Monday, 8 December 2014

Just when you think...

Ok, NOW I've seen everything.

That's a phrase that enters my brain almost every time I am on call.  After seeing children shot in the head, grown men crying like babies over minor abrasions, a woman kicked in the head by a deer, a man impaled in the boy-parts by a piece of his broken motorcycle, fingers cut off by power saws, and every conceivable traumatic injury in between, it seems like the Call Gods can't possibly find something I've never seen.  I think that everything that could possibly happen has happened, and I've seen it.  But then the Call Gods throw me a curve ball, something that even my wildest imagination couldn't envisage.
Yes, it happened again.

My second patient of the day was another fall victim.  The first one had been an elderly lady who fell down the stairs and broke her back.  This one, however, had fallen from a standing position.  When I heard that mechanism of injury, I groaned.  Audibly.  LOUDLY.  For patients like these, I think of it this way: if you fall from a standing position badly enough to pass out, you probably are A) drunk, B) drunk, C) drunk, or D) otherwise unhealthy enough to have passed out merely from falling down.  They are usually not the worst injured patients, and I rarely get too excited at the prospect of seeing another elderly ground-level fall "victim" with bumps and bruises and little else.

A few minutes later Arthur (not his real name©) arrived moaning and groaning, yelling that his hands hurt, his head hurt, his neck hurt, his legs hurt . . . pretty much everything from the tips of his hair to his toenails hurt.  He was a rather burly guy, about 120kg, but he was acting like a 15kg toddler.  His only outward signs of trauma were some abrasions on the bridge of his nose and his forehead, but whenever I touched his hands or legs, he screamed.

His workup was essentially negative - bumps and bruises, a cervical strain (whiplash), and a concussion.  So if he sounds like most of the other ground-level falls, why the hell am I writing about him?

Because he wasn't drunk.  He didn't trip and fall.  No, Arthur was wrestling with his wife who got the better of him, jumped on his back, and put him in a choke hold until he passed out and fell flat on his face.  Five minutes later when he still hadn't awakened, his wife freaked out and called emergency services.

As he explained what had happened, his wife walked in.  She couldn't possibly have been as tall as Arthur's chest, and she might have weighed 1/3 what he did.  I listened to Arthur intently, my eyes flitting from him to her, trying to look him in the eye while all the time doing my best not to break out in a fit of raucous laughter.

Did he let her win, or is she some kind of human honey badger?  I have no idea, but fortunately the little Tasmanian devil didn't do any major damage.  As I walked out, only one thought crossed my mind:

NOW I've seen everything.

12 comments:

  1. nowhere near. but why was he in such excruciating pain? was it just that he was a bit of a wimp, or was it something to do with the chokehold? maybe pins and needles from the chokehold interfering with circulation?

    some time back, we had a "fell from standing and passed out" call, that turned out the patient had been standing on a ladder changing a light bulb when he had a dizzy spell and fell off the ladder. since then I have typically made a point to ask, "did the fall cause passing out or did passing out cause the fall?"

    ReplyDelete
    Replies
    1. and in the "seen everything" department, my department once got a call on a report of a man passed out against a signpost on the roadway. first on scene immediately cancelled all other response.

      a man had been jogging, and at his turnaround point had felt a bit tired, so he sat down against a signpost to take a rest. no, he wasn't even napping, let alone unconscious.

      Delete
  2. C'mon then Doc! I'm sure we've only heard about half of these:

    "children shot in the head, grown men crying like babies over minor abrasions, a woman kicked in the head by a deer, a man impaled in the boy-parts by a piece of his broken motorcycle, fingers cut off by power saws, and every conceivable traumatic injury in between"

    Are you holding out on us?

    And why did the half-strangled guy hurt so much if he only had such minor issues? Can you really weigh nearly 19 stone and be so delicate?

    ReplyDelete
  3. Couple's wresting never goes in favor of the man. The guy holds back because he's afraid of hurting the girl, and girl uses no restraint what so ever because she doesn't think she can hurt the guy. Surprise, surprise... Men do indeed have nerve endings.

    Agree with Ugi. I don't think you've touched on half that list. I'm intrigued.

    ReplyDelete
  4. Yes, big guys can be delicate. And they can be big babies when put in their place by tiny women. I am barely over 5" tall and when I was taking Kempo in college I weighed 93 pounds. In a sparing match I threw the biggest guy in the class. He was easily 6"3' and weighed well over 200 pounds, and that was muscle, not fat. I just had the right leverage and speed going. He whined and wussed about it for over a month until in my best bible college etiquette to shut the eff up. And I do have dents in my skull from falling from a standing position during a ventricular arrhythmia with out being drunk. So that happens too.

    ReplyDelete
    Replies
    1. "I am barely over 5" tall and when I was taking Kempo in college I weighed 93 pounds. In a sparing match I threw the biggest guy in the class. "

      I would pay big money to watch a 5 inch tall, 93 pound lady spar against a big guy.

      Delete
  5. So. My question is. What would the reaction have been had he strangled his wife until she passed out? Were police involved and domestic violence charges filed or was everything "ok" because she's a woman and women aren't abusive?

    Why isn't anyone wondering about how he is doing with having a wife who dang near strangled him to death???

    ReplyDelete
    Replies
    1. the odd thing is: if he claimed the wrestling was consensual, then it doesn't count as domestic violence.

      it is only violence if someone objects to it.

      Delete
    2. I have to agree with Anonymous. The first thing that went through my mind was if the sexes were reversed, he wouldn't have been allowed in the exam room while she was explaining what had happened. Not to mention the police would have been called, even if the female victim had claimed it was consensual.

      Delete
    3. so, if she was 6' tall and 120KG, and he was only as tall as her chest and a third her weight?

      Delete
    4. If I went into the ER because my toddler slammed me in the face with a wooden train and I needed stitches, it would not raise alarm bells. If I slammed my toddler in the face with a wooden train, I'd quite rightly have the police all over me. Not all situations work the same in reverse.

      Let's not get disingenuous and pretend that a 5ft woman hitting a 6ft 260lb man is the same thing as him hitting her. It's not even close. There is a huge difference between a huge person who can easily over power a smaller person exercising that power to hurt someone weaker than them, and a weaker person accidentally hurting a bigger person because they over estimated how much they could take. The fact of the matter is, he could have very easily thrown her off or defended himself if he chose to. He got carried away and so did she.

      Delete
    5. "If I went into the ER because my toddler slammed me in the face with a wooden train and I needed stitches, it would not raise alarm bells. If I slammed my toddler in the face with a wooden train, I'd quite rightly have the police all over me. Not all situations work the same in reverse. "

      For one thing, a toddler can't consent.

      Delete

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