Chronicles of Chaos
Emergency Rooms
Saturday afternoon Lyndsey calls, “Waylon sliced open his forehead. We’re driving to the ER, it pretty much stopped bleeding, tell me what I need to know.”
She’s at her nephew’s Bar Mitzvah, they’re hours and hours from home.
I say, “You need a plastic surgeon. No matter what, make them get you a plastic surgeon.”
In the past year, Wyatt cut his face twice. Both times at home, without sharp objects. The first cut was to the right of his eyebrow, and happened on a Sunday. We called an urgent care doctor because pediatricians here don’t work after hours. I love the urgent care doctor, she’s a former ER doctor/homeopath. I can call her cell anytime and she answers. She gives me advice over the phone, she’ll meet me at her office on a Sunday.
She puts a butterfly bandaid on Wyatt’s small cut, it heals and we use sunscreen and then Mederma and now it’s a thin white line that you have to look for to see.
The second time Wyatt fell on the floor and sliced open his chin. It was under his chin so I wasn’t worried about the scar. We got the last appointment of the afternoon with the local pediatrician. She glued it closed. The glue is clear and holds the wound together like stitches, then comes off later in a thick scab.
It’s been several months, and I was too overwhelmed with other stuff to apply Mederma three times a day. The scar is pink, bumpy and would be terrible if it were on his face. Last month, Wyatt had a check up with our regular pediatrician. He looks at the scar and tells me that after talking to a few plastic surgeons, he advises parents always to ask for a plastic surgeon.
Years before getting this advice, I had an ER experience with Michael when he cut his face in a ski accident on a Saturday morning. I asked the ER doctor for a plastic surgeon to sew the small cut by Michael’s eyebrow. The plastic surgeon (there’s only one in the area) wasn’t on call that day, and after a brief conversation with the ER doctor, said no. I tried to sort of politely demand a plastic surgeon, but they were unimpressed. I finally let it go when Michael’s friends in the waiting room said guys don’t care about face stuff. The stitching doctor on call was an ears nose and throat specialist. His hands shook with every stitch.
I call Lyndsey back on her cell, which barely works in the hospital. The ER doctor wants to glue the cut. She keeps asking for a plastic surgeon. The third guy on the plastic surgeon list finally agrees to come to the hospital.
I say thank god.
Half an hour later Lyndsey calls me back. The plastic surgeon won’t sew Waylon’s cut with parents in the room. A stranger is going to strap a two year old to the table to keep him still (which they actually have to do), give him a local anesthetic and then stitch his cut. Lyndsey can’t get the plastic surgeon to change his mind, she asks me is this normal, what am I supposed to do?
I call my doctor sister in law. She calls the UCLA ER and talks to the attending who says it’s old school, but some plastic surgeons make parents stay outside the treatment room. Since Lyndsey doesn’t have another option, my sister in law suggests they focus on supporting Waylon and just go along with the doctor.
I pass on the message to Lyndsey. She’s already accepted that they need the plastic surgeon. Every time we talk she and her husband Steve also are managing the other two kids. They’re doling out calming pills (Rescue Remedy Pastilles
Lyndsey listens in the hallway to Waylon crying as the plastic surgeon sutures his cut. When they let her back in the room, the doctor says it went down to the bone. If she’d followed the ER doctor’s advice to use glue, Waylon would have a train track scar across his forehead.
Lyndsey and Steve drive from the ER to get ice cream for the boys. When I talk to her again they’re back at the hotel, past dinner, past bedtime, the kids bouncing on the beds. They’re packing to leave for home in the morning. The experience was terrible, and at the same time, they navigated doctors, unfriendly nurses and managed three kids at a hospital where they had no allies. They had to prod the doctors to give them the best care for their two year old, without becoming difficult. They survived the plastic surgeon’s conditions, though Waylon’s cries will echo in their heads for days. They stayed present.
I have since called my dermatologist for a plastic surgeon referral, one she recommends for kids. I also talked to a mom of Amelia’s classmate who’s an ER doctor. She tells me not to go to our closest ER, the nurses are terrible with kids, and the doctors not as good as the slightly further away hospital. She recommends academic hospitals (universities) as they have specialists, like plastic surgeons, more available to the ER. Then she says, remember you have eight hours from the time of injury to get the cut fixed.
Lyndsey gets a recommendation for a local plastic surgeon to remove Waylon’s stitches. When they arrive, the doctor’s office feels more like a spa than reception area. The secretary offers them tea, talks to Waylon about his cut, asks him how he’s feeling. Waylon, still wary of all doctors, calmly answers her questions. A nurse appears and continues the conversation with Waylon. She gets him comfortable on the table as the doctor explains how he’ll be helping Waylon’s cut get better. Once the doctor gently starts working on the stitches, the nurse captivates Waylon with her perky voice. Before he realizes it, the doctor’s done.
The challenge of emergencies is there’s no time to prepare. We have to adapt, collect information and make decisions quickly–while controlling the instinctive panic at the sight of our toddler bleeding. Even if we’re far from home, we reach out to our community. We think about who might give us advice, call parents who’ve had similar experiences. We listen to our intuition, take it step by step, and ask for what we need for our kids.
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