Finger Laceration

Between my sophomore and junior years in medical school I had the privilege of working in the medical office of Drs. Eldon and Julian Fairley in Osceola, Arkansas. I was there as part of the Preceptor program from the medical school, which gave students hands-on experience working with family practitioners in small towns throughout the state. Our responsibilities as students included mostly observation, but depending on the doctor and the trust they had in a particular student they would allow more active participation in patient care. Both Osceola doctors were aware that my Dad and brother were doctors and had taught me to do certain things most students at my stage in training had not done. I demonstrated to their satisfaction I was very capable of suturing most lacerations.

One morning a patient came to the office needing repair of a minor laceration to his left index finger. He had been sharpening his pocket knife and carelessly cut his finger when he became distracted. The patient was in his mid-forty’s in age, of average height, but weighing about 275 pounds. He was a cotton farmer, so he was quite strong with broad shoulders. He also happened to be the Mayor of Osceola so was well-known and beloved in the community. When Dr. Eldon examined the wound he announced to the patient; “Mr. Mayor, we have the honor of having Dr. Moore with us, and he happens to be an expert in laceration repair. He has graciously agreed to repair your finger!” With such an introduction I knew I had to do my best suturing job on this dignitary from Osceola.

The nurse set up the suture tray with everything I needed, and I had the Mayor sit on the examining table without lying down. This was a critical error in judgment, and one I never made again in my forty-seven years of medical practice. I took the syringe with the local anesthetic and began injecting the small laceration after I had very carefully cleaned the wound. I was holding his finger with the fingers of my left hand while numbing the wound all the while telling him that this part would only take a few seconds. I was not looking at the Mayor’s face but was intent on getting the finger injected. I noticed he was gradually pulling the finger from my grasp, and I told him, “Just relax, it’s almost numb.” As the force of the pull increased I looked into his face and saw his eyes rolling back and heard him moan and gasp. I was so startled I released my hold on his finger and quickly grasped his shirt as he was falling backwards off the table. My hold on his index finger was the only thing keeping him upright. He was so large his weight pulled me with him off the other side of the table, and our combined size knocked over the IV stand and the light stand with a loud, reverberating crash. I could only think as I was falling over the table, “I’ve just killed the Mayor of Osceola, and my career as a doctor is over!”

When I landed atop the mayor he fortunately began to awaken from his faint and groggily asked what had happened. Dr. Fairley quickly entered the room to see this pitiful scene and teasingly said, “Dr. Moore, this is not quite what I had in mind for your suture job on the Mayor!” I was very thankful the Mayor was still alive, and I had the opportunity to continue my career in medicine. We examined him to make certain he had not sustained any injuries from the fall, and he was fine except for a bruised ego. My ego had also suffered from the fall. I did have enough presence of mind to repair the laceration after we got the Mayor back onto the table, but I don’t think it was my best suturing job. I’m confident the Mayor didn’t care, and he seemed glad to leave the office.

There was not another time in my long career as a surgeon whenever I sutured a finger laceration I didn’t remember this incident with the Mayor of Osceola, and I never allowed another patient to sit up while I injected their finger. I did have a few other patients faint under different circumstances, but at least I didn’t fall on top of them!

Dr. John