A patient is being wheeled fast as hell down the hallway of our Level 1 trauma center. Blood is dripping off the steel frame of his cart. A collection of the older, goopier stuff rests in a pool under his left leg. I see an entry point near the middle of his tibia as he enters the shock room, a great crevasse. I do not see an exit.
A memory bubbles up from medical school. My orthopedic attending, explaining that it is much worse when the bullets do not go all the way through. It means all the kinetic energy was transferred to the flesh. I didn’t understand what he was saying, but I didn’t want anybody to know that. So I nodded in amazement anyway.
Most truths in medicine are not profound. It is indeed better not to have a bullet inside of you.
I just see blood. The same substance in so many colors – black, pink, bright red – all mixing with his blue jeans. I am mesmerized by the landscape, the buzzing of twenty-some worker ants all around him shouting various statements or commands.
“Femoral pulses 2+ bilaterally.”
“Lung sounds intact.”
“Let’s get an IV.”
“Only have pedal pulses on the right.”
“Pushing fluids.”
In this organized chaos, the ER resident pulls out big, gnarly scissors and starts slicing the jeans. The patient’s face is bright and full of glee, and he laughs as he speaks: “Damn man! I would have changed if I knew y’all were taking them!”
The resident replies: “Ha! Just getting a better look, my friend.”
This makes the patient laugh harder. A social contagion: chuckles from the other workers.
The team flips the patient on his side; they need to ensure there are no other wounds. The resident slips down the patient’s boxers to look at his ass.
The patient squirms and wriggles and begins to laugh even harder: “Buy me dinner first, man!”
Laughter erupts from the room.
The patient goes for imaging, then comes back some minutes later. The trauma surgeon takes a look at the imaging, then whispers to the ER doc: “Looks like there is vascular compromise, and the shrapnel is everywhere. Need to get this going. This thing might have to come off.”
The pit crew unlocks the wheels and starts racing him down the hallway again.
The patient’s shimmery white teeth are still beaming: “Ha! Where we headed now? Y’all always taking me off somewhere.”
The team’s laughter echoes down the hallway.
Chad Emerson Childers
Indianapolis, Indiana