The femur is the largest bone in the human body, situated below the hip and running the length of the thigh. It is thick, durable, and very strong. It almost never breaks, but when it does, it is always spectacular.
The immediate treatment for a femur fracture is a traction splint. It is a mechanical device that sits below the injured extremity, running from the base of the spine to the leg. The first step is to lay it next to the injured person and measure it against their leg as to properly adjust it.
In this case, it is a little girl, fallen out of a tree, and it's my fifth shift on the ambulance. The Philadelphia sun is hot and sweat is in my eyes as I pull the splint out of its case and measure it against her. It looks like a toy.
It is harnessed in four places: first, and most importantly, strapped to the hip, and lastly a harness around the foot of the injured extremely, which is attached to a cord attached to a crank. The other two straps are meant to stabilize, but their exact placement is not important.
What is important is what comes next. The traction splint works by pulling the two halves of the severed bone away from each other, using a crank. Muscle is torn, flesh is ripped, and the worst pain imaginable often works to put a patient out. However, once the crank has extended far enough, relief is instant, like the pain simply vanishes as the last few nerves stop crying out in agony.
So, we hook her up, and my partner starts to crank. The sound is terrible as it cracks and gnashes through her leg, sliding the bone against bone.
It should be enough after a few turns, but it's not. I stare at my patient, incredulous. The little girl is still screaming. We continue to crank.
Muscles pull and sinews snap like larvae pulling under the skin. I tell my partner to stop. Something must be wrong...but the screaming was too loud, and he had lost track, so he keeps cranking.
In the hospital, "Why wouldn't she stop screaming?" my partner demands, his face twitching. "They're supposed to stop screaming." He doesn't have to wait long for an answer. The girl suffers from a rare condition, congenital analgesia, which is the absence of physical sensation of pain. She wasn't screaming from the pain, she was screaming because she was scared; of course she wouldn't stop when the pain stopped...so she never stopped screaming.
Forgive me, forgive me. I'm so sorry. Forgive me.