Vital Signs – 2nd August 2008

Vital Signs

BMA News, 2nd August 2008

Aidan M. O’Donnell. 

How would you feel if you lost a finger?

I still have all mine, but I am certain I would feel angry and bereft. Having burned a finger quite badly once, I was astonished at how many simple daily activities seemed to require that finger. From the way I did my buttons, to the way I put my front door key in, I became aware that my fingers get on with a multitude of jobs without fuss.

Jim was a 54 year old man who had degloved his finger in an accident at home. The plastic surgeons wanted to repair the finger, but this was going to take several hours. Jim was adamant that he just wanted to go home. He had a plane to catch.

It turned out that he had degloved the finger when attempting to take suitcases from the attic in preparation to go on holiday. This was a much needed holiday, he told me. He didn’t care about the finger. He would rather it were amputated than face a delay to his plans. He wasn’t particularly angry, or frightened. I believed that he meant it. On the consent form, he scored out what the surgeon had written and wrote “Amputation” on it in capital letters.

Rachel was only 32, and her finger was already gone. She had had a malignant tumour of her right index finger, which had previously been removed. The tumour had recurred in the stump of the finger, and she was listed for a mid-forearm amputation. I noticed that all her fingernails were professionally manicured and painted, and asked her about this.

She told me that she had had a farewell party for her hand. Her sister and friends had come round, and they had paid a professional nail artist to do all their nails. Rachel wanted to celebrate all the fun and good use she had had from her hand. Rachel was not angry or frightened either, but displayed fortitude and composure which astonished me. The nurses wanted to remove the nail polish but I insisted that they leave it.

Would I rather cancel my holiday than lose a finger? Without a doubt. But would I be able to bid a fond farewell to my hand, to thank it for all its hard work, and reassure it I would be OK without it? Not in a million years.

In theatre, the surgeon showed me that Jim’s finger could not have been saved anyway. His wife changed the tickets, and they went the next day.

Aidan O’Donnell is a consultant anaesthetist from Livingston, West Lothian.

Copyright © Aidan O’Donnell 2008.
This article first appeared in BMA News on 2nd August 2008.
Unauthorised reproduction prohibited.