Amputation. It’s not a pleasant word. I sit here at my computer as a 51 year old furnituremaker/carpenter/musician, and begin a new chapter in my life as a newly minted amputee.
I have never read a blog, let alone created one myself. I am beginning this one with a few hopes in mind. I think there is value in documenting the struggle from the nightmare of the trauma bay at our local hospital, through the various stages of pain/progress cycles of healing, to the hopeful goal of catharsis and understanding of the new reality any amputee has to face. And to be a little philosophical, maybe those lessons might be of value to intangible types of amputations, such as the loss of loved ones as well.
Out of jointer
I have been a furnituremaker for 27 years. I have had a few close calls, but I have never had a major injury in my workshop. Seven weeks ago (at the time of this writing), on 10/25/2018, I had spent most of a day working at another shop, helping start a project for which they needed a bit of help. At the end of the day, I decided I would ride out to my shop to do a few odds and ends on several of the irons which always seem to be in carpenter’s fires. In particular, I had resawn an interesting piece of walnut that I had sitting in my “too good to throw away, but I have no idea what I’m going to use this for” pile. Being a part time hobbyist luthier, I had been thinking about building a small run of acoustic guitars of identical shape and size, but with different materials. The idea was to see how the different back and side woods would affect a guitar with tops all cut from the same billet of spruce.
I was face surfacing about a 8″ wide by 1/2″ thick piece on a tool called a “jointer”. For those unfamiliar, the jointer is one of the three most fundamental tools in a woodworking shop, along with the table saw, and planer-also known as a “thicknesser”. The jointer is the first tool used to take rough lumber from a saw mill, and begin the process of milling it into a useable material that is straight, square, and parallel. Those three machines accomplish that.
On that Tuesday afternoon, I had finished all the other things I wanted to do, and was about to go home. I saw the walnut sitting on the saw, and decided I would make a few light passes over the jointer to clean up the bandsaw marks and see what the grain looked like. I set the machine for a very light cut, and began passing the board over the cutterhead. I had made about six or seven passes when suddenly, just at the point that I began to put weight on the outfeed side of the jointer, the wood grabbed violently, pulling my hand into the cutterhead.
I remember feeling the intense shock of my left hand entering the cutterhead.
For those unfamiliar with the tool, a jointer is a machine consisting of a spinning cylinder which traditionally hold straight knives, and two tables on which the wood is passed over the cutters. One of the tables adjusts up and down to allow for deeper or more shallow cuts. The purpose is to take rough or warped lumber and make one edge straight, and one face flat, creating a square corner and two adjacent flat planes to begin the process of making useable milled lumber.
This was the smaller of my two jointers, an 8″ 1965 “Powermatic”. It is a nice old tool I bought for 50.00 at an industrial auction (The other is a massive 24″ Oliver). I replaced the original straight-knife cutterhead with a fairly new “spiral insert cutterhead” These heads use multiple small carbide blades set in a shearing spiral configuration which produces a very smooth cut. There is very little tearout on the wood, and there are other benefits. However, these cutters have a much greater “depth of cut” than the straight -knife type. These are aggressive cutters, to be sure.
I remember a deep guttural scream, I remember the scream was the cry of instant recognition of the severity of what I had just done. It was shockingly painful, and continued to be so for around an hour until I actually reached the trauma bay at the hospital 16.8 miles from my workshop.
I switched off the machine, I switched off the lights and power to the shop, I struggled to get my keys out of my left pocket with my right hand to lock the door. This and the floorboard of my van was where most of the blood fell. I couldn’t bring myself to look at the wound in full yet, but I could see several parts of bones dangling here and there. I knew I had not gotten lucky and just lost some skin or a tip or two. This was bad. I could tell however that it was only the fingers, and not the whole hand involved, so I made the split second decision that A) I was not going to bleed out from this for a while, if at all, and B) since A was true, any second creating a tourniquet was a second I could be driving to the ER.
I jumped in the van and cranked it. At the same time I was dialing my wife. I think I told her in probably a very troubled and shrill voice that I had ruined my hand, and to meet me at the ER closest to our house. She corrected me that I should go to the main hospital in Birmingham instead. I agreed and was by then flying down the road to town. She was frantic for me to pull off and call 911. I initially refused because I felt sure that I could reach the ER just fine, and any microsecond waiting on an ambulance, would be one more microsecond in that incandescent pain. She convinced me that I might pass out and have a wreck, compounding an already fairly bad situation. So I pulled off a couple of miles up the road at the locals gas station, where I knew I could leave the truck with thousands of dollars worth of tools, and it would be relatively safe. I dialed 911…and had to run in to get the address. It was like a Ben Stiller movie for just a minute.
It was not like anything I have ever felt, and I feel certain that I did not go into any kind of shock that would blanket the pain. It wasn’t the worst pain a human can go through, I’m sure, but it made my kidney stone feel like a stubbed toe.
