Finger in a bag 

“Hello, Minors” I answered to the ringing phone. I was coordinating the minors department today. 

“Hey mate, I’ve got someone with a finger in a bag here on the front door, can I send them round to you?” Chirped the triage nurse casually. 

“Ah g’wan then” I replied. 

Mr Singh waltzed through the doors of our minor injuries department holding one hand in the air with an obvious gap on his hand where his index finger was supposed to be- a roughly applied and bloodied bandage hung uselessly from it and the the other hand indeed holding what looked like a sandwich bag with a lone finger in it. He’d left a nice trail of spots of blood behind him, and our permanently disgruntled cleaner followed behind him furiously mopping away at the floor, cursing in punjabi under his breath at the patient, gesturing between the patient and the floor. He has never given a shit about people- in fact he hates people (I empathise sometimes to be honest…), but by god he ran a clean Emergency Department. The nurses used to do their best to avoid his wrath if they’d made a mess on the floor, be it applying a plaster cast or some unfortunate patient had bled everywhere. He was a shark with a mop. He smelt blood, and he’d be there behind your shoulder without you realising, armed with his trusty mop and trademark scowl with punjabi cursing and gesturing under his breath. I’d grown to relish his appearance after a bloodbath in resus where you’d dealt with a heavily bleeding patient. When you didn’t expect it, amongst the silence and taking in the scene in front of you, he would appear to the side with his mop and bucket, hands on hips sighing heavily- the angry punjabi barrage just moments from beginning. 

I’d already set up a room for the patient to come into, complete with all the necessary bits and bobs that we’d need. A mountain of bandages, stitches, ring tourniquets (finger sized tourniquet basically) and I even wheeled in the minor injuries specialist doctor to have a look. He’d been in the department longer than anyone could remember, and breezed about the chaotic department with casual optimism and happiness, defiant (or oblivious) to the obvious metaphoric fires in the rooms around him. Despite some of the mangled, wretched cases he dealt with in front of him, he was unnervingly jolly and blasé about the whole thing. I remember one case in my very junior days as a nurse, he was explaining to me the anatomy of the hand, and how to deal with certain injuries, whilst holding the mangled hand of a patient who’d crushed it in a press machine- flicking blood everywhere and oblivious to the patient’s uncertainty at his joviality, before turning to the patient and declaring “Heyyy! Young man your hand is gonna be just FIIIINE. You relax we’ll get you patched up in no time eh?” Giving a pat on the shoulder, as he departed the room to fetch the stuff he needed. None the less, he was a brilliant doctor, and very good at what he did, he regularly worked miracles from often irreparable situations. I think he’d just done so much of it that he saw injuries and not patients. Which was fine to be honest, it came with a certain reassurance for patients that he was going to sort it out. 

We first cleaned up his wound and had a proper look at it. There wasn’t much to clean up to be honest, it was just a mildly bloodied stump, and it looked like a gorier version of a cross section cut out of a tree, the rings and centre dot (the bone obviously) visible. 

“So er…..what happened then mate?” I dared to ask. 

He began to explain how it was his anniversary and so for his meal that he was cooking for his wife he went and bought a nice new set of knives (for those not medically minded…this is the cats part. We don’t need this…just tell us what happened), and he decided to go for the more expensive range of knives as he felt they’d do a much better job of cutting. Anyway he had a nice leg of lamb that he’d gone specifically to M&S for (none of that “cheap factory produced crap from Asda”) on the chopping board, and he was also dog sitting for his sister so they had a nervous Labrador who was pacing around the house a lot and barking at anything that happened outside. So, just as he’d seasoned the leg of lamb and prepared it to go in the oven he decided he wanted to dice it up (seriously….get to it….WHAT HAPPENED? HOW AND WHY DID YOU CHOP YOUR FINGER OFF!!!) So he got his new knife out, and just as he was swinging down to chop it up, the dog barked, causing him to avert his gaze in a fright and he chopped down hard. He realised he’d missed where he wanted to cut so moved the leg of lamb over a bit, when he noticed there was more blood than he expected. As he moved it, he saw his finger on the board. Realising what he’d done, he immediately began shouting for help. He yelled at his nephew that was present to bag his finger up hastily, and they both jumped in the car and came to ED- and breathe.

So here we are, finger in a bag, a sheepish husband, a disconcertingly jolly consultant, a disgruntled cleaner and a derisive A&E nurse still to this day wondering how people manage to do this to themselves. Seriously though, could that not have just been “ah well I hit me finger instead of the lamb chop”? 

Next up, as is routine with missing limbs or body parts, a trusty x ray. Yes, this is to confirm that said body part is indeed missing, but also so we can see what the extent of the damage is. In this case, we needed to see how much of the finger was missing- including the detached finger in the same image, as if in some grotesque form of mockery. As if to say ‘hahaaa! here it is! The bit you lopped off, not attached!’ Yes, its sort of stating the obvious but really it’s so we can see it’s an exact match, whether it’s a clean cut and what’s missing if anything. Which, in this instance proved to be the case.

After deliberating with the consultant, I approached Mr Singh, a bit confused. 

“So erm…we’ve looked at the x ray and erm…have you got any more erm…finger?” I struggled out, trying (and failing) to think on the spot how to phrase it better.

Bewildered, he looked at me, mouth agape, unsure of what I was asking. I tried again.

“So er, on the x-ray. We’ve had a good look and we can see that there is a missing bit of finger. Are you sure you brought all of it?” 

“Young man!” The consultant burst in jovially, swishing aside the curtains on his entrance with grandeur. 

“Did you do a double chop with the lamb jalfrezi eh? Did you cut the finger twice??” He said with a chuckle. 

I turned my head to him in an obvious slow astonishment, trying to stare daggers into the side of his head to not be so bloody cack handed. Yes mate, he chopped his finger once, and then decided he didn’t do it well enough the first time so had another go. Of course he bloody didn’t. Mind you, if my experience in ED is anything to go by, I really wouldn’t be surprised if someone did actually do this. 

“N….no I…no only once…no we picked up the finger, I don’t know I didn’t see I was….Jameel?!” He turned angrily to his brother, the poor soul entrusted with retrieval of said finger. Jameel started to stumble and fluster, of course he picked up all the pieces there was only one!

Scenes played out in my head, of Jameel chasing around desperately after the mischievous, waggy tailed family dog with the missing piece of finger in it’s mouth, thoroughly enjoying the exciting game of catch-me-if-you can, whilst painfully oblivious to the anger and desperation from Jameel. “Bad dog!!! No! Drop it! Bad dog! BAD!!! DOG!!!” 

Another scene floated by in my head, of Jameel doing the morning hoovering at home, stopping in confusion at the odd rattling and juddering from the Dyson, as he raised the dust collector bin in slow horror to his eyeline seeing said missing piece of finger. 

Honestly, we never got to the bottom of where the missing finger went. I don’t know if they managed to reattached the remaining bits of his finger, though I highly doubt it. Sorry for the anticlimax, but this is the reality of A&E nursing- we spend forever getting into a good story and then never finding out the ending or getting to take any credit for it. The wards or theatres always get that bit. We spend our lives frustrated wondering what happened next. We’ll resort to digging though their notes on the system to see what happened, begging the receptionists/clerks to dig out the notes and tell us what happened whilst juggling whatever we’re doing at that moment in time.

So no, I never found out what happened to Mr Singh , or his finger. 

On the other hand, he was fine…

I suspect he fell out of touch with cooking after that……..

No, YOUR jokes are shit.