My final time on call…

A quiet suburb in Stoke was turned upside down when, in a moment of total madness and drug-fuelled insanity, a man reversed his car into a random thirteen-year-old girl at high velocity. The rear bumper smashed into her right thigh and she was thrown backwards against a low garden wall and over a hedge into the front garden of a house.

She was airlifted to Birmingham Children’s Hospital with a shattered leg, a fractured skull but she was conscious and her spinal column, chest and abdomen were uninjured.  After the primary and secondary surveys of her injuries, she is rushed to the emergency theatre.  I join the team of surgeons, anaesthetists, theatre nurses and operating assistants engaged in an intense but calm and orderly activity to treat the girl urgently.

The temporary compressive dressings are removed revealing that the front of her thigh has been blown away leaving torn and shredded muscle. The femur bone is shattered underneath and the huge wound is contaminated with bits of car, wall and dirt from the front garden.

Six hours later the complex fracture is stabilised with an amazing scaffold of external fixators or rods on the outside of the limb but there is still a large hole at the front of the thigh because of how much dead skin and muscle had to removed following the incident. To help keep the wounds clean a special vacuum dressing was applied to gently suck up any fluids. In 48 hours’ time the girl will be taken for a second look surgery, hopefully, by then the wounds will be clean enough to graft with her own skin and eventually an internal metal rod can be used to keep her leg stable.

After the operation, I look around at the scene in theatre; it is like the aftermath of a battle.  I have been a surgeon for over thirty years yet I still marvel at what we can be done as a team when we use the very utmost of our abilities, experience and the technology at hand.  It is a strange kind of privilege for all of us.

I also think about the cost to the girl and how this will change her life – the time she’ll spend in the hospital, rehabilitation process and other long-term effects that she will face because of this tragedy.

I see her the next day, she is bewildered and still in a lot of pain despite very large doses of drugs she has been given. The shock and the painkillers stop her from really expressing herself or understanding what has happened which, at this point, I feel may be a small blessing.

She has been dealt a brutal flash of indiscriminate fate and it seems so unfair that the state of one man’s troubled mind has now changed her life forever.