Warning: Not for the Faint of Heart (Seriously, Don't Read if Squeamish)

I cut my foot last night.  In the kitchen.  With the serrated knife.

I was wrapping leftover chicken in aluminum foil when a felt a searing pain in my right foot and then a loud crashing sound.  The knife I had used to cut the chicken, which is entirely metal, including the handle, had fallen off the counter and landed, blade first, onto the top of my foot.  I couldn't bear weight on my foot, so I hopped around stupidly for a few seconds while my dog ravenously lapped up the blood that had dripped onto the floor.  If you ever thought for a second that dogs aren't disgusting creatures, please allow your visual imagination of my experience to change your mind.  I finally got the good sense to sit on the floor and examine my foot.  The gash was on top, about three inches from my inner ankle and was bleeding an impressive amount.  The length of the gash was about 2 1/2 inches, but it was to the bone in depth.  My big toe was pointed downward involuntarily, so I knew then that: A. I had to get to the hospital and B: surgery may be in my future.

Without much forward planning, I hobbled to my bathroom to grab some toilet paper so I could blot the blood that was dripping down my foot off of my toes and then hobbled out of my apartment down the stairs to ring my sweet neighbor's doorbell and hope that she answered.  The lovely Eleanor opened the door and didn't hesistate to agree to take me to the ER.  I sat in the hall in front of the building's front door while Eleanor went to my apartment to fetch my wallet and a pair of flip flops.  She had given me one of her towels to hold pressure on my wound in the meantime.  She then pulled her car up to the door and I hopped down the steps and climbed into her car.

"I don't mind if you bleed in my car."  Kinder words I had never heard before.  Eleanor, who deserves some Georgetown Cupcakes or something, parked at the front entrance of the ER, went inside the building, and came out with a tech pushing a wheelchair.  I couldn't help but laugh at the ridiculousness of my situation.  I was in a bright yellow t shirt, gray baggy gym shorts, one flip flop on my left foot, the other in my right hand, and a white, blood-stained hand towel draped over my right foot.  I heard a beeping noise while being wheeled in and I realized I had put my cordless land phone in my pocket before leaving my apartment.

This ER was not busy, and I was whisked into an exam room, but not before a tech had taken my vitals.  I was really nervous.  My pulse was something like 110 and my blood pressure was 140s/90s.  Despite the ugly gash, I wasn't in any pain.  The bleeding had also stopped by the time I had arrived at the ER.  By this time, Eleanor had left only after I declined her offer to stay (she had gone over-and-above already).  She gave me her phone number in case I had trouble getting a cab home.  Is this woman not an angel?

Now, this is my hospital.  I work here.  I was in the ER as a consultant 24 hours before then.  I really didn't want any of my residents to see me in such a ludicrous situation.  They didn't.  My first visitor was a very young woman, a fourth year med student.  I was very tempted to ask to just see the attending, but I believe very much in the process of medical education and now was not the time to be a hypocrite.  The woman was very kind, confident and competent.  She was also gently, which was a godsend.  Although it didn't hurt at the cut, just the right amount of manipulation of my toe was torture. She excused herself to get the resident, but instead came back with the attending.  The attending was also kind, confident and competent.  They were a good team.  They grabbed supplies and got to work, all the while explaining what they were doing.  The attending numbed the laceration with lidocaine, which initally burned like fire.  I involuntarily moaned and immediately thought about the numerous times I'd injected that wretched medication.  Why did an anesthetic have to hurt so much?  Relief came soon after, and the doctor irrigated and examined the wound, which was clear down to the bone.  She couldn't see the tendon, and she suspected (I did too) that the tendon to my big toe had been severed.  She scrubbed the laceration, sewed it up and cleaned the blood off my foot.  She sent my nurse in, who was excellent, and he dressed my foot.  I felt so much better psychologically just knowing that gash was closed.

They nurse fitted me for a hard-soled shoe of sorts.  It has a soft heel, and the top is two pieces of what I assume is nylon that come together with adjustable velcro straps.  I could actually walk on my foot because the hard sole supports my big toe.  Dear reader, if you've never had a foot injury, know that the big toe is essential for balance.  I can't live without this cheap-looking but effective piece of footwear.

The ER physician came in and told me she had spoken with an orthopedics resident and he said I should see one of his attendings on Wednesday.  Then, in a flurry of activity, I was discharged.  If an ER experience by definition can't be described as pleasant, this one at least wasn't terribly unpleasant.  I was extremely grateful.

I called a cab.  I waited.  And waited.  And waited.  Finally I decided one wasn't coming anytime soon, so I called Eleanor the Magnificent and she gave me a ride home.  She even offered to take my dog outside for me the next day.  Can we say grande dame?

I didn't get to sleep until 1:30 in the morning, but I still got up at 5:30 and left for work before 6:30.  Yes, I worked.  I was on L and D in the morning and saw patients in the afternoon.  People were very nice to me today, although my efficiency was slowed tremendously.  My medical assistant, Terry, brought me water and ibuprofen, which helped me get through the second half of the day.  I felt pampered.

Oh, and in case the dear reader is wondering, Keith was out of town for all of this.  He's been very supportive over the phone :)

My appointment with the orthopod is tomorrow.  I'm nearly certain he's going recommend surgery, which is fine by me.  I can't wait to get the use of my big toe back.  

And wouldn't you know, I locked myself out of my bathroom this evening.  How did I do that?  I turned the lock before leaving the bathroom and shut the door.  I felt like a Mensa member.  I screwed off the door knob with a (very flimsy, harmless) steak knife and played with the mechanism for about 30 minutes before resorting to Google for further instructions.  I finally got the damn door to open, and I'm just too tired to try putting the door knob back on.

I got in about 30 minutes of practicing today.  Only long tones and harmonics.  I actually made good on my promise from yesterday's blog post to record my session.  It's getting late, so I'll upload the sound files later this week if I can figure out how.  I'm on call tomorrow, so hopefully I'll get in a better practice session.  If call is busy, I don't know what I'll do.  People will just have to hold those babies in until I can hobble to their deliveries.

Here are a couple of pictures of my foot before it was stitched and cleaned.  Note the downward pointing toe.  Again, I have no control over this.  I hope I don't lose my relatively small audience, but these are too good not to share.  Until next time ...