Dr. Joel Aronowitz - Plastic Surgeon Reacts to Johnny Depp Finger Amputation in Amber Heard Defamation Trial!
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| Dr. Joel Aronowitz |
Dr. Joel Aronowitz: "I want to do a little reaction video to Johnny Depp describing how he lost his fingertip from the medical point of view. So let's follow along in the trial, which is fascinating if you have all day to listen to it. And then let's talk about exactly the mechanism of injury, how this is treated, what you should do in a similar situation. Okay, so let's go. This is a video from the testimony itself in court. So he's describing the mechanism of the injury, which is very important.
So what happened here most likely is that his finger got trapped between the bar and this heavy glass bottle. And that's not unusual. Many patients will describe a sudden shock, and they don't even realize something has happened, especially in a blunt injury like this. Because it's not the broken glass that has caused the laceration. It's probably what's happened is it's a crush injury where the fingertip is pinched between that bottle that's striking it and the bar or where his finger was. So he felt the blood coming out, and that's the warm feeling, but he didn't realize his finger had been cut off. Now you know it's below the nail since there's bone there because the nail is sitting directly on the flattened part of the bone, the distal phalanx, it's called. When he's saying meaty parts, this part, the pad of the finger isn't meat. It's actually just fibro-fatty tissue with a lot of nerve endings.
I think that I went into some sort of, I don't know what a nervous breakdown feels like.
Well, I think he went into a little bit of a panic because he realized that something bad had happened and he didn't realize exactly what bad had happened.
And I knew in my mind and in my heart, this is not life. This is not life.
This is life. You don't want it to be life.
No one should have to go through this. And as I said, this feeling of nervous being in the middle of some sort of nervous breakdown, I started to write with my blood, in my own blood, on the walls.
Now we're going from the hand injury to more psychiatric, which I'm not really an expert in. I will say that what he's looking at here is the tip of the bone sticking out, the fat that he severed. So he's looking at the pad of the finger here, that fibro-fatty tissue, the bone, and then some of the nail plate. That's the actual fingernail is called the nail plate. And as you can imagine, there's a good blood supply there, so it's probably bleeding pretty briskly by now. Now what should you do if that happens? You should find the, first you should apply pressure directly to the area that's bleeding so you can take a clean gauze or even a tissue and clean off the blood, apply the gauze, and then just hold gentle pressure. Even though it's bleeding briskly, it's not going to be able to continue bleeding if you're holding pressure because the force of the blood is not very high by the time you get to the fingertip. Even arterial bleeding, it's not a very powerful surge of blood, so just gentle pressure should be able to take care of it. And within about 10 to 12 minutes, any bleeding should stop, and you can take your finger off and put a temporary band-aid on. Then find the part because it's going to be very important to bring that piece of tissue in, whether it's just a piece of skin that's mangled or it's a, if it's, regardless of the mechanism, it's better to bring in that tissue and let the doctor in the emergency room decide whether or not they can actually use it and sew it back on. I think Johnny Depp here probably doesn't remember the whole thing. He had been drinking and had been in an emotionally fraught kind of situation, but...
Attack of insults, it was just jumbled words to me in a very high frequency and I...
So, I think that's enough of the video because it describes the medical portion here. Let's just review. So the fingertip is a complex area. We have the nail plate, the hard nail. It's sitting on what's called the sterile matrix, which is a little pad like the padding of a, that you put down before you put carpet down. That's sitting directly on a flattened bone that's the distal phalanx and that flat bone is what the nail sits directly upon. Underneath the bone is this, what he's describing is the meat. That's fibro-fatty tissue and if you open that up, what you see is little globs of fat, that's sort of tight with fibrous tissue, as well as little organelles that sense temperature and pressure, and all the sensations of touch that we have. And you can see a lot of those with the naked eye. That basically, they're transducing temperature, pressure, light touch, vibration, heavy touch. They're transducing those physical characteristics into nerve impulses that go through the digital nerve, the sensory. This is a sensory nerve, all the way back up to our spine; from the spine, into the brain, where we sense that what is going on. And, in a way, you can look at the fingertips being our sense of touch with the rest of the world, and the arm, the shoulder, everything else, just there in order to get those fingertips to whatever it is we want to touch and manipulate. So, I hope that helps.
