Ankle dislocation

Even after I was graduated from my residency program and was working as an attending at another hospital, I continued to play volleyball in the residency hospital league. We would play once a week and then meet at a local bar afterward.

I jumped up to block a spike coming from the other side of the net. When I landed, I landed on the opposing player’s foot. This impact twisted my ankle into a grossly abnormal position. It also hurt.

I was in a gymnasium full of doctors, nurses, and other hospital personnel. One shouted, “Call 911.”. Another shouted, “Call an ambulance!” I interrupted and said, “Don’t be silly. Chandra (my wife) can take me to the hospital.”

I was helped to my little car, a Honda Prelude, with a manual transmission. Chandra knew how to drive a stick, but was anxious. I told her to calm down. We took off and the engine revved. I told her, “Honey, you need to shift.” She obliged.

After we arrived at my hospital of employment, I received VIP treatment. All the nurses stopped in to say, “Hi, I hear you twisted your ankle.” They would look at my ankle and then make a face. My foot was pointing in the wrong direction.

None of the nurses wanted to start my IV. They sent in a paramedic. I have great veins, so it was no issue. The IV Demerol that I was given made me loopy but did nothing for the pain. X-rays showed that I had a lateral subtalar ankle dislocation with a fractured fibula.

I requested and they called an Orthopedist that was a friend of mine. Tony came in and told Chandra and me that he would try to reduce the dislocation in the Emergency Center, but that frequently it would have to be done in the OR. Tony called down the Anesthesiologist, Bill, also a friend of mine. I was Bill’s supervising resident when he was an intern.

Tony asked Bill, “I need him relaxed. Can you put him down deep?” Bill replied, “Don’t worry, he will be relaxed.” That is the last I remember. Bill gave me 50mcg of Fentanyl and 200 mg of Propofol. The rest of this story is what I was later told.

Chandra said that I was unconscious immediately. My ankle went back into normal position with the typical clunk. A post reduction x-ray showed good reduction and normal alignment.

When Tony was putting on the splint to hold my ankle in place, I was starting to awaken. I told him that, in my opinion, he should do the reduction before he splinted my ankle. I was unaware that the reduction was already finished. He told me, “Shut up.” Afterward, Tony requested we set a follow-up appointment in his office in one week. Chandra replied, “I will have to see if I can get someone to watch the kids.” I told her, “Don’t worry, I will watch the kids.” Chandra sarcastically said, “I think Tony wants you there also.”

Chandra asked if I wanted her to let them know that I would not be able to work my shift the next day. I had never missed a shift and had not thought about it. I told her that I could do my shift on crutches. I had one more shift in the Urgent Care before I had a week off. Urgent Care was low stress and not a problem on crutches.

The next morning, I awoke and stood up next to my bed. The blood drained out of my head and felt like it was all in my ankle. Chandra said I turned white. I laid back down and decided that that would be my first missed shift.