A large and significant portion of the practice life of a general surgeon involves taking emergency room calls and treating patients involved in trauma such as automobile accidents, gunshot and stabbing wounds, industrial accidents, domestic and workplace violence and injuries sustained at home such as lacerations and puncture wounds. Over the years in a busy surgical practice, I began to believe that I had seen and treated patients with every type of injury. That might have been true until I received a call from the ER one Saturday in mid-afternoon. The ER nurse said there was a 45-year-old man who had sustained a large puncture wound to his left thigh while working on a tractor earlier in the day. “How large is the puncture wound?” I asked. She responded, “It is really big!”
Not knowing what I might find, I didn’t waste any time getting to the ER because of the nurse’s answer of “really big.” I had gotten other vital information from her such as his vital signs and whether he was actively bleeding; whether he was conscious and alert and how much pain he was enduring. When I entered the ER, the excellent staff at the South Arkansas Medical Center had an intravenous line well placed and Robert was receiving fluids, pain medicines and his lab work was already being processed. He was conscious, but groggy from the sedation when I told him I wanted to inspect the wound. As I lifted the sheet to inspect his left groin area, I saw an 8 inch limb from an oak tree protruding from a puncture wound to his upper, inner left thigh. The limb was approximately 2 inches in diameter and I could tell by slightly moving the limb that it was deeply imbedded. The wound was very close to the femoral artery and vein which are the main blood supply to the leg, and because there was no active bleeding, I was fairly certain those essential vessels were not injured. “How in the world did this happen? I asked him. Here’s what he told me:
“I was driving a big tractor this morning clearing land and uprooting very large trees and stumps. There was another man about a quarter of a mile away on a similar tractor clearing this land along with me, but we were not in contact with each other. I saw an oak sapling ahead that I thought I could run over and it would break to the ground. What I didn’t know was the sapling bent over, and when it did snap, the lower end sprang back into the cab of my tractor, passed into my leg, lifted me off the seat and pinned me to the top of the cab. For some reason when I was lifted off the seat, the tractor stopped running or the tree in my leg would have torn me in two. Normally a D2 tractor will keep running until it runs out of gas. I was pinned so high in the cab that I couldn’t reach anything to help me free myself. I reached in my pocket and got my pocket knife and began cutting the limb. Because of the intense pain I kept passing out but was able to hold onto the knife. I was screaming for my friend to come help me, but he was too far away to hear me. After at least 15 minutes I was able to cut through the limb and I dropped to the seat of the cab. At about the same time help arrived because my friend could see the tractor was not moving and he came to check on me. I’m sure glad he did.”
Following the necessary tests and x-rays to determine the extent of internal injury, Robert was taken to the OR and anesthetized for the exploratory operation. Before we prepped the operative site. I firmly grasped the protruding tree and pulled it out. The internal portion was another 10 ” so the total length was about 1.5 feet. The internal injuries were repaired and with the extent of the injuries, it was miraculous that there were no major blood vessel penetrations, which would have surely meant death from bleeding while pinned to that tractor.
During his prolonged recovery, I discovered that Robert was a bi-vocational pastor, and we both agreed that he would now have many sermon illustrations as a result of his experiences that day while clearing land. We also agreed that in God’s plan for each of us, we are indestructible until God’s purposes are completed. From a surgical perspective, it is amazing the extent of injuries the body can sustain and continue to function properly. It is also a wonder to me that some physicians, despite their experience of observing numerous healing miracles, still do not acknowledge and worship the sovereign God who fearfully and wonderfully made us in His image.