Scalpel-stuck

Argh. I had my first “needlestick” injury today. Okay, technically it wasn’t a needle. It was a big bloody scalpel that I grabbed the wrong way. Not much better. In fact, I’d wager to say a whole lot worse. It all happened so fast. I was stitching a central line into place, grabbed my scalpel to cut the suture, and STAB! In shock I looked down at my glove, which was filling up with blood. “Fuck!” I say out loud. (Good thing my patient was intubated and sedated, lest he hear my potty mouth.) The hour that followed was one of sheer terror.

I have many friends and colleagues that have been stuck by sharps while practicing medicine. In fact, one study showed that 99% of surgical residents have had at least 8 needlestick accidents in their first 5 years of residency(1). Regardless, nothing could have prepared me for the flood of emotions that would roll through me when it was my turn.

The first emotion: Anger. How could I let this happen? I'm a surgeon! I work with sharps all the time! I should know better! The anger quickly ensues into self-disparagement. If only I had been paying more attention… If only I hadn’t been so overconfident… if only, if only, if only.
Second emotion: Embarrassment. Great, now the team is going to think I am a total klutz. We have a super busy morning and I’ve just slowed everyone down with my ineptitude. I bet they are never going to let me place a line again. Stupid, stupid, stupid.
Third emotion: Outright fear. My life could completely and utterly change in this moment. This patient just came into the hospital this morning. All I know about him is that he is a drinker with acute pancreatitis. I have no idea if he has a history of IV drug use. Nor do I know anything about his sexual history. Is he HIV positive? Am I going to spend the next 4 weeks on hard-hitting antiretrovirals? Or worse, is he Hepatitis C positive? In which case, there will be nothing I can take to prevent transmission. It will be a slow and painful waiting game of testing over the next six months.

The risk of hepatitis C is what scares me the most and my imagination is getting the best of me. I envision myself in and out of hospitals, visiting with various GI specialists. I see myself sick from the effects of those heavy duty Hep C drugs. I see my skin turning yellow. I see my belly swelling with fluid and my bleeding difficult to control as my liver starts to fail me. I see the radiologist’s grim face when he sees my liver lesions on CT scan, suspicious for cancer.

Tomorrow I get the test results. Until then, all I can do is breathe.

(1) Makary, M. et al. Needlestick Injuries among Surgeons in Training. New England Journal of Medicine. 356 (26). June 28, 2007.