Posted by: notdeaddinosaur | January 8, 2009

Limits Gone Wild

I saw a little girl the other day with a splinter in her knee.

Her parents had done their best to get it out, but didn’t think they had gotten all of it. When I took a look, I saw what looked like a tiny splinter remnant about 3 millimeters long (ie, really small) nestled in the bottom of a small cut. I pressed on it gently and asked the kid if it hurt. From experience both clinical and personal, I’ve found that this is a fairly decent way to tell if there’s anything still in there. She didn’t complain much, so I wasn’t all that worried.

I got my splinter forceps, pushed upward on the visible part of what might have been the rest of the splinter and managed to grasp it. Then I pulled…

And kept on pulling, until lo and behold a full half inch (11 mm; I measured) of splinter materialized before my eyes. It was impressive, given that it must have gone straight “down” into her knee, as opposed to tangentially along the skin, which is what the original wound looked like. The kid did great; nary a wince and not a peep. I put the splinter into a little tube and gave it to her to take home to show Daddy, along with stickers (my office goodies-of-choice.)

What does this have to do with limits? In the course of the visit, the mom mentioned to me that school nurses are no longer allowed to take out splinters when kids acquire them at school. That struck the both of us as pretty stupid. Why make a kid suffer with a splinter all day instead of at least trying to give it a little tug. It doesn’t really apply to this case, but it struck me as just the latest in the slow and lingering death of common sense as it succumbs to the continued onslaught of the lawyers. The new prohibition is clearly the result of increasing liability fears.

I’ve posted several times bemoaning the failure of assorted medical personnel to recognize their limits. As it happens, I do feel that there are some groups of people who are better at this vital life skill than others. Among them tend to be school nurses (and often, parents.) This family only brought the kid to me after giving it their all to get this nasty splinter out on their own. I’m pretty confident that a school nurse would be even quicker to punt. But forbidding them to even touch it in the first place? The nanny state strikes once again, when fears of lawsuits outweigh a child’s comfort.

That was one impressively big-ass splinter, though.


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