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October 9, 2014

After losing her fingers, a surgeon returns to work

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Writing in General Surgery News last month, Christina Frangou tells the story of pediatric surgeon Sarah Jones, who lost her middle three fingers on her dominant hand in a 2009 woodcutting accident.

"The first thing I thought was, 'I am no longer a surgeon. I'll never operate again," Jones says. After running nearly a mile to the main road to meet an ambulance, Jones was on the verge of fainting, her husband carrying her severed fingers and holding her right arm up in the air to cut off the circulation.

When she arrived at the hospital, Jones underwent 12 hours of surgery as surgeons worked to reattach her fingers. Plastic surgeon Kimberley Meathrel, who operated on Jones, says, "To have this traumatic event happen to a colleague was dramatic," adding, "To know this was another surgeon's fingers and operating on someone I know and like a respect was really upsetting."

The long road to recovery

After her surgery, Jones spent two weeks in the hospital recovering and undergoing leech therapy to keep blood flowing into her fingers. She says that she could feel pain in her fingers, but could not move them.

Six weeks later, she began physiotherapy with occupational therapist Juliana Salgado, hoping to be able to move her fingers enough to use a cross-country ski pole, garden, and play with her children. Returning to surgery seemed impossible.

Every morning for the next several months, Salgado worked with Jones to improve dexterity in her non-dominant left hand and to work the fingers on her right hand. Throughout the sessions, Jones' fingers were able to recognize feelings of hot, cold, smooth, and rough—although every sensation caused her pain.

Getting a second opinion

After five months with little progress, Jones decided to get a second opinion and undergo surgery at the Hand and Upper Limb Centre at the University of Western Ontario (UWO). Bing Siang Gan operated on Jones' hand three times. Between operations, Jones continued therapy with Salgado, learning to retrieve objects from bowls of rice, popcorn, and quinoa.

At the time, returning to life as a surgeon seemed improbable, so Jones took a position as UWO's head of pediatrics.

But while at home one afternoon, she found a hemostat and, to her surprise, discovered the she could open and close the instrument. She later found that she could sew with a suture kit. Jones began to retrain her right hand to become dominant again.

Three months later, Jones began assisting as an attending at Dalhousie University, where she had completed her residency and fellowship. After two weeks, she returned to her position at the Kingston, Ontario, hospital where she had been working at the time of her accident.

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Back to surgery

Today, Jones serves as a pediatric surgeon at UWO. She has learned to operate despite one of her fingers being shortened, uses her left hand more than she did previously, and holds instruments in a different way than before.

"What we expect with multiple grafts is that someone will have an assist hand... For her to regain that kind of dexterity required for her to operate is quite remarkable and quite unheard of," Meathrel says.

Jones offers this to surgeons who find themselves in similar situations as hers: "Be fair on yourself. There are some things you can't do the same as other people will do them, but that doesn’t mean you can't do them well." She also encourages patients not to hesitate when asking for a second opinion (Frangou, General Surgery News, September 2014).

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