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How a doctor learned how to suture

Fizzy, MD
Physician
July 27, 2011
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One of the skills I really wanted to learn in med school was how to suture. It’s just one of those things that I felt like you’re supposed to know if you’re a doctor. How can you be a doctor if you don’t know how to suture?Anyway, by fourth year of med school, I had totally failed at my goal. I had already done a surgery rotation, but while I was really, really good at cutting sutures that other people had already tied, I couldn’t really tie them on my own.

Moreover, some of my classmates were really experienced. My housemate, a future ER doc, would breeze home from his EM rotation, talking about all the lacs he sewed up that night and also how he reached into some guy’s chest and massaged his heart or something. Meanwhile, I was watching pregnant women deliver babies from the far corner of the room. I don’t think I was aggressive enough.

When I got to my Emergency Med rotation during fourth year, I thought to myself, “FINALLY, I am going to learn how to suture!”Except again, I was thwarted. I did my EM rotation at a hospital where no lacs were seen in the main ER, only in fast track. And I was only allowed to do two shifts total in fast track. And there were never any lacs. The second I’d leave, apparently five would come in all at once, but it’s like the patients knew to avoid the clueless med student who wanted to stick a needle in them.

On my last day, I got a patient who had sliced his hand with a propeller from a plane and he was totally down with letting me suture him up. I was so psyched. I would love to tell you that I did a fantastic job and was met with glowing adulation, but the truth was that it took me like twenty minutes to put in one stitch before the PA insisted on taking over, and ended up undoing the one stitch I managed to put in.

And that was kind of it for med school.

For the longest time, I was embarrassed to tell this story. I had graduated from med school without learning how to suture. That’s like… graduating from high school without learning how to read (sort of). Luckily, I got to do another EM rotation early in my intern year.

I still remember my first patient with a laceration, who was listed as the victim of domestic violence. I felt a little bad practicing on a domestic violence victim, until I saw the varsity football player whose girlfriend had sliced him up because she caught him cheating on her. I was totally fine with practicing on that guy.

Let me give you a tip: the key to doing something in medicine that you don’t really know how to do is to act totally confident and don’t say things like, “oops” or “whoops” or “uh oh” (you get the idea). The first few stitches took me an eternity to put in, but I continued to act like I wasn’t dropping every stitch, and the guy didn’t seem like he was in a rush. He was just lying there, looking unhappy about the events of the night, so I just took my time. And eventually, I finished sewing him up.

Then on my next shift, I had a patient who had the skin on his hands sliced to shreds by a band saw. It took me two hours, but by the end of that, I felt like a freaking expert at suturing. (And the patient was grateful. After I finished bandaging his fingers up, he told me that his hand looked like “a beautiful flower.”)

So that’s my suturing story. It’s kind of a disgrace that I didn’t learn the skill in med school, but at least I learned it eventually. And then likely forgot it in the subsequent five years, since I was never once asked to suture again.

“Fizzy” is a physician who blogs at
A Cartoon Guide to Becoming a Doctor.

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