The One-Handed Surgical Tie

 D. E. Larsen, DVM

It was the fall quarter of our junior year of veterinary school. We had a heavy class load plus clinic rotations. This meant we were in the clinic from eight in the morning until five in the afternoon. They just fit the classes in the middle of all of that stuff.

Realistically, I arrived at the clinic shortly after seven and usually didn’t leave until well after six in the evening. These last two years of school were busy. 

The worst was that it left me with little or no time to work. With the Federal GI Bill monies being exhausted, we were left with just the Oregon GI Bill. That only paid fifty-some dollars a month. We would be living on borrowed money.

We would start surgery lab this fall, but before we would work on a patient, we had to demonstrate various skills. Our surgery instructor was Dr. Creed. 

Dr. Creed handed out practice boards. We had to tie ligatures in all different angles and locations, down in a hole in the board, under a ledge, and on a hook. We also had to tie good surgical knots in various methods: instrument ties, two-handed ties, and one-handed ties.

Those knots on the practice board were all pretty straightforward. That is, most of them were easy. The one-handed tie was a bitch. 

I could get it done, but my one-handed tie and the book’s one-handed tie did not look anything alike. It didn’t matter how hard I tried. I could not tie that one-handed tie like the book said to do it.

After a week with the practice board, Dr. Creed felt everyone should be able to do all the prescribed ties.

“On Friday, everyone will have a minute or two in front of me with your practice board,” Dr. Creed said. “You must be able to make all the ties to advance to the surgery lab.”

Great! How was I going to tie that one-handed tie in front of Dr. Creed?

I practiced hard Thursday night. I could make the tie my way. There was no way Dr. Creed would approve of that tie. 

After thinking about how to get through this, I figured I would just have to go fast. Larsen would be in the middle of the class. He would probably be tired by the time he got to me anyway.

The following day, I was still practicing on my board as we all sat in the classroom waiting for our turn in front of Creed. Looking around, I was not the only one practicing.

When my turn came, I sat down in front of Dr. Creed and started tying knots right away. I went through the routine as fast as I could. I thought if I went fast enough, he might lose track of where I was at and forget to one-handed tie.

“You look like you have things down pretty good,” Dr. Creed said. “But you haven’t done a one-handed tie yet.”

So, without looking him in the eye, I returned my attention to the board and tied the knot as fast as possible.

“Wait a minute, that didn’t look quite right,” Dr. Creed said as he checked the knot I had just tied. “The knot looks okay. Let me see you do that again.”

I took a deep breath. I knew he would be watching like a hawk. I would have make my fingers move like the wind.

Someone must have been watching over me because just as I started the tie, Dr. Ingram stepped into the room to speak with Dr. Creed. Dr. Creed glanced away for a moment, just long enough for me to finish the tie.

Dr. Creed looked back at me with just a slight frown. He checked the knot. He had already spent too much time with me.

“You’re going to be a cow doctor away, right?” Dr. Creed asked.

“That’s my plan,” I said. 

“Okay, your knot is secure,” Dr. Creed said. “I’m not sure how you got it done, but you did it with one hand. You pass.”

That was a relief. I think the only time I used a one-handed tie after that day was when I had to suture a laceration on my left hand.

Photo by Pranidchakan Boonrom on Pexels.