Chapter 7: Othering Ortho

Before allowing his discharge, an orthopedist reviewed his skull, arm, and leg. Dr. Astrid Carlssen was almost six feet tall, blonde, over 60 years old, and seemingly humorless.

She stuck his x-rays up on the lighted review panels and studied them with pursed lips. Then she asked him to wait inside the examination room while she spoke to Dee outside.

“It says here you’re an RN, yes?”

There was an edge in her voice. Dolores suddenly felt a little anxious.

“I have a master’s, and I’m a certified Family Nurse Practitioner, Doctor.”

“I see. You diagnosed him with a patella fracture and a severe wrist sprain, and you prescribed bed rest to allow these injuries to heal naturally.”

“Yes, that’s right.”

“Tell me, Ms. Lincoln, which bone is the scaphoid?”

“It’s, um, it’s this one, in the base of the thumb.”

She pointed to it, while Dr. Carlssen waited with poorly concealed impatience.

“That’s correct. If Mr. Ellis had a fracture in his scaphoid, it likely would not heal on its own. The damaged bone could partially die, and then he would have a permanent disability. These injuries are difficult to diagnose, even by experienced specialists such as myself, and often require surgical repairs. Scaphoid fractures are extremely common in falls and vehicle accidents.”

Dolores realized she might have mismanaged his case, causing him permanent harm. Her anxiety and guilt were going through the roof.

Then, the doctor’s stern expression relaxed, and she put her arm out on Dee’s shoulder.

“He’s very lucky, though. He does have a fracture, but it’s in his trapezium, which you know to be the next bone up towards his thumb. That bone is much easier to treat. I’m sorry to make you upset, but I’ve seen scaphoid fractures go untreated so often and for so long, with dire results.

“Trapezium fractures are rare, but immobilization can treat them. I’d recommend six weeks for him, and then he should be fine.

“Now, since his patella is not displaced, immobilizing his leg will correct the knee issue. Ms. Lincoln, I’ll depend on you to help him cope with the fixation processes for his leg and his wrist. Next, you need to assist with the therapy process so that he regains full function and avoids any future arthritis.

“Are you willing to help him get well?”

“I swear. He’s my everything, Doctor. And thank you for being so straight with me. I was trying to spare him, and it was the wrong thing to do. My orthopedics courses at the university were deficient, it seems.”

“You’re not the first well-meaning nurse practitioner I’ve encountered who might have made a similar subtle mistake. But usually NPs get things right, and I recognize the system would collapse without them.

“Please, just tell Mr. Ellis you’re going to work with us closely, and he should comply with the treatment plan. I’m sure he’s going to heal well, provided that you give him the proper support.”