12 April 2011
Fell on Head
Working in an ER, it is impossible to plan out your day beforehand, to organize your thoughts on the drive to the hospital and to divide your shift's work into discreet plans of attack. You take what comes your way. You try to move quickly. You remain flexible and you hope, when you disappear into a room for the better part of an hour to repair a laceration requiring countless stitches, that your colleagues pick up the slack.
But there are sometimes hints about how the hours will go. There will not, for example, be many patients during the American Idol finale. Then, twenty minutes after it has ended, there will be a dozen or so children with sniffles tramping through the waiting room doors. It will be quiet during the Super Bowl, the Oscars, and countless other television events, only to explode with activity in the moments afterward. And when it is rainy and disgusting those ERs in the city, where people generally walk or take public transportation, oftentimes feel a lull until the downpour has ended.
This sort of variation in activity has prompted me to repeatedly ask, what will the day bring? What can I guess from the date or the weather about what children will be doing? On Halloween I spend the evening sewing up chins. While parents fretted about the dangers of their children talking to strangers or wandering into the street and being struck by a passing car, the far and away winner for the night in terms of most frequent diagnosis was "cut on chin". Children, it seems, cannot be snatched by predators or run into traffic if they are too busy tripping on their costumes and falling flat on their faces.
Similarly, last night had a majority winner, with the triage sheets and tracking board repeatedly reporting "fell on head" next to the name of the child. I spent the evening discussing the risks of intracranial bleeding in the setting of a fall from the monkey bars. I spent more than a few minutes picking mulch out of hair. I was asked on more than one occasion by parents to tell their child not to swing upside down, which I declined to do since being upside down in by and large a wonderful thing and who was a to stifle a future member of Cirque du Soleil? I was happy, however, to caution my young clients to try to remember to hold on.
As spring comes into full bloom, doubtless there will be more broken arms and scraped knees to keep me occupied. Likely there will be nights featuring clusters of "got sand in eye" and "burned tongue on marshmallow". Hopefully the injuries will be mild. In the meantime, might I remind you all that bike helmets, sunscreen, and swim lessons are all a fantastic idea.
Thank goodness for spring.