THE ON-CALL room was tiny, measuring about eight by seven feet, with most of the space taken up by twin bunk beds and a wooden desk with a computer that connected me to the ever-changing goings-on of the hospital outside the door. There were actually two doors—one that led to the hallway and the insanity of the patient rooms beyond, and one that led to a bathroom that was shared with an adjoining call room. Thus, any time you were on call at the same time as the constipation-afflicted general surgery resident, every one of his trips to the toilet became a team sport. (“Grab the towel rack and try your best not to pop a blood vessel in your eyeball, Jared. We’re going to get through this!”) There were no windows and questionable ventilation, so the room always felt slightly damp. And finally, the body odor, body sweat, and body hair of the last two or three residents who’d slept there were usually present, as the hospital cleaning crew made it to the call rooms perhaps once every four days. The Holiday Inn Express this was not.
But I was not there for late checkout and a continental breakfast. I was there to doctor. I began my medical career as an intern on the plastic surgery service, and it was not as glamorous as it sounds. The days were not filled with fancy face-lifts and nose jobs but with grimy skin infections, hands that had been crushed in car doors, and faces that had gone head to head with steering wheels and lost. For the last three days, I’d been shadowing the junior resident on the service and furiously taking notes on how to write postoperative orders, how to check lab values in the morning, what the best way was to wear my pager (always clip it to the waist of your scrubs, never to one of your white coat pockets, because you can lose your coat; you can lose your pants too, but it’s much more difficult), and what tools actually needed to be in my coat. (Surgeons never carry a stethoscope with them, by the way. Ever. Any television show depicting otherwise is lying to your uninformed face.)
On July 4, however, I sat in the call room on my own for the first time and wiped a thin film of condensation from the wall with my finger. As the only representative of the plastic surgery service in the hospital from 7:00 a.m. to 7:00 p.m., I’d been instructed to call my senior resident (who was relaxing at home, presumably getting ready to head out to a barbecue) if I had any questions or needed any help.
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Were they kidding me? Of course I had questions. I’d been feeling so lost since starting work three days prior, on July 1, that I needed help tying my own shoelaces. But here’s the thing about asking for help in residency: you’re only supposed to do it as a last resort. The majority of your questions could be answered if you did a bit of independent research, and if you did call your superior, he or she would always want to know that you’d at least attempted to answer the question on your own. Show initiative, but don’t be cavalier. Try to be independent, but don’t be dangerous. Trying to find that balance on my first day alone was terrifying. So I sat in the call room wiping questionable moisture from my armrest, willing my pager into silence. But no such luck.
At 11:43 a.m., that little black Motorola box of horrors chirped at me for the first time. I might or might not have spontaneously peed a couple of drops before I got it together. No big deal, right? Happens to everybody?
I picked up the phone and dialed the emergency room. The conversation panned out just like a scene from your average nineties era fish-out-of-water comedy except significantly less funny, as functioning body parts were at stake.
Emergency Room Resident (ER)
This is the ER.
(still damp in the pants)
Hi, this is Dr. Chin-Quee from plastic surgery returning a page.
Yeah, um, cool. So listen, we’ve got a forty-year-old gentleman down here who dislocated his right ring finger when he fell off a bike this morning. We’ve had a couple of residents and attendings try to pop it back in place but no dice, so we wanted to have the hand specialist come and take a look.
Yeah, it sounds like you should totally do that.
So…are you going to come down, or…?
(Oh right, that’s me! The hand specialist!)
Oh yeah, absolutely! I’ll be down in a few.
I got on the computer and looked up the patient’s X- ray, holding my right hand up for reference, as the number of hand X-rays I’d critically evaluated to that point in my life was equal to zero.
Despite my lack of experience, even I could see that his right ring finger looked funny as hell. Suddenly (and thankfully), anatomical vocabulary came flooding back to me from some dusty med school corner of my brain. There was no evidence of fracture in any of the bones of the hand. The fourth metacarpophalangeal joint (the base of the finger) had been dislocated. The finger seemed to be seated dorsal to (behind) the metacarpal bone, which comprised the “palm” portion of the digit.
I had successfully completed step one: determine that the emergency room wasn’t lying to me. Awesome. Now for step two: do something.
But wait, should I do something? I had never, ever fixed a dislocated finger in my life. Maybe it was time to call my senior and ask him to come to the hospital and show me how to do it?
