been enclosed in a cast to my mid-thigh -- higher than it would otherwise be  because of the injury to the ACL. The doctor really wants me ACL to heal without surgery, as do I. I will need to use crutches for six weeks. I'll be in the hospital until Friday. I may be allowed to return to work as early as Tuesday.

I'm not really hallucinating now, but neither am I feeling much pain. Negotiating for drugs has been a bit like participating on "Let's Make a Deal." Fentanyl seems to be the drug of choice these days, but I dislike it and fear it. I don't care for morphine, either. I'll deal with Demerol or Dilaudid if necessary, but's that's as far as I want to go with IV pain killers. My brother already filled my prescription for Vitamin V that one of the residents gave me Tuesday night, so I can use those if there isn't time to fill whatever the surgeon gives me when I'm discharged from this place.

My supervising attending physician has been very kind to me, especially considering that the accident wasn't in any way connected to him. I had already put in a full 50 hours for this week by the time I left the hospital on Tuesday night. I did so last week s well, which means that I'm ten hours ahead.  Still, he's taking the position that because the accident happened at work, I should not be penalized  for needing to be off work any more than I would be if I were a paid employee of the hospital and now on Worker's Comp. (From what I've heard about worker's Compensation, I'm very fortunate not to be dealing with the nightmarish red tape associated with it.) My uncle was injured on-the-job when he was a resident. He told me that if he were ever injured on-the-job again, he would drag himself home and would lie with his hand on a stack of Bibles if necessary in order to convince everyone concerned that the accident had not happened at work and was, therefore, not subject to Worker's Compensation regulations.

I was concerned about an earlier blog I had authored describing the accident, as I didn't want to suffer any wrath from my medical school's powers that be. He asked if he could see the blog. I brought up a draft of it that didn't identify my URL (I don't need additional scrutiny). He read it and said it was fine. It painted my former supervising resident in a somewhat negative light, but, he said, deservedly so, and was mostly a recitation of events with the minimal judgment  of only a few adjectives interjected on my part as commentary to the dialogue offered by the former supervising resident.  Since I have no intention of suing anyone, it's fair game, he said,  to share what was said in the heat of the moment. Since I'm not naming my medical school, my administrators don't have to fear being made to look bad by my recounting of the events.

I was set to begin my sub-internship in October. My preceptor was contacted, and she made the necessary contacts in order to delay my externship until November. With some specialties, it really wouldn't matter one way or another if I were in a cast, but with a pediatric surgery specialty, I will need the ability to be on my feet. I will have my neonatology clerkship following this one, and will then fulfill my sub-internship. In some ways it might be better to get a bit more experience with neonates before potentially assisting with their surgeries, anyway.

If I were a religious zealot, I might say the leg injury happened so that my schedule could be changed for the better. I'm not a religious zealot, though, and I don't believe that silly line about everything happening for a reason. The flying object hit my fibula because I was in the wrong place at the wrong time. Period.

Perhaps I look a bit this way right now. IV opioids are potent.