Yay! Caleb had his first stitches today! (Click here to see a few photos, or on the photo to the right.)

OK, so I’m trying to be overly positive about the experience. It was quite traumatic, but perhaps more so for Megan and I than for Caleb. Earlier this morning we were hanging out in our apartment trying to get ready for the day (it’s Megan’s birthday — we were planning on a family breakfast), and suddenly Caleb was wailing is in Megan’s arms, rubbing his eyes furiously, and smearing blood all over her hands and cheek. In short order we decided that he had tripped or slipped in our living room and after falling backward, rammed his head on a protruding corner of the molding that ran along the base of the wall between our kitchen and living room.

After soaking up some of the blood, even a quick glance at the wound would tell most anyone that stitches were needed. The cut was deep, long, and spreading out. (Don’t read this sentence if you want to avoid a more gory description — essentially the little skin that is on that part of his head had been split by the corner, pretty much down to the bone. The wound was opening up, and seemed to be widening as the minutes passed. It was incredibly obvious that it needed to be cleaned and closed up quickly…)

During a quick phone call to the health clinic just a few blocks from our home, we were assured that yes, they can do stitches. The cut is on his head, we pointed out, and we gave a pretty descriptive overview of the magnitude. No problem, they said, bring him in.

So we quickly walked over, nixing the emergency room option, more relaxed that our son was going to be attended to quickly and stitched up soon.

Whoops! I guess we don’t do stitches for head wounds at this clinic and you have to go to the hospital! But why don’t I put some tap water on this un-sanitized gauze pad (open in a drawer) directly on the cut while I give you that information! Yay!

Our frustration with the process was just beginning.

Forty five minutes or so burned waiting to hear news we thought we had clarified unequivocally up front, we grabbed our car and then trudged through traffic on our way to the emergency room at Mass General.

(As a side note, I impressed on the last person we talked to at the clinic that we were *somewhat* irritated at the process and that we would appreciate it if they would contact the hospital to figure out if we could be admitted more efficiently than the standard wait… insurance forms… wait some more… here’s a towel for your blood… whoops, more forms… OK someone can see you now… the doctor will be in shortly… do you want some water?… the doctor is coming in just a minute… what are your symptoms?… just a minute… more water?… hi, I’m from triage, what are your symptoms?… hi, I’m the doctor, what are your symptoms?… more forms… hi, I’m the PA that is going to be helping you, what are your symptoms?… process most of us have endured at least once in our lives. To her credit, she did call. In fact, she called Megan’s cell phone after Caleb was discharged from the hospital and followed up as well. I thought that was very nice and thoughtful.

The process, despite the phone call, was just as expected, unfortunately. The triage station in the ER seemed to be completely devoid of any kind of urgency or emergency (just what exactly are the 10 nurses, administrators, and other hospital staff that are standing around waiting for? — 2 of the 4 triage stations are open, and my boy is collecting airborne junk in his wound every second!). They handled my insistent requests (can I have some gauze please?) with a certain poise, however. They must deal with quite a few fathers during their shifts.

The chairs in the main waiting area led to the triage nurse (who was fantastically efficient — thank you), then some forms and lots of questions. I repeated for about the 10th time that morning that he had a laceration, it was quite deep, about a half an inch long, and needed to be cleaned and sutured… Name? Social security number? Date of birth? Religious affiliation (are they serious?)? Etc. Etc. Etc.

Triage led to another waiting room, deeper into the hospital (yay! we were making progress). As soon as we plopped down in the chairs, we decided Caleb most likely had to go to the bathroom. He and Megan were gone for no more than five minutes. Naturally, the attending pediatric specialist visited with me for 2 seconds about a minute into Megan and Caleb’s absence. Funny, if I had known she was going to high tail it to some other part of the hospital, I would have grabbed Megan and Caleb from the bathroom. When they returned, we were told that we would have to wait a while to see the specialist again.

Me: How long?

Her: Oh a while, she’s probably with another patient or something.

Me: Can we find out please — would it be five minutes or more like twenty?

Her: We’re not sure Sir — she could be anywhere in the hospital and is probably with another patient.

Me: He just needs his cut cleaned out and stitched up — it’s been open for almost two hours now, can we just get someone to close him up?

Her: Like I said Sir, it will be a while. (Sigh, no urgency. I’m almost off in fifteen minutes. Rock on!)

Me, internally: (You’ve got to be kidding me — she definitely does not have kids. Or a dog. Or a cat. Or a fish. Or a pet rock.) …then out loud: Here’s the thing — some kind of information would be much appreciated so please let us know if he is going to be seen shortly or in a long time — he just needs his head cleaned up and stitched together. Thank You.

Miraculously, our wait was subsequently only about five minutes long (as mentioned, this is now around two hours post-head wound incident) and we were brought to a room in a different part of the hospital.

Oh thank goodness — an undersea mural on the wall for Caleb to look at (he had already devoured the cereal bar we were saving as a post-suture treat, and was clearly getting restless). Another new face, and I gave the overview of the incident for the 20th time that morning. I again reiterated how important it was for his head to get cleaned out sooner rather than later (it was clotting too much by that point and I was worried that the irrigation process would be really painful for Caleb, plus all of the junk that had likely soaked into the wound by that point). Perhaps she was a parent, or at least in possession of a higher than average emotional intelligence, or perhaps she read in my eyes that I was not going to repeat the story or my request again — it was time to take care of our son — but she showed the first inkling of urgency we had seen that morning.

We were whisked to yet another room (alas, no mural, just sterile white walls and a ton of gadgets), and finally progress was starting to happen. Caleb’s pajamas came off, we wrapped him up in a towel, I got on the gurney next to him, and while Megan held the bedpan over his ear, the doctor (perhaps a PA) started irrigating his head. First Caleb squirmed a bit because it was cold. When the first layer of clotted blood came off, then he started to show how painful it was (those of you who have had a water rinse in a laceration know what I am talking about). Caleb did phenomenal — we were so proud of him.

A short discussion between Megan and I and the doctors about sutures versus staples, and we all seemed to agree that the quick stapling method would probably be the best approach (it was a good choice for the type of wound as well as for its speed). Sutures would have required a local anesthetic (which burns quite a bit at first), and then for my two year old to keep his head still for minutes on end while the stitches (probably 3-5 of them) were sown in place. So staples it was.

They irrigated the cut once more and then had me lay Caleb on his side. Caleb started laying down as they were instructing me, so I simply covered him with some towels to keep him warm and then held him close. I think there were several people in the room, but I was only aware of Caleb (he was squeezing a penguin they gave him), the nurse holding his head down and to the side, and the person holding the staple gun.

As soon as the first one went into his head, you could tell that it hurt Caleb a lot. They thankfully only took a few seconds to put the second one in, and moments later I was holding and rocking Caleb trying to help him deal with the stress, shock, and certainly the pain. He was clearly hurting, but crouching down, I pointed out the foot break on the gurney. Transfixed, he started talking with me about it, and the doctor showed him how they can raise the bed up with just a foot pedal.

Good boy! Convinced everything was over, he sat patiently while his head was wrapped in gauze and then was very polite and thankful when the doctor gave him a stash of q-tips (he was playing with the one in the second photo) and the bed pan, irrigation syringe, and a plastic bowl.

Overall, Caleb was amazingly calm, helpful, polite, and bore all of the unpleasantness with poise. We are so proud of you Boots!

Oh yeah, and Happy Birthday Megan!