Pains exquisite texture – 3



“Maggie,” began the surgeon, “without sounding pretentious, I will give you your injuries in layman’s term’s. Your pelvis is broken in three places. Both of your femurs have minor fractures. Your spleen has been ruptured. Four of the lower ribs on the left side of your chest have been broken in two or more places each. This resulted in you having what is known as a ‘flail chest’. What that means is every time you took a breath, the affected area of your chest moved opposite to the rest of it. So each time your chest expanded to draw air in, the broken area got sucked in, instead of moving out with the rest of your ribs.


“Christ.” mumbled Maggie through a swollen and bruised lips.


“Now, there are two other injuries far more serious in nature.” Dr. McGovern said, turning from her to include her parents, seated beside her ICU bed in Royal Perth Hospital. Taking a deep breath in, he continued. “We aren’t out of the woods yet. After the medical staff at Moora District Hospital had stabilised you, they deserve medals incidentally, the RAC Rescue Helicopter rushed you here to Royal Perth Hospital. On arrival you were sent straight in for emergency surgery.”


“First of all, we had no option other than to remove your lower right leg below the knee. The crush injury you sustained was so extensive as to render your leg beyond repair. I personally fought for an hour and a half to save it, however, between ruptured blood vessels, crushed muscle, and your tibia and fibula being reduced to eleven separate bone fragments, my fight was in vain. Sadly, it was a battle I could not win. I am truly sorry.”


Silent tears filled Maggie’s eyes.


“Whilst I was fighting for your leg, another surgeon removed your spleen, and worked on your chest. However, there was a much larger fight going on. In your accident, you sustained two major injuries.”


‘What could be worse than the ones so far?’ Maggie thought through a drug induced mist to herself.


“The lesser of the two is known as a ‘base of skull’ fracture. Which we successfully repaired. It is the type of injury that is synonymous with ‘coward punches’. The injury sustained after someone king hits another without giving them forewarning, therefore giving them no opportunity to protect or defend themselves. The invariable injury resultant of this is the victim falls over backwards, and cracks the back of their head on the footpath behind them. I am sure, considering your profession, you are aware of this. Judging by the pieces of asphalt at the wound site to the back of your head, this occurred after the initial accident.”


“However, the greatest injury you sustained, was a massive blow to the temporal region of the left side of your head. We believe it is due to you banging your head with extreme force against the steel seat belt loop next to the door. It is the silver coloured loop that feeds your seat belt from above your shoulder, allowing the belt to be pulled down over your chest. Again, this resulted in multiple fractures of your skull around the region of your ear. This lead to a large intracranial bleed on both sides of your temple, within your cranium. It is a result of something known as ‘coup and contrecoup’. Basically your brain has bounced against both sides of your skull, bruising and causing a cranial bleed to both sides of the brain. It is a very serious injury. The blood from the bleed, unable to escape from beneath the skull, caused a pressure build up against your brain, compressing it, as well as that of your spinal cord. It is likely the base of skull fracture added to this, however, all scans point to the temporal point of impact as the cause. This was initially relieved via an emergency procedure performed at the Moora District Hospital. Once here, we operated on your skull immediately, as the fracture’s you sustained were numerous. Some pieces of bone had broken away from the main body of your skull, forming nine separate pieces of bone that were floating. X-rays, and various other scans done in theatre revealed all to us, and we were able to secure and either re-attach or remove them entirely.”


Looking from patient to parents, he continued.


“Getting you to Perth, and under normal circumstances this would not have considered, let alone done, incidentally. The RAC helicopter had to fly as low as physically possible. As I am sure you are aware, with altitude comes expansion, and taking in not only your head injuries, but your chest and other fractures, we usually would have had you delivered via ambulance. However, with time well and truly against us, we had little option. A shade under 200km in the back of an ambulance with head and chest injuries, was completely out of the question. Thankfully in this case, the gamble paid off, and you arrived no worse than when you left Moora.”


Talking directly to Maggie’s parents, Dr. Tony McGovern continued. “Recovery and rehabilitation will occur in time, but we have a way to go yet.”


Mrs. Fox began to sob. Maggie’s father just stared at the halo of surgical steel and rods sticking out from his daughter’s head. The array of wires and weights that seemed to be attached to every part of her body seemed almost surreal. Until that point he had been unaware she had lost a leg. Mr. Fox had never felt more useless, than sitting there looking at his badly injured daughter.



A tenth, missed, fragment of bone from Maggie’s fractured temple continued to float between skull and brain. Roughly 12mm long, and .5mm wide, shaped like a stilettos blade, and as deadly as a depth charge to a ‘U’ boat.


Eight days post op., it came to rest against another part of the brain. By day nine the sharp tip caught against it, by the eleventh day, it had penetrated, and slid in to it, its entire length.


Not even Maggie knew it had happened.




Click that funky picture white boy. Augie March follows.




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