Sunday 28 July 2013
Not his time
I've been on this planet for quite a while, and thinking about things is one of my favourite pastimes. Unlike most of my patients, I actually like to use my brain. And after all those years of thinking about stuff, I've managed to come to a few concrete conclusions:
1) I'm fairly certain that I don't believe in fate or destiny.
2) I'm pretty sure that everything doesn't happen for a reason.
3) I'm kind of convinced that luck (good or bad) doesn't exist.
4) I'm nearly 100% positive that coincidences are merely coincidences.
What, not concrete enough? If none of those statements sound like I'm totally convinced, there's a damned good reason. And that reason is exemplified by this next guy I'm going to tell you about.
A young man in his early 20's was brought to me having been shot twice in the abdomen. A gunshot to the abdomen is bad, because bullets tend to tumble around, break apart, and change direction as they encounter soft, wet, squishy things like livers and spleens and guts and stuff. One gunshot to the abdomen is bad, but two gunshots is more than twice as bad. As he rolled through the door, he was pale as a sheet and sweating profusely, even though it was frigid outside.
Uh oh. Bad sign.
We tore his clothes off, and he did indeed have two gunshot wounds on his abdomen, one near the middle and the other about 6 cm (2.5 inches) away to the right. His initial vital signs showed that his heart was racing and his blood pressure was low. He was bleeding to death - actively dying - and needed immediate surgery. I had no time to do a CT scan or any other diagnostic test to try to find out what was injured. The only way to get any additional information was to stick a long cotton-tipped swab into the wounds to see which direction the bullet went - up, down, left, right, or straight in. It's not a lot of help (and not necessary), but at least it's something. And in that situation, the more information I have, the better.
As the nurses were frantically preparing to bring him down to the operating theatre, I grabbed a swab and gently inserted it into the wound on his right side, looking for the bullet tract. It didn't go up, not down, not straight in...ah, there it was - it went left, towards his belly button. I followed the tract along his abdominal wall looking for the site where it penetrated into his abdomen...
...and the swab came out the other hole. Wait, what? I checked again, this time inserting the swab into the other hole. And it came right out the first hole. I double and triple checked, and finally came to the conclusion that the bullet had gone into his abdominal wall at a sharp angle, tracked through the soft tissue, and had come right back out without doing any major damage.
So why was he so sweaty with a rapid heart rate? He had simply fainted from seeing his own blood. That was it. He was absolutely fine.
After he woke up a few minutes later, his vital signs stabilised, and a CT scan confirmed that the bullet never penetrated into his abdomen. I cleaned up his wounds and sent him home, AFTER making sure that he was perfectly aware that he is one of the luckiest people I've ever met.
Fate? Destiny? Coincidence? Good luck? Ha! Hell if I know. Mrs. Bastard would simply say it just wasn't his time to go.
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