Posted: Dec 22, 07 4:00pm
WARNING...the following post is true. Explicit scenes of gore and trauma....please don't read if you are in the least bit sensitive to this type of material......
The information bounces from one to the other "chest stabbing in 10" , "stab wound coming in 10 minutes", "did you hear about the trauma coming in? 10 minutes, no vitals yet". We assemble in the trauma bay, the adrenaline starts to rise. Plastic butcher aprons, waterproof (blood proof) shoe covers, gloves, masks with plastic eye shields....we wear the costume so we can shed the plastic after and remain ourselves inside. Bins of equipment are made ready, seals broken. Scalpels and suctions and drugs are at hand. The adrenaline rush continues. We feed off each others energy....it is palpable. Pupils dilate, breathing quickens, synapses fire quicker and more efficiently...no wasted thought or movement. The young ones overdose and they shake. They talk a little too fast and sweat. They have not yet learned to control the rush....virgins of emergency. There are enough old dogs here to control the scene.
The trauma surgeon arrives, all five feet, 100 pounds of her. She is an Irish lass with a slight brogue, a sharp wit, and a red pony tail. It is after midnight and we woke her....she is slightly rumpled but throws her purse strap onto her shoulder and prepares to battle with us. Her skills with a blade are unmatched.
The ambulance backs in....the patient arrives. The medics and firemen are panicky....this call has gone terribly wrong. The gurney is wheeled in. One fireman is doing chest compressions, one is attempting to ventilate but there is too much vomit. They all talk at once..."He was talking when we picked him up", "we couldn't get a line", "we couldn't get an airway", "he bled out","sorry","we don't know anything, we just picked him up out of the street". No one is listening. We are doing what we are here for. What happened before is of no use....we are dealing with what needs to be done.
The sharp tang of bile and beer assaults our noses...it is everywhere. Slippery slimey puke in his mouth, eyes, throat....it is occluding his airway. Suction and towels assist and the airway is secure. His lungs inflate and we breathe again, too.
Quick assessment....skin color too pale for a Mexican, belly too big, one half-dollar size hole under his right clavicle but not bleeding. This is bad, this no blood thing. No pulses. The surgeon grabs her scalpel and cuts. Deep slice horizontally between the 4th and 5th ribs, all the way in. A hammer and chisel is used to break the sternum, carpenter sounds but not construction. Bones crack, crack, crack. The rib spreader is placed into the gash and the handle turned to spread the chest. Like an oyster protecting his pearl, the chest protects its heart. But she attains her prize, flesh and bone no match for a surgeons tools. She reaches in and pulls clots of blood away, the coppery odor overwhelming our noses and throats. We taste the smell of it.
Everyone is busy doing something to save this life. Needles are poked into veins, lungs inflated, suction applied, No talking, except for the surgeon who gets what she needs. Her hand in his chest, fingers as eyes, relaying the extent of the damage through experienced fingertips. Probing, feeling, buried up to her forearm in his chest wall, purse still on her shoulder. "The right atrium is gone". "I don't think I can fix this". Eye contact. "Wait, wait. Maybe some suture" She feels. "No, no. Nevermind. There's nothing here. There's nothing left to sew together".
She removes her hand, we stop and wait for her. Heads swivel to the clock. "Time of death, 0102". Whoever stabbed this man tonight and left him for dead has succeeded in his goal.
Talking resumes, costumes disposed of. Paperwork is shifted from resuscitation forms to autopsy requests. Adrenaline levels taper off as we walk away. We turn our attention to the living that still require care...the shift is still young and there are plenty of hours left to go. We live for this.