Nah, eff that noise. Was I really going to call my senior for my first consult of all time without even trying to fix the problem? And honestly, what was the worst thing that could happen? I could try and fail and the poor biker’s finger would continue to dangle in the breeze. He might be in a little bit more pain, but none the worse for wear. No, there would be no call to my senior. That day, I would celebrate my Independence Day.
To that end, I exercised one of the great freedoms my forefathers had fought, bled, and died for: the internet search. I logged on to YouTube and typed in “how to fix a dislocated finger.” Please hold your applause. Ten minutes later, I walked through the doors of the ER with the tails of my white coat billowing behind me. Emboldened by the treasures of the web, my swagger was fully flexed. The hand specialist was on the loose.
I walked into the patient’s room and introduced myself as Dr. Chin-Quee from plastic surgery, the title still ringing false as it escaped my lips. The patient looked up, relieved that “the specialist” had finally arrived. I was immediately struck by how tall he was: easily six foot nine, with enormous hands and long, chubby hot-dog fingers. And of course one of those Ball Park franks was jutting out of his hand at an unnatural angle.
“Alright, Doc,” he said, reclining in his oversize spandex riding kit. “Do your worst.”
I’d been running each step in my mind for the last fifteen minutes: numb him with an injection of lidocaine on each side of the joint, flex his wrist, stabilize the palm bone with my left hand, hyperextend his jacked-up finger with my right hand, then push the bone back toward its correct position until I felt a pop, drop the mic, moonwalk out of the room, and give the Black Man Head Nod to the first of my brethren I passed on the way out.
But in the moment, I very nearly froze and ran away.
What the hell was I doing there other than playing dress-up in doctor’s clothing?
There was an expectant patient in pain waiting for my “expertise,” and that impostor bullshit held my hands hostage in my pockets when I needed them most.
But then, like a beacon in the night, the voice of Hollywood actor Bill Pullman spoke to me from on high: his iconic speech as President Whitmore in Independence Day commenced between my ears. I finally understood the feeling those fighter pilots must have had as their president rallied them to fly out into battle against highly intelligent extraterrestrials with every tactical advantage. And it gave me life:
“We will not go quietly into the night.”
I poked the injection into one side of the finger. THHHHWIP!
“We will not vanish without a fight.”
Injection into the other side. FFFFFWUP!
“We’re going to live on.”
And pull the finger slowly backward. SCREEEEEE!
“We’re going to survive.”
Push the finger back down toward its natural position until…POP!
“Today we celebrate OUR INDEPENDENCE DAY!”
Well, holy shit. I fucking did it.
My enormous patient knew immediately that his finger was back in place and couldn’t stop himself from playing a quick song on an imaginary piano. I, on the other hand, had just realized that I’d been holding my breath the entire time and was trying to ease air out of my lungs as inconspicuously as possible. He thanked me and wrapped me up in a glorious embrace that was one part joyous, one part creepy cuddle from an oversize, bony tarantula covered in spandex. Either way, I definitely needed that hug, so I held on perhaps seven seconds longer than was appropriate before I wished him well.
“Hey, I think he’s all fixed, but you might want to get another X- ray just to be sure,” I said to the attending. “You can go ahead and wrap his fingers together for a few days. No need to follow up in clinic.”
That was me doing my best “Tony is cool, modest, and respectful even though I’m secretly feeling like the MacGyver of fingers and I deserve ice cream and fireworks” impression. I didn’t have the heart to tell them that I’d just learned to do that shit on YouTube. Throwing barbs at their pride was not a cool-guy move and was totally unbecoming of the best hand specialist alive.
They thanked me, I left the ER, and I treated myself to a personal pepperoni pizza from Little Caesars—the only twenty-four-hour food option in the hospital, because we love to give our patients and staff easy access to grease, processed cheese, and early diabetes.
Happy Independence Day, ya filthy animals.
Excerpted from I CAN’T SAVE YOU by Anthony Chin-Quee. Copyright © 2023 by Anthony Chin-Quee. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Anthony Chin-Quee, M.D., is a board-certified otolaryngologist with degrees from Harvard University and Emory University School of Medicine. An award-winning storyteller with The Moth, he has been on the writing staff of FOX’s The Resident and a medical adviser for ABC’s Grey’s Anatomy.
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