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[QUOTE=Simon Bolivar;176947]Part 14: ?He?s stolen my finger!?
After the first day on the Burns ward, I went to my cabin to find a bluey on my bunk. However tired you are, reading bluey?s is compulsive so as I lay on my bunk, I read the most surprising letter from the RG. One day out of the blue she had heard from my Mother, who suggested they all go out for dinner together so they could get to know her & offer each other some mutual support. I was utterly amazed by this revelation. I had only taken one girl home since joining up, Karen a leading Wren Grubber. I said Grubber not Scrubber! She used to kick start Seakings for a living at RNAS Culdrose. I met her on my 21st birthday & a few months later we moved into a mobile home in Cury (known as Sin City due to the numerous unmarried service couples living there). I had taken her home for a w/end to meet the family as things seemed to be getting serious but I made the mistake of telling Mother that she was divorced. Not just separated but legally divorced. Mother said ?Hello? & that was it; for the whole w/end! My father & sister didn?t approve either but were decent enough to be polite. Needless to say I didn?t take any more girls home.
I had obviously mentioned the RG but they had never met or spoken. They didn?t have her address, apart from knowing she worked at RNH Haslar. So I can only assume Mother wrote her letter & addressed it to the nurse?s quarters. I was just as astonished that the RG had agreed to meet them, can?t have been easy. Later I saw a very nice group photo of them together, all dressed up & smiling. I guess we were out of the loop a bit with the mood back home. We did receive anonymous letters from the public wishing us well; small parcels were sent to the troops (stopped in Afghanistan as the Post Office mail claimed not to be able to cope anymore). There seems to have been a ground swell of support of concern & warmth for the troops & those they had left behind. In Mother?s letter that followed later she described the RG as ?She seemed like a nice girl.? Which is Mother speak for single & modestly turned out. At least I hadn?t had to sit there whilst they weren?t through my embarrassing baby/childhood photos!
Next day & I was back on the Burns Ward & I went around with the Consultant as he did his ward round. He was further assessing the extent of each patients burns, up dating the provisional sketches made on the beach in extremis. There are two main methods: for First Aid purposes Wallace?s Rule of Nines is good enough, counting the whole are arm or leg or chest & adding them up for total area burned. The arm is 9% of the surface area of the body so is the head. The front & back of the leg is 9% each side, the chest & back is 18% each & the groin is 1%. The surface of the patients hand is 1%. So as patients are rarely burned over the whole of a limb but in patches, the alternative method is to calculate the area by imagining their hand covering the areas burned. Now I know all doctors think they have sterile hands (one reason infection control is so difficult in a hospital) but this was a Consultant Burns specialist so obviously we were going to do this by the book. He explained to me what he was doing & promptly put the palm of his own hand on every patch of burned flesh of this patient!!! Oh I forgot to mention, he was doing his ward round with a G&T in his hand, oblivious of the insensitivity to drinking in front of those who couldn?t, let alone
looking like a professional alcoholic.
Once his had put the drink down to write up the charts, he decided that this patients fingers were in danger of being lost due to the cooking effect. When the skin has been burnt all around the finger, the skin contracts & cuts of the blood supply. This can happen to the limbs & chest as well. The solution is to use a scalpel & perform escharotomy i.e. cut into the burnt skin along designated lines i.e. avoiding the nerve paths, on both side of the finger/limb to relive the pressure & allow the blood flow to return. This is a medical emergency procedure. He asked me if I had ever done it before. I am sure I looked at him as if he was completely mad. Although it was taught in the training school, I can?t imagine any ordinary medic had performed this since WWII. I might be wrong but the impression I got was that if I had said yes, he would have let me do it (in fact I think he wanted me to do it), so he had to have ago. Anaesthesia is not required & generally there is little bleeding but it is quite dramatic to do & to explain to the patient. As usual doctors & surgeons are lousy at explaining the procedures to patients & the patients generally nod & when the doctor has left the room the patient then asks the Nurse/medic ,what the hell the Quack is going to do. Whilst he went to get a scalpel & probably a stiffener, I tried to reassure Taffy that this was the proper thing to do & the consequences if we didn?t.
So the Consultant went in with the scalpel. He was hesitant & unsure & I wondered how many times he had done it before. It?s possible he only done it a few times since his training, many yrs previously as he was unlikely to come across such burns in then Navy. It turned out in the long term that the fingers were saved but there was significant clawing due to contractures. I met this patient 3yrs later at the Thanksgiving service in London & his hands were pretty useless despite physio & skin grafts. I imagine these days he can tap away using two fingers, on a computer but anything more dexterous would be beyond him. To my mind this injury would prove in the long term to be far
more devastating & life altering than his face, as bad as that was.
I had science teacher who was ex RAF called Mr Garside, who had been shot down in a Sunderland flying boat, which had crashed landed on a Scottish island. He had escaped the plane by using one hand to cover his face & the back of his other hand to feel for the engine exhaust & then turn way from the wing, run for cover. The depth charges then started blowing. His hands were papery brown, his face different shades of brown & pink & his hair shocking white. Apart from the colour of his hair he looked similar to Simon Weston today. Well although we were rather horrified on first seeing Mr Garside, we quickly became used to his appearance & for those who see Simon regularly get used to him as well & then see past it to the person behind the mask. Strangers will always stare as, thank God it?s still a very unusual sight to see such a badly burned & scarred face but to friends & family he?s just Simon. But your hands are so much more important to live a normal & useful life. I dressed his hands & put bags back on.
Next the Plastics Consultant showed our shift of 3 staff how to de-bride hands. This bit isn?t for the squeamish but basically after days in plastic bags, covered in antibacterial cream, the hand resembled a white rubber glove. Remember how wrinkly your hands got as kids, playing in the
bath? Well it?s the same process.
Normally this technique would have been carried out by the doctors on the burns unit, probably in theatre for sterility; onboard neither was an option. We were told to de-bride one hand per patient very 3days. The plastic bags filled up with serous fluid daily & the bags should have been removed & replaced but we didn?t have sufficient supplies or time so we cut the bottom of a corner
of the bag, drained the fluid & put sleek tape across the corner to stop leaking. This obviously meant it was no longer sterile but was the best we could do. So under the age old medical rule, see one do one, we went off to practise our newly learnt skill. As with any such procedure (in those days) we didn?t approach the patient & say, I need to do this to you, it?s quite tricky & is usually done by doctors but I am here to have a go, any objections? We just told the patients what we needed to do, got the gear & got on with it. The patient had enough to worry about, without worrying about things that couldn?t be changed. So I spoke nicely to this poor Taffy & I started...