Now we're going from the hand injury to more psychiatric, which I'm not really an expert in. I will say that what he's looking at here is the tip of the bone sticking out, the fat that he severed. So he's looking at the pad of the finger here, that fibro-fatty tissue, the bone, and then some of the nail plate. That's the actual fingernail is called the nail plate. And as you can imagine, there's a good blood supply there, so it's probably bleeding pretty briskly by now. Now what should you do if that happens? You should find the, first you should apply pressure directly to the area that's bleeding so you can take a clean gauze or even a tissue and clean off the blood, apply the gauze, and then just hold gentle pressure. Even though it's bleeding briskly, it's not going to be able to continue bleeding if you're holding pressure because the force of the blood is not very high by the time you get to the fingertip. Even arterial bleeding, it's not a very powerful surge of blood, so just gentle pressure should be able to take care of it. And within about 10 to 12 minutes, any bleeding should stop, and you can take your finger off and put a temporary band-aid on. Then find the part because it's going to be very important to bring that piece of tissue in, whether it's just a piece of skin that's mangled or it's a, if it's, regardless of the mechanism, it's better to bring in that tissue and let the doctor in the emergency room decide whether or not they can actually use it and sew it back on. I think Johnny Depp here probably doesn't remember the whole thing. He had been drinking and had been in an emotionally fraught kind of situation, but...
Attack of insults, it was just jumbled words to me in a very high frequency and I...
So, I think that's enough of the video because it describes the medical portion here. Let's just review. So the fingertip is a complex area. We have the nail plate, the hard nail. It's sitting on what's called the sterile matrix, which is a little pad like the padding of a, that you put down before you put carpet down. That's sitting directly on a flattened bone that's the distal phalanx and that flat bone is what the nail sits directly upon. Underneath the bone is this, what he's describing is the meat. That's fibro-fatty tissue and if you open that up, what you see is little globs of fat, that's sort of tight with fibrous tissue, as well as little organelles that sense temperature and pressure, and all the sensations of touch that we have. And you can see a lot of those with the naked eye. That basically, they're transducing temperature, pressure, light touch, vibration, heavy touch. They're transducing those physical characteristics into nerve impulses that go through the digital nerve, the sensory. This is a sensory nerve, all the way back up to our spine; from the spine, into the brain, where we sense that what is going on. And, in a way, you can look at the fingertips being our sense of touch with the rest of the world, and the arm, the shoulder, everything else, just there in order to get those fingertips to whatever it is we want to touch and manipulate. So, I hope that helps.
Here's the lesson: if this happens to you, or somebody that you encounter this, first stop the bleeding. Gentle pressure with a clean gauze, or even napkin, or something cotton, because the cotton will stop bleeding. Just gentle pressure. If it's still bleeding underneath that, take it off, clean this surface, even though it hurts, you can do it quickly, apply a fresh gauze, and apply fresh pressure directly on the area that's bleeding. That should be able to control it. Once you get the bleeding control, the person sitting down, find the part. Don't go to the emergency room without the part, bring the part in. If you need to store it for a while, you can put it in a cloth, or even a napkin, whatever clean thing that you can find. Put it in a little container, if you can find one. Don't worry about putting it in water, that sort of thing. I wouldn't do that unless you happen to have sterile saline. But, if there is a little blood, the blood is relatively balanced, and you can put it in a bloody gauze, that will keep it a little bit moist, then you should be able to get to a hospital, to a doctor, or urgent care, within an hour, two hours, three hours, and even the next day, that amputated part can be useful to the doctor taking care of the injury. So, I hope that helps, and I hope that never happens to you, or anyone that you care about. And I hope that you learned a little something from Johnny Depp's unfortunate accident."
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