One of my favourite things to do is to lecture people. By "lecture" I don't mean lecturing medical students, which I am unfortunately contractually obligated to do. It turns out I'm a terrible teacher; I just have absolutely no patience for people who just don't get it. Ironically, my backup plan if my medical career fizzled was to be a biology teacher. Yeah . . . that would not have gone well.
No, what I mean is lecturing patients, most notably drunk drivers. I love it. I relish it. I enjoy every opportunity to tell people that what they just did was stupid, reckless (though not wreckless, har har), irresponsