I have to resist the urge to slap them.
After I'm finished explaining that I'm NOT an emergency physician, I describe to them that I fix soft squishy stuff - spleens, livers, intestines, stomachs, etc. I also have to explain that there are several things in trauma that I don't do -
- bones - there is a reason why orthopaedic surgeons exist
- brains - no one really understand how they work, least of all me
- burns - burn centres exist for a reason too
Believe it or not I actually strongly considered going into paediatrics when I was in medical school. On my short list . . . ok ok, you can stop laughing now. I'm serious. As I was saying, on my short list was paediatrics and surgery. I've always loved kids, so what could be better than helping them? This philosophy remained until one fateful day during my paediatrics clerkship in medical school. I was in the clinic seeing a 3-year old girl who had an earache. I was dressed in my perfectly pressed white coat, freshly-laundered white shirt, and a Winne-the-Pooh tie that Mrs. Bastard had given me for just this occasion. I walked into her examination room, got down on one knee, and said with a smile in my kindest, warmest voice, "Hi there. What's bothering you today?" The girl looked at me, turned to her mother, turned back to me, shut her eyes, opened her mouth, and let out the loudest, most blood-curdling scream I've ever heard.
At that very second my list immediately changed to this:
Even though my hospital isn't supposed to treat paediatric trauma (ambulances are supposed to take these patients to the local children's trauma hospital), every now and then they bring a little tyke to me for evaluation. And every single time it reminds me exactly why I didn't choose paediatrics.
Little Mary (not her real name) was clearly heard screaming way down the hall as she was wheeled towards my trauma bay. As soon as I saw her, I saw that her distress was fully justified - she had obvious scald burns over her chest, shoulders, back, and half her face. My first thought was "WHAT THE HELL HAPPENED TO THIS POOR GIRL??". My second thought was, "Wait, I don't do burns, and I don't do kids. I sure as hell don't do kids' burns!" Regardless, here she was being deposited on a gurney that appeared much too large for her. Mary's mother accompanied her, looking none-too-upset while she chatted to someone on her mobile phone about a household bill. A quick (but thorough) evaluation revealed an adorable 3-year old girl with second-degree burns over approximately 15% of her body, but thankfully no third-degree burns.
Mom was now talking on her phone about a post on Facebook. I turned to ask her a few questions about Mary's medical history. I actually had to stand in front of her, staring at her, for at least 30 seconds before she acknowledged my presence.
"Hang on a second, the doctor wants something."
'Wants something'? Yeah, I want to know what the hell happened.
Mary's mom told me that Mary was a healthy girl with no medical problems. When I asked her what happened, the story she told made me want to jump on her and tear her hair out.
"Well you see, I was cooking noodles on the stove, and I don't like to use the back burners because it's too far away when I have to stir. So anyway (yeah, hang on, I'm talking to the doctor) I walked out of the kitchen to check something on my phone, and I couldn't have been away for more than, like, a minute when I hear a crash and Mary screaming."
You read that right - Mary's mother left a boiling pot of water on the front of the stove, well within the reach of any curious 3-year old, and then she inexplicably walked away. TO CHECK HER FUCKING PHONE.
There were no words to say. I guess the incredulous look on my face made no impact, because mom went right back to her conversation about her hair appointment later that day, which she may have to call and postpone because of this.
We bandaged up Mary and gave her some pain medicine, and once she was comfortable we transferred her to the children's hospital for further care. I didn't think she would need any skin grafts, but burns have a tendency to deepen over the ensuing 24 hours after the injury, so only time would tell.
Mary's mom almost became my next trauma patient, because every nurse in the room nearly attacked her. I couldn't get her out of my trauma bay fast enough.