I helped take sutures out of little boy's head today, he had amazing green eyes. Unfortunately a scab had formed over the sutures. I think if the sutured laceration had been cleaned regularly it would have been fine, but it hadn’t been, so the sutures were matted under dried blood. I thought it would be easiest to clean the suture site with gauze and water, but the doctor said it’s better to remove the scab with a scalpel. We did so, but the edges hadn’t solidified yet and so the laceration bled a little and caused the boy a little bit of pain, but other than that he was fine. I’ve seen this kid every day I’ve been in the ER, both of his arms are broken and his face is badly banged up. He had two sutured lacerations, one just above his right eye and the other less than an inch above that. I’m curious what happened to him.
A man a little bit older than me came in with shrapnel in his right hand from a “firecracker accident”; he was missing all the fingertips on his left hand from an old wound. The wound itself wasn’t terrible but he'd gone to an outpatient clinic when it happened four days ago. All the outpatient GP did was wrap his hand in gauze and prescribe “a strong antibiotic”, which one I didn’t ask but it’s irrelevant. When we removed the gauze it was clear that nobody had even irrigated the wound, let alone removed the half-inch wide collection of foreign bodies in it (and, now, the necrotic tissue). The guy had to be schedule for surgery tomorrow morning.
Dr. Ahmed, the doctor who told me about being denied a permit to Jerusalem to see the American consulate, was really upset about this; he said malpractice is rampant at the outpatient clinics. I asked why a doctor wouldn’t have done this properly, since even I know what basically needs to be done to a wound with shrapnel in it. Ahmed said it’s just out of laziness. That’s shameful, doctors like that deserve a swift kick in the face. The guy could have lost his hand if he’d waited two weeks instead of four days to come to the hospital; now he could easily lose a good deal of function and sensation in his hand, either from the damage or from the now-necessary surgery.