I’m doing fact-checking for a story in which a character will have both of her thumbs snipped off down to the second joint with a rusty paper cutter. I’ve consulted with my mother, who is a nurse, even though this is not her particular field, and have a broad idea of the realistic medical implications. I’d appreciate it if someone else with knowledge of the subject could fill in the blanks. I’ve found that an Altavista search for “+dismembered +thumbs” or “+physical +therapy +thumbs” tends not to turn up the kind of information I require.
First of all, apparently one can expect blood loss to cause either shock or death within thirty minutes (I don’t remember which) from such wounds.
Stopping the blood flow could not be effectively achieved either by direct pressure on the wound or by applying a tourniquet further down than the forearm. The tourniquet on the forearm may cause the loss of the arm after an hour.
I’m not clear on how the blood flow could be brought under control in the hospital so that the tourniquet could be removed, except that the patient would probably be placed on a gurney that kept her heart above the level of her head. I understand that the lost fluids must be replaced as soon as possible, preferably with blood, but also possibly with a saline solution.
The extremities will be cool and pale, as the body has concentrated the remaining blood at the vital organs. I don’t know what effect this will have on the subject’s ability to use her limbs.
From such an injury, we can expect blood loss from the brain, but I don’t know what effect this will have on subject’s presence of mind.
Apparently, the subject would experience pain requiring strong drugs for 2-3 days, and less after that. She would be hospitalized for a week, and would go through approximately 6 weeks of physical therapy. I don’t know what that therapy would involve or what work-arounds she would learn to deal with the lack of thumbs, though through my own experiments I’ve determined that it is feasable that she could learn to shuffle a pack of cards, use a cigarette lighter, and snap a cigarette butt to the ground with a flourish.
I may be wrong, but it’s my understanding that as the patient goes into shock the severed arteries veins and cappillaries will constrict, reducing blood flow. THis should happen pretty fast. The wound will continue to ooze until it coagulates.
If the patient is normal physiologically they probably won’t die of blood loss. Infection is the big worry.
I know several people who have lost fingers, parts of hands, and one who lost most of an arm working with farm machinery. When I heard the stories, blood loss, was not the problem.
My neigbor has a cat who lost part of a leg jumping through the fan in a cow barn. It was completely severed, and the cat survived just fine without medical attention. I had a cat named Lucky who got into a fight as a kitten, and had a front leg almost completely severed one night. In the morning it was still alive, and didn’t appear to be suffering signigficant blood loss.
The vet was able to tape the whole thing up in a splint and it became kind of a peg leg, even though it was only hanging by a little flesh.
Yeah, life in the country.
People are pretty tough, and I don’t think losing a thumb or two is going to immediately kill you.
If you’re worried about stopping blood flow couldn’t you cauterize it with a blow torch or hot iron etc. ? Granted it’s probably not the best way to do it but you wouldn’t have to worry about blood loss if you were stuck out in the middle of nowhere.
Bloody stumps and farm machinery, they go hand in shredded hand.
i had my index finger severed at the first knuckle, there was virtually no loss of blood other than a coupla drops on the floor. i laid in ER 61/2 hours till surgery. they kept the area misted with saline. i was so doped up i was hallucinating yet the pain was still incredible.
Someone I knew when I was a kid lost his thumb in a fishing boat mishap. He sure didn’t die of loss of blood. In fact, he didn’t even know it had happened till long afterward - no pain, not much blood.
He’s fine. Wasn’t even a little bit of trauma for him as far as I know (he was about 9 at the time).
There’s a lovely little scene in The English Patient where a character has both his thumbs cut off with a straight razor. I closed my eyes, so I can’t tell you how much blood they showed, but the character did survive. I’m pretty sure they showed the whole thing on-screen.
Well, coming from the SNL/Julia Child school of know-it-all medicine I’d have to say there would be a whole lot of blood. (Don’t throw out the liver! You never know what you might need it for.)
Both my mother and the doctor she spoke with felt that there would be a dangerous loss of blood in such a situation. I’ll ask them again, but I understand there’s some kind of an important artery in the area.
A good friend of mine was born with no thumbs. Over his life he has achieved a rather big-ass spread between his index and middle fingers, so that even though they don’t oppose, they can easily handle the gripping duties of the missing thumbs (he can even make the A-OK sign).
According to Thumbless, his primary burden is that when he goes to shake someone’s hand, they tend to slip right up his forearm.
J.Angel:
There’s supposedly an Asian practice of cutting off one of your fingers as a sign of shame - the sort of thing the [whisper]Yakuza[/whisper] might demand of an errant member. Prior to the act, the person would wrap the base of the finger tightly with a long strip of cloth. Partial loss of feeling prior to the cut, and little blood.
Sure, I’m all for moderation – as long as it’s not excessive.
Do you happen to know how far down the thumb is missing? It seems as though if that last bone is there, you’d be tempted to use it for some leverage. Really, any details about how your friend has adapted would be interesting and useful.
InutilisVisEst wrote:
I don’t think that would quite work with the thumb, at least not to the second joint. And in the story, the character won’t have any special preparation.
go to this link, then to “crazy crap” , then to “videos”, then to “Seriously Disturbed Videos”, then click the “Bring On The Sick Stuff” link, then you’ll see an AVI of a figer chop (Not to mention some of the most disgusting AVI’s and MPG’s I have found on the Web).
That probably doesn’t help you much, but this is probably the only time I’ll have use to refer someone to that AVI.
“My Accountz Reeceevable Posse don’t call me Tha Troubleshoota for nothin’. Suckas think I be chillin’, but I gots to represent at all times, 'cuz ain’t nobody else reeceeve accountz right but ME.” --Herbert Kornfeld
Never seen an X-ray, but there appears to be nary so much as a nub of potential leverage there. Take your left hand and place it along the back of your right, pressing the thumb down under the palm: you should get a smooth running line from your index finger to the base of your palm. That’s my boy.
BTW, Thumbless works as a DJ, and has no prob opening CD jewel cases between his index and middle fingers (like I mentioned, his spread is something). When it comes to manipulating silverware, sometimes he employs the ring finger for additional angles of leverage. Nose picking is accomplished as with a standard-issue hand. Bird flipping remains similarly unimpaired.
Unfortunately, I’ve never seen him tie a shoe, but I’ve seen him wear laces. If I remember I’ll ask for a demonstration and then issue a report.
I’ve never heard of anyone bleeding to death from losing a finger or thumb. The radial artery goes pretty close to the thumb, but otherwise I’m not aware of any particularly big bleeders there. Even if you had an arterial bleeder there, the surface area would be small enough that cauterizing it with heat or silver nitrate would be fairly easy to do.
I’ve seen a few times on TV people who’ve lost thumbs to frostbite, trauma, or whatever, and often a surgeon with replace the thumb with one of the patient’s own big toes. It’s so difficult to function without thumbs, especially if you’ve grown accustomed to having one or two. Apparently, the big toes work wonderfully and even look almost exactly like thumbs.