Part Two - The ER (Bad Luck).

(Survived the trip to Montreal and back, by the way. Although some people out there still need to learn the art of "driving to arrive".)

Now before we start, I want to remind you to read my little "disclaimer" beside my photo there on the top right. Although the events here are more or less unchanged, I took some liberties with the identifying details. I'm a little paranoid, but in this business, I believe that's an advantage.

So, I want to tell you about the night I spent helping out in the ER, which just so happened to be the night of Last Class Bash. The night that students from both Universities in this relatively small town are celebrating the end of their classes. Drinking, obviously. Every single person we met after about 10 pm had been drinking. I'm not exaggerating either, I mean everyone.

Although they had all been drinking, some were not to blame for whatever put them in the hospital that night. Some certainly were. (This is really the night that inspired my previous written post). Drunk patients with their drunk friends. With various injuries: serious, minor, or imagined. Self-inflicted or otherwise, we saw it all that night. And although alcohol was always a factor somehow, and some patients may very well have deserved what they got, some were just plain unlucky. It seemed to become a theme for the night.

My first indication of this was a young man who was walking across a fast food parking lot, minding his own business, and was hit by a speeding car. It was a hit and run. Apparently the patient was also seizing on scene. He did have some pre-existing neurological problems. When he was brought in, he seemed to be alert, although quite anxious. The nurse began with the quick, basic neuro exam which consists of asking the patient their name, date, where they are, and what happened to them. He passed the first question just fine, "My name is Joey", (not the real name, of course). The nurse asked, "Do you know the date?". Reply, "My name is Joey... my name is Joey". Okay... yes, we've established that, but can you tell me what happened to you? "I don't know... my name is Joey, my name is Joey...". Obviously a fractured leg was no longer the main concern.

While I was with this patient, I overheard a radio patch to another ambulance. Two unresponsive patients at a motor vehicle accident. I knew we'd be getting no sleep tonight. They wheeled them in. These guys were in rough shape. All cuts and bruises and road rash. Fading in and out of consciousness. I learned that they had both been drinking. One was the driver, the other his passenger. They had gone off the road, single vehicle accident, and rolled the car into a field. Only the passenger was well enough to leave the car and return to the road to flag down help. In keeping with our theme, as he walked to the side of the road he was struck by another car. Another hit and run. The next driver to pass by called 911.

Shortly after that, another unfortunate young man came through the doors. The story here was that he had stepped in front of a car and had broken his femur. Now this is not just another broken bone, femur fractures are taken very seriously. The reason is that your femoral artery travels just parallel to the bone down your leg. When there is a complete fracture there is also the danger that the broken bone could sever the artery, causing you to bleed out.

He had obviously not touched the artery, so first on the to-do list was to stabilize the broken femur. The doctor and nurses fiddled with the traction splint while I stood back. (I began to explain how to use it, because we had many times in class, but I'm "just a student", so they didn't pay me much attention. Others were more receptive, but I knew when to just back off). The patient had been sedated for the splinting, and if you've ever had a bone re-set, you'll know why. Something that was interesting to see was how much the leg had been shortened. He had suffered a complete fracture, so the muscles and tendons in the leg pulled the bones together, looking something like this. Leaving his left leg about 3 inches shorter that his right. The doctor stretched his leg down to even the length, and I grabbed a hold of his thigh to hold the fracture steady. I'll tell you, I have never felt anything quite like it. There was nothing holding his thigh together, the flesh and muscle were like jelly in my hands. Sorry, that was gross. I still have to get used to telling these stories.

The splint was applied. Unfortunately, during the procedure, the effect of the sedation had been amplified by the amount of alcohol in his system. Just as I let go of his leg, he stopped breathing. The respiratory therapist began to ventilate him with the bag valve mask (BVM). I pitched in and took over. He was fine, but he was so heavily sedated that his body could not breathe for itself. Another first for me. The responsibility of knowing that if you don't squeeze air into this man's lungs, he will die. Obviously there were lots of people around to keep an eye on him, but still, it's a feeling that will control you. And when I would test his body's respiratory effort, by removing the mask to see if he could breathe on his own, and nothing would happen, I'd realize just how much we depend on others to keep us alive when we are unconscious and have no idea what's happening. That drove home the fact that I can't be getting into this job for the recognition.

I was with him, squeezing the BVM and holding his jaw up to keep his tongue out of his throat, for about 40 minutes before he recovered. All of this, and all the while I am thinking, "Why did he step in front of that car? Suicide attempt, just drunk and being stupid?". I put it down to alcohol and that he had probably made some sort of terribly stupid decision. When he awoke, he told his parents the story, who then passed it onto me. I learned to always wait for the first person account. Apparently he had just left his building, and as he walked past, saw several others beating up a younger man beside the building. He went over to see what was happening, and tried to pull off one of the attackers. All he wanted to do was help. They immediately turned their attention to him, and began to chase him. He ran, and as he ran he came to a snowbank. He ran over the bank, and landed in the road, and was immediately struck by the car.

Bad luck.

-AM

the only living boy in New York