Lee Anne Gallaway-Mitchell
Dr. Allen B. Kanavel identified four cardinal signs for tendon infection in the hand, often localized to a finger:
Trigger finger: A medical condition in which the tendon becomes inflamed. Fingers function like pulleys. With trigger finger, the tendon locks up and when released the finger pops back like the trigger of a gun.
Placing too much of one’s finger along the trigger will cause the gun to pull to one side. The trigger should sit just ahead of the distal joint of the trigger finger. Breathe in and out to get the muscle of your heart to slow. Just breathe. Then, squeeze.
Dr. Kanavel, who pioneered surgeries of the brain, spine, and peripheral nerves, who told us what to look for in cases of tendon infection in the hand, died in 1938. He was taking his sons fishing when his car crashed in Pasadena, California. His sons survived.
Depending on the skin—a man’s calloused hand or a child’s eyelid—a bullet has to travel at least 136 miles per hour to break flesh.
In car accidents, blunt force trauma causes the majority of deaths. While something like a seat belt had been invented in the mid-nineteenth century, it was used primarily to keep workers safe as they were raised and lowered along a pulley. The modern, three-point seatbelt used in automobiles wasn’t patented until 1958, twenty years after Dr. Kanavel died.
When I was little, my granny’s neighbor Lorene cut my hair. Her husband was the local bootlegger. He answered to the nickname, “MD.” He reckoned himself a doctor, a healer of sorts. He once pulled out a very large rifle while Lorene trimmed my bangs. He noticed I was frightened and laughed; then he pointed the gun at me. “Are you scared, little girl?” Did I put my small hands in front of my face? I had nightmares for over a year.
Bullets cause penetrating trauma. Debridement removes both damaged tissues and foreign objects like bullets. But, bullets can stay there in the body. The movies get it wrong. Simply removing a bullet won’t take away its damage. The surgeon opens the body up, looks for shattered bones, devitalized tissues, torn vessels, and liquefied organs.
When the bullet hits a hand, the bullet punctures the epidermis. Then the surrounding tissues absorb the bullet’s destructive high energy. Hydrostatic shock results in remote tissue death. That necrotic tissue has to be removed as it impedes healing. The wound must be left open. After a day or two it can be closed.
Put your hands together as if in prayer. Feel your bones, your skin, maybe your pulse. Now imagine using those hands to stop a bullet fired at close range. Keep praying. Breathe. Slow your heart. Squeeze.
About the Author: Lee Anne Gallaway-Mitchell grew up working on a family farm in Lockney, a small town between Lubbock and Amarillo, Texas. Her essays and poems can be found in Iron Horse Literary Review, 0-Dark-Thirty, terrain.org, and Essay Daily among others. She is an MFA candidate in creative writing at the University of Arizona.