While playing on a wagon during a family outing in June 2019, Jonathan McDermott, 6, of Dyersville, Iowa, got his hand caught in the wheel. In an instant, his right index finger was torn open badly.

The damage was so severe that emergency room doctors in Dubuque wondered whether the finger should be amputated. But they also knew that that question was better answered by a University of Iowa Health Care hand expert.

Jonathan Mcdermott sitting at a keyboard for physical therapy
Jonathan’s physical therapy after the skin graft included “just being a kid.”

“Right when they saw it, they said, ‘He has to go to Iowa City,’” says Jackie McDermott, Jonathan’s mom.

The McDermotts went to UI Stead Family Children’s Hospital, where orthopedic surgeon Lindsey S. Caldwell, MD, saved Jonathan’s finger by repairing it with a skin graft, and the whole care team helped the family cope with the trauma.

‘We can fix this’

After the initial shock of the accident and the frantic trip to the emergency room in Dubuque, Jonathan was shaken, and the family dreaded putting him through another round of frightening experiences in the hospital.

“He didn’t trust anybody, and he was scared,” Jackie says.

The first visit with Caldwell put their minds at ease.

“Dr. Caldwell was so optimistic,” Jackie says. “She saw Jonathan and said, ‘I think this is going to be good. We can fix this.’ It was like a day-and-night difference. We were so grateful to be there.”

Caldwell decided that a skin graft, using skin from Jonathan’s abdomen, could save the finger, and she recommended waiting a few days to let the wound begin to heal, which would make it easier to determine how much of the skin around the finger could be salvaged.

The McDermotts were able to return home for the weekend, knowing Jonathan wouldn’t lose his finger.

Keeping a scared young patient—and his parents—calm

Jonathan wasn’t looking forward to the procedure, understandably, but Jackie says the care team, supported by the UI Stead Family Children’s Hospital Child Life staff, did a remarkable job of keeping Jonathan—and his parents—in a good frame of mind.

“What kept my husband and I calm was the way they focused on keeping Jonathan calm and not scared,” Jackie says. “They really did a good job of coming down to a 6-year-old’s level. But when they did that, they also turned to us, like, ‘Are you OK with this?’ It was comforting.”

As with many children his age, Jonathan was especially afraid of needles. The care team knew just what to do.

“I don’t even know how he did it, but one nurse was able to distract Jonathan so well that he didn’t even know he was having his IV put in,” Jackie says. “And that’s what he was most scared of through the whole thing.”

‘Just being a kid’ is the best rehab

After the procedure, Jonathan’s hand remained in a bandage through the summer and was removed in August, just before school started.

Jackie wondered how much physical therapy would be required when the bandage came off, but Caldwell assured her that Jonathan would do the work on his own.

“Everything Dr. Caldwell said made sense to us,” Jackie says. “She told us that just being a kid is therapy, that he’d just eventually start using it so much that he won’t even notice anymore. Now it looks really good. He had some bad scarring, but it’s really healed nicely.”

The McDermotts are grateful, not just because Jonathan’s finger was saved but also because the care he received was so obviously delivered in a way that took the whole family and its concerns into account.

“Everybody did an awesome job,” she says. “We were so blessed and thankful to be in a place where the medical team understood he was 6 and very scared.”

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