Disclaimer – If you are grossed out by medical stuff, skip this post. I keep it pretty clean, but it still might make some people feel queasy.

It’s a word you hear a lot in nursing school. It’s the key to passing the nursing boards. It takes years of experience to really make those judgements with aplomb, and even then, you can walk in for a shift and things start getting thrown at you that make those decisions for you.

At work, we shake our heads when we come across a patient or family who ignored stroke symptoms, or difficulty walking, or a deteriorating mental state, for weeks before seeking medical care. By then symptoms that might have been relieved with prompt treatment are now a dire situation, and options are more limited.

In reality, we are making medical judgements about our families and ourselves all the time, although for most of us the consequences aren’t as grim. Does that cough merit a trip to the pediatrician? Is that knock on the head something serious? Do I really need to schedule a physical, or could I go another year? I feel fine!

The amazing day at the waterfall, as we were coming down the trail approaching the water, a wet piece of bamboo snapped, flew up, and into my leg. I felt it go in deep, and carefully pulled it straight out in the direction it went in… but a piece broke off. It was below the level of my skin and I couldn’t see it, but I knew it was there.

Over the next several days, we applied poultices, essential oils, fresh aloe, antibiotic ointment. I took ibuprofen and soaked my leg in a bucket of cool water whenever I was sitting down. My nurse sister-in-law and I examined the angry red and swollen area every day and discussed if we should head up to the hospital.

There’s no urgent care in Tobago, so it was Accident & Casualty or nothing, and this didn’t feel like a true emergency.

A week after it happened, I was soaking my leg again. It was showing every sign of infection and the worst case scenarios had been flitting in and out of my thoughts. Up until then there had been nothing visible for me to pull out, and I knew better than to go digging.

This time, I pulled my leg out of the bucket and thought I saw the end of my bamboo. I washed up, sterilized my tweezers with a lighter, and pulled out a piece of bamboo 1/2 in. long and several millimeters wide.

My leg was still angry and red a couple of days later, with what nurses call +1 pitting edema around where the bamboo had come out. It would be a while before it looked normal again, I thought.

When I got home, two weeks after it had happened, it still hadn’t healed. A trip to my doctor bought me some antibiotics, and instructions to call if it hadn’t improved after a couple of days. Because I am slow to intervene and because of when the weekend fell, two days became five.

When the antibiotics didn’t make a difference, my doctor sent me to a surgeon. Yesterday they Explored the Wound. The surgeon and the nurse who was assisting him conferred briefly on what size scalpel to use, probably forgetting that I am a nurse and knew what they were talking about even though the word “scalpel” was never actually mentioned.

There were painful injections of lidocaine, then the doctor started digging. He soon pulled out another splinter almost as wide and just as long as the first, and some debris. I watched with a mixture of horror and fascination, knowing that although the surgeon wasn’t making a big deal about it, that sucker was going to hurt later after all that manipulation.

He finished looking around, and then packed the wound and wrapped it up. I was to change the dressing every 24 hours and come back in two days. Even though the antibiotics aren’t doing anything, I have to finish the course so that I’m not the cause of the pandemic that will one day hit the earth and decimate its population. (I hope that as a nurse, I have colonized all of the nasty bugs that might be involved in that deadly illness and given them to my family so that when that fearful day comes, we will all be Super Immunes.)

It will definitely leave a scar, but I won’t have to amputate.

Sometimes outcomes like those two seem so far from one another. But most people who end up going down a certain path… towards sepsis, or irreversible brain damage, or whatever it is… those often aren’t sudden events, one choice that led to a terrible end. They are a series of choices we make, maybe going back as far as lifestyle choices and whether or not we dealt with a less important health concern in a timely way and stayed on top of it.

How can we know which of those micro-decisions we make every day is going to send us down a certain path? We really can’t.

I could have let my leg fester for a pretty long time while telling myself it would get better. Instead, I found out by visiting my doctor that I’ve been away for six years and was even guilted into scheduling an annual physical while I was there.

True to my prediction, my leg is twinging something awful today and I’m procrastinating the dressing change because what nurse wants to do a dressing change on themselves? Not this one.

I’m experiencing some relief, and also a little more understanding of folks who wait before seeking care. This was a reminder of how easy it is to tell yourself “It’s nothing,” even when it’s not.