Our son broke his arm.
Charlie is 4 years old. He loves to play. If you ask him what he wants to do, he says “I want to play”. It doesn’t matter what type of play. He just wants to play.
On Wednesday this week - after soccer practice - Charlie played on the playground. And he fell off the monkey bars and dislocated/broke his elbow. He made a yelping noise I’ve never heard come out of his mouth before. One of the dads on the soccer team immediately shouted “broken arm! broken arm!”. Charlie rushed over to me holding his arm (which immediately swelled up and was clearly in a position an arm is not supposed to be in). He was in agony. Physical and mental anguish. I’m sure it hurt like crazy. But he was terrified. I was terrified. I think the parents who saw it happen were terrified too. I carefully scooped him up choosing not to look at his arm (which was slowly morphing into something that looked like an arm a child would draw in a picture with the scale and angles all akimbo). I called Jamie and asked her to meet me at the ER at Good Samaritan in Downers Grove (which thankfully was only a 5-minute drive away). My gut started to pinch with a combination of anxiety and adrenaline as I rushed to the ER with my son in the back seat emitting a stream of noises/emotions that were hard to isolate. All I could think to say was “deep breaths”, “we’re almost there”, and “I know it hurts” on repeat. Charlie kept telling me “I hate the monkey bars” and “this is the worst day of my life”. Both points were 100% accurate.
The ER checked us in immediately. The nurses gave him some ibuprofen (which he hated). The radiologists got some pictures of his arm with a portable x-ray unit (which he hated even more). And the ER doctor diagnosed it as a dislocated and broken elbow. Given the nature of the break and the potential threat to nerves and vasculature in the elbow, they recommended transferring us to Lutheran General where they have a more robust set of pediatric services. Charlie would soon be taking his first ambulance ride! But first they needed to get the arm into a better position for the surgeon. They gave Charlie morphine for the pain. And they gave him ketamine in order to reposition the arm without Charlie tearing the whole place down in anger and pain. Jamie and I decided that she would ride in the ambulance and I would put together overnight bags. So I left the hospital, my son in a state of dissociative anesthesia (which looked to me like he was dead), not sure what would happen and having plenty of time to consider the worst possible outcomes.
The rational part of me knew that he would be fine. But the irrational part of me couldn’t get past the ketamine glaze in his eyes, the uncertainty of what would happen next, the need for surgery, the complications that could arise from surgery, intubation, post-surgical complications, blood supply damage, nerve damage to the hand, and so on. It’s stupid in hindsight, but the thought of Charlie not being around anymore was close to the surface. And it sucked. It sucked more than anything I’ve ever felt. I’ve lived a charmed life and faced minimal tragedy. My life has gone to plan. But pondering the uncertainty in Charlie’s immediate future made me as sad as I’ve ever been.
When I got to Lutheran General and walked into the pre-operative waiting room in which Charlie and Jamie were resting, and I saw my son awake (tired - but awake) and in decent spirits, a wave of relief crashed over me. My throat swelled up and I couldn’t talk. My eyes filled with tears. My heart shifted upwards. And my breathing sped up. It was an incredible feeling. I was so proud of Charlie for his strength and calm. I wanted to pick him up and squeeze him, tickle him, give him butterfly kisses and raspberries, and hear him giggle. That would have to come later though. Surgery was next. The surgeon explained what they hoped to do (i.e., relocate the elbow externally and drill in some pins to hold stuff together) and what they may have to do (i.e., open his elbow to more invasively get everything back into place). We kissed Charlie goodnight and told him we loved him and that we would see him soon. I don’t know why, but once I saw Charlie at Lutheran General after being transferred from Good Samaritan, I wasn’t worried. I knew he’d be ok. Sure, there were minor bumps along the way. He didn’t wake up immediately after surgery (he was totally gassed), he was super protective of his arm and didn’t want to prop it up on a pillow, he hated the medicine, he resisted the sling, he was scared of all the people coming into and out of his room. But he was ok. We’ll have to go through some serious recovery over the next couple of weeks. But he’ll be ok.
Through a different lens, it was interesting to ponder Charlie’s care delivery (obviously in a much more serious and complex ecosystem compared to dentistry). Don’t get me wrong, Jamie and I were super happy with the outcomes and the key doctor’s with whom we worked. They had a plan, communicated the plan, and executed the plan. But there were some things that surprised me:
It took what felt like forever to get serious pain medication into Charlie. That was probably a function of having to bear Charlie’s agony. When your kid is in pain, time stretches out.
One of the anesthesiologists asked Charlie if his hand was numb. Charlie has no idea what the word “numb” means. His hand has never been numb. Context matters.
The nurses kept asking Charlie to tell them how bad his pain was on a scale of 1 - 10. Charlie can count to 10. But he has no idea how to relabel his pain in terms of numbers. Once again, context matters.
The interaction between all the different specialists was clunky. Nurses, nurse assistants, nurse trainees, surgeon, pediatrician, occupational therapist, child life crew. They were in and out of the room constantly. And it definitely spooked Charlie.
It’s a good reminder as a dental practice owner to constantly remind yourself to see your business through your patients’ eyes. What’s it like for a kid coming in for their first cleaning? What’s it like for an 80-year old taking the bus to get a new denture. What’s it like for a parent taking time off work to get a filling or taking their kids out of school to come in for a checkup? Context and perspective are incredibly important. We do everything in our power at Hofmeister Family Dentistry to put ourselves in our patients shoes and walk around in them a bit.
And I suppose in a broader sense, the perspective granted through this recent experience with Charlie is informative too. Don’t take anything for granted. Charlie will keep playing. Thank goodness.