Healing Touch

There are certain cases that are such a joy to treat in the emergency department. One of those cases is called Nurse Maid's elbow. The reason it is a joy to treat is that you can take away the pain and restore the patient's pain free status. Ultimately the patients are very happy with their doctor. This usually occurs when a young child is tugged by the hand and causes a type of elbow joint dislocation. It can be very painful and only occurs in younger children because of their specific anatomy allows for this type of dislocation. Older children and adults have different shaped bones making this type of injury unlikely.

I had a young patient brought in by the parents. They were shopping at a big department store and the father was holding hands with the child and they were looking at some ornaments on a tree. The child was trying to grab some of the ornaments off the tree and the father tugged the child away from the tree. The parents heard a popping sound and their child began crying out in excruciating pain. The parents were scared and the father felt guilty.

I entered the room and the crying child began to cry even more and shouted out to me "go away, go away, go away now!" The parents were embarrassed and told the child to not be rude. Then the child blurted out "you are stupid!!" I smiled and carefully approached the child and explained the diagnosis to the parents and eased their concerns and fears. I also explained the cure / maneuver to reduce the injury and relieve the pain. The father while holding the screaming child gave me the indication to proceed with the maneuver and I took the child's arm and moved it in a fashion that restored its proper position. It takes a lot of force and the child usually screeches even louder but only for a second or two and then slumps in relief as the pain subsides. I performed the maneuver successfully.

You relief and thankfulness was palpable and auditory as the parents verbalized their thanks. I told them to wait for five minutes or so and that I would return to make sure that the arm / elbow was back to normal and check to see if there was any nerve damage from the injury which can occur in some occasions. I returned and completed the proper examination of the child's arm and all of the neuro functions were intact and appeared to be normal. The child was smiling and happy playing with a toy and the parents were beaming with a sense of relief.

I explained that the nurse would be in shortly to discharge them and then turned to leave the room when the child said "doctor, I am sorry I said you were stupid" I kneeled down to the child's so we were looking at each other eye to eye and said "I understand that you were in a lot of pain and scared. Thank you for apologizing that makes me feel so much better and now my feelings are not hurt anymore." The child smiled and said "thank you." Then as I left the room the mother stood up and before I knew it she gave me a big embrace and said "thanks for fixing our little baby and thanks for not ruining a teaching opportunity by telling our child that it was ok to call you stupid."

I smiled and said "thanks" Now I can fix your child but your husband needs more help than I can offer so you are going to have to fix him." We all laughed, especially the husband as he confirmed my diagnosis. I said to the mother "don't worry about it, my wife has the same task with me and it is a life long process to fix a husband." We shook hands and I left the room. I walked towards the room of my next patient, a 55 year old man with chest pain and I smiled and thought to myself "I love this job!"

This is why doctors have certain diseases or problems they like to treat or fix.