(heading) It’s not good
Therein followed a scene of incompetence and stupidity from the responders that only seems to happen in rural locales. Two jurisdictions arrived, and began debating who would take me to the hospital. I sat back in my work vehicle and began to answer what seemed like an SAT worth of questions as I watched a group of people from the gas station slowly gather around with horrified looks on their faces, since I was holding my collection of stuff that used to be a hand over my head. I shouted and cursed and laughed without meaning to. They started a fluid line, and I was briefly amused at the thought of “in one hand, and out the other”. I also thought and cursed aloud, “why the fuck are you giving me fluids sitting here, WHEN WE COULD ALREADY BE HALFWAY TO THE HOSPITAL?!” Then I realized that a young boy, maybe 12-14 was holding the IV bag and looking at his cellphone. He kept absentmindedly lowering the bag, and I said “HEY, it’s back flowing! Get that bag up!”. One of the men on the fire and rescue group must have brought his son along, because upon hearing me he echoed, “Get that bag up boy!”
After the exam, a gurney was bobbled up the broken asphalt of the gas station. At this point the absurdity of the moment was blowing my mind. Again I cursed and yelled, “I fucking drove here, I can WALK! Load me in the damned box and LET’S GOOOO!” They almost seemed like they were dragging this process out on purpose. I have to hold on to the hope for humanity that it took less time than I actually think, and that they were marginally trained, and they were trying not to make any major mistakes.
Then they loaded me in the van and my confidence in their abilities evaporated. As an aside here, I have to say that it was torturous being awake and in a reclined position with a clear view out the rear window of the fire and rescue van. I laughed again without amusement that it sucked being able too see exactly how far we were from the hospital for the whole trip. As I called my cousin who has worked with me for years, but who had moved on to become a construction superintendent, I heard the attendant in the back with me call someone and say these words: “hey…umm, I need some help here…umm, is it 0.2mg per kg of weight for the ketamine, or 2mg per kg? I literally scream at him with my cousin still on the phone, “ARE YOU FUCKING KIDDING ME!!!! You don’t know the protocol for giving pain meds??!!!”. He said frantically, “I’m sorry man, we just got this drug onboard a couple of days ago”. “You have a drug onboard that you have no idea how to administer?!?!…start with the small dose!! NOW!!!”. He says kind of sympathetically, “buddy, we don’t want this to be a trip to the morgue instead of a trip to the hospital.”. Again I berated him, the whole group, and probably every other human for not knowing how to give pain meds in a fire and rescue truck. I the end, there were no pain meds given until I actually was in the ER. Probably close to 50 minutes after the accident.
By the end of the ride, I was again laughing uncontrollably. I have no idea why. I couldn’t stop, and I’m sure it was unnerving for the guy sitting there with me. I was aware of another part of me noticing, and also being unnerved by the laughing.
The first shot of Fentanyl quieted the fire a bit like a sudden rain on a brush fire. By now I was shaking in pain but otherwise ok. Another long list of questions and another shot of Fentanyl. No, I didn’t smoke, yes, I would accept blood. The pain was now under the level that had been making me want to run and hide somewhere… No, I didn’t have any religious qualms about them treating me. My hand was wrapped up gently to the size of an otter…say. A very pretty and calm nurse came up to the right side of the bed and held my right hand as they started to unwrap what they had done at the gas station for transport. I still wasn’t ready to look at the hand fully, so I watched her eyes closely. She had an almost imperceptible eye squint. I said, “pretty bad, huh?”. She asked why I said that, and I said “I saw it in your eyes”. She assured me that she saw worse every day. I said, “I have no doubt, but it’s bad, right?”. “it’s not good”
Another last shot of Fentanyl, 250mg total by that point, and a wrist block. Every hint of pain was magically gone. Pain has a way of focusing your mind in a profoundly singular way. Another funny realization is that you never seem to be bored when you are in intense pain. Angry maybe, frustrated, anxious possibly, but not bored. Now with the pain moved on, the metaphorical sun came out after the tornado, and I could actually think again about what was going on around me.
Can I have a xanax?
To my utter amazement, a xanax pill was produced within seconds. I threw it in my mouth.
“Can I watch?” “Yes” she said without a pause…”just don’t try to help.” She laid out the almost comic assortments of “Various surgical ER props here”
“Ok, what can I do?” The first sliver of grin I’d seen. Yeah. Corny. I felt entitled to a couple.
I looked at it then and saw what a mess it was. Of course, I am not a doctor, but I’m not stupid either. I could plainly see that the cutterhead of the jointer had shredded my fingers into a condition that I didn’t imagine would be salvageable. I took a photo of it for the side with my phone. I’ll probably post it on here in a not-so-easy place to run across. It is not pretty. I started making small talk as she started trimming the bones back.
The surgeon was a bright and confident young woman, a retired Air Force surgeon who had worked at Walter Reed, and whom I was confident had seen plenty of this stuff. I had told everyone that I was a guitarist, and that this constituted my worst fears as such. I believe that she did the very best she could do with what she had to work with. However…I cannot help but wonder if I’d had the presence of mind to call a different surgeon, could perhaps more of the fingers been saved? I’ll never know of course. I watched her trim everything and stitch me up in a pan in the ER.
That’s it. Time to go home with my 5mg percocet prescription.