It was the lady who was in tears, but the 8-ish year old boy who walked in besides his mother was calm. My first impression was a bad knife cut injury to the lady. But it wasn’t the lady who had a big white hanky wrapped around the hand. The boy came close and just said “pin”. I thought, my heart had just skipped a beat. There were two more ladies accompanying the mother to comfort her instead of the boy who was by then sitting on the wooden chair next to me. One of those ladies said that it was not a “pin”, but a “fish hook” stuck in the boy’s hand.
|A Fish Hook
Image Courtesy – AntanO, Wikimedia Commons
I looked at the mother and asked her what had happened. Eventhough she was looking at me, she didn’t respond to my question. Then the other lady who had accompanied her explained to me that the mother was deaf and dumb. She then told me that, it was the mother who had injured the boy unknowingly and that was the reason behind her emotional outburst. After a deeper enquiry, I came to the conclusion that it was actually the boy who was the culprit. His mother had accidentally stepped over the line (string) attached to the hook, which the boy had tied to the leg of a chair. The other end of the line tied to the fish hook was in the boy’s hand at that time. The hook had pierced his index finger, and the “barb” of the hook was lodged deep in the boy’s finger. Even though I was a little taken back by the thoughts of the mother being “differently abled”, my heart was delighted to resume it’s duties at a normal rate.
I sighed and calmly asked her to escort her son to the “Dressing Room”. How big can a fishing hook be? Was she crying loud only because she was deaf? Why wasn’t the boy crying? Isn’t he supposed to be in pain? These questions were looming in my mind when the Nursing Assistant was unwrapping the home made bandage which was surprisingly not at all blood stained. After cleaning up the wound with saline, I had a look at the hook.
It was a small hook, the size of a shirt button, The line tied to the “eye” of the hook was hanging by the side of the hook. The barb was not visible superficially. There was only discrete bleeding at the site of injury. By that time, the boy had started to panic and was refusing to let me touch his hand. I asked one of the lady to stand besides him while attending to him. I tried to calm him by telling him that the hook could be removed easily if he allowed me to administer the local anaesthetic. I guaranteed him that there won’t be any pain at all. The Nursing Assistant and the lady were also trying their best to deviate the boy’s attention. After gloving up and injecting the local anaesthetic, I waited for a few minutes before going into the action.
I knew that the barb of the hook which was stuck in the finger was pointed inwards. I had the sterile cutting blade kept ready for the action. But before I used the blade, I wanted to try a simple method of removing the hook which I was not sure whether it would work or not. Nevertheless, I had to try to find out. I made a simple loop with the line (string tied to the eye of the hook for fishing) around the bend of the hook and asked the Nursing Assistant to hold it for me. Then after making sure that the boy was not in pain, I pushed the hook slightly deeper into the finger (away from the barb) so that the barb disengages itself from the tissue. Holding the hook in this position applying continuos pressure, I clearly instructed the Nursing Assistant to pull the line out with a sudden jerk. The Nursing Assistant was slightly confused, but she did as instructed and the fish hook popped out of the finger just like that. Pheww… even I was relieved to see the full fish hook in one single piece. Everybody was happy again, the air of tension was now replaced with a joyous one. The mother was also smiling now.
I prescribed antibiotics, light dressing with povidone iodine and made sure that the boy was immunized properly against Tetanus. The time was 1:00 pm by then, there were about 30 more patients waiting in the lobby. But I was a happy man at that time and the remaining number of patients and the “time” wasn’t a matter of concern for me then. I had just helped someone and that was “cool” if you know what I mean.