We Stay Seeing Fractures (Like, Every Day)
You never truly realize how many road traffic accidents (RTAs) happen until you work in a hospital. When I was on call, I’d say over 90% of the cases I was called to review were RTA victims. The rest were either assault or armed robbery cases.
It made me look at life differently. Every day you get into a car and come out in one piece? You're one of the lucky ones. Really.
Most patients came in with facial lacerations that needed suturing, and many had obvious or suspected fractures—so we’d send them for a CT scan. It quickly became routine. But some cases… stick with you.
One patient in particular I’ll never forget.
I was called in to review her, and as soon as I got to the hospital, I made my way to the trauma center. I had no idea what I was walking into. The woman was in visible distress—disoriented, crying, pleading with anyone nearby to help her. And when I got closer and we made eye contact, she started begging me directly. Her voice, her expression—completely broken.
To say her face was mangled would be an understatement. It didn’t even look like a face anymore.
I immediately felt sick for her. The doctor on duty told me she was brought in during the night—another RTA victim.
The accident had rewritten her face into something unrecognizable:
Bandages soaked through with blood and despair
Eyes wild with terror beneath swollen lids
A voice shredded from hours of screaming
She’d been stabilized, then referred to our unit for further management. I slowly unwrapped the bandages to examine her face. I took photos, documented everything I could, and left that room completely shook. Her pain was visible in every single sound she made. No one could look at her and not feel something.
The doctor later brought in two other house officers to help suture her facial lacerations. They worked from 9 a.m. to 5 p.m. Straight. And here’s the worst part: the trauma team had only been giving her regular pain meds the entire time. It wasn’t until the house officers stepped in and insisted on administering morphine that she finally calmed down, fell asleep, and they were able to finish stitching her without her crying out every five seconds.
And then came another sad reality—she was listed as "unknown." No family. No guardian. No one to pay for her CT scan. But judging by the state of her face and how severe everything looked, I’m sure she had some kind of fracture—probably more than one.
That day wasn’t just a lesson in trauma. It was a reminder of how brutally unfair the system can be. Of how pain, poverty, and poor access to care collide in the worst ways. And of how sometimes, the only thing standing between a patient and actual relief… is whether someone fights hard enough to make sure they get morphine.
Other days were more mundane. You’d walk into the trauma ward and immediately spot your patient—the one with the swollen face and bandages. No need to ask. You already knew. And then you’d go through the whole protocol like clockwork.
Now here’s something that surprised me: because this is a government hospital and most patients can’t afford major surgeries or general anesthesia, some procedures are done right there on the dental chair. No OR. No fancy setup. That part really shocked me.
There was one patient with a mandibular fracture around the submental area. I was asked to assist the doctor with his open reduction and internal fixation (ORIF) procedure—on the chair. It was one of the most exhausting cases I’ve assisted on.
We started by placing an IV and giving him pain meds. Then came the local anesthesia, followed by careful incisions into the vestibule, then the drilling. Into the bone.
Now here’s something you might not know about me: I hate the sight of blood. It makes me queasy. I don’t even know how I keep ending up in situations like this. On top of that, I hate seeing people in pain. And this patient? Was very much still in pain throughout the procedure. He wasn’t numb enough. You could see it in his face. At one point, tears started rolling down his cheeks. A full-grown man. Crying. And there I was, standing next to him, feeling every bit of it.
Normally, a surgery like this would be done under general anesthesia. The patient goes to sleep, wakes up, and it’s all over. But here? He was wide awake through the whole thing.
After the drilling, the doctor took a chisel and mallet and split the bone in half. I shuddered behind my face mask. No one noticed, thankfully. But inside, I was trying not to panic. She then reduced the fracture and secured everything with screws and plates. After that, it was just suturing and closing up.
Post-op instructions, medications, and a follow-up in a week. That’s the routine.
This surgery didn’t end till 7 p.m. And that’s another thing I didn’t love about this unit—the unpredictability. You show up in the morning and have no idea what your day will look like. You don’t know when you’ll finish or what kind of case will walk through the door. You could be planning to leave by 3 p.m. and next thing you know, you’re assisting in emergency surgery at 8.
Just like the time we had that elderly patient who came in after being shot in the jaw…
The case that truly felt like something out of a medical drama.
By the time he showed up, infection had already set in, so the doctor quickly wrote a prescription for antibiotics and began debridement. What should have been a straightforward debridement turned surreal when the consultant ran her fingers along his chest. "There's something here," she murmured.
There was a bullet lodged in his chest. Yes—this man had been shot. And because the bullet was lodged just beneath the skin, the doctor calmly removed it right there on the dental chair. No operating room, no sedation. Just precision, gauze, and a lot of disbelief from me. The ping of metal hitting the stainless-steel tray echoed through the room.
He eventually needed an NG tube to be able to eat, Watching the NG tube insertion was its own special horror—his gag reflex triggering as the tube snaked through his nose into his stomach. "This is how you'll eat now," the doctor explained, while the old man's watery eyes begged for mercy.
We immediately started sending him for lab work to prep for surgery. But this case was cursed—every time we thought we were ready to proceed, something would pop up.
The Surgery That Almost Wasn’t
Every time we thought he was stable enough for the OR, new obstacles emerged:
Day 3: Sodium levels cratered
Day 5: Suspected malaria parasites swarming his blood smear
Day 7: Fever spiked to 40°C
Then something else. The surgery was postponed again and again.
Meanwhile, since he was admitted, we were constantly doing oral toileting to control the infection. Round-the-clock cleaning. This was not an easy case. At all.
Eventually, we got to do the surgery—an exploratory procedure to open up the mandible, assess the damage, fix what could be fixed, and close him back up. But as with everything in this unit, surgery day came with its own stress.
First off, surgery never starts on time. Ever. Doesn’t matter what’s written on paper. “9 a.m.” is a polite suggestion, not a real thing. Then there’s the battle for space in the OR—every department wants to use the theatre, and you basically have to claim your spot and guard it like Black Friday shoppers wrestling for the last discounted air fryer.
We’d arrive early, ensure our patient was fully prepped, scrub in, and then enter the theatre. As house officers, our main job was to observe and assist where needed—which often meant being glorified errand runners. If blood was needed, we were sent to get it. If meds were missing, we’d be the ones updating the family. Occasionally, we’d help out more directly—a.k.a. suctioning. But let’s be honest: I personally avoided that gig at all costs. Standing for hours just to suction blood? Yeah… no thanks.
After surgery, we’d monitor the patient for about an hour before transferring them back to the ward. Then, the house officer on call would continue checking on them throughout the night.
Surgery days were long, unpredictable, and stressful. But somehow, we made it through every time. With blood on our scrubs, sweat on our backs, and an ever-growing list of wild stories we couldn’t believe actually happened.
By the end of my time in MFU, I had seen more trauma than I ever imagined I would so early in my career. Gunshot wounds, shattered jaws, emergency surgeries done on dental chairs—things that should’ve shocked me eventually became routine. That’s the wild part.
What this rotation taught me is that maxillofacial surgery isn’t just about skill—it’s about endurance, improvisation, and a lot of emotional detachment (still working on that last one). Some days were boring, some were bloody, and some made me question everything. But through it all, you learn. You adapt. You survive.
And most importantly, you never trust the phrase “it’s going to be a light day.” Because it never is.
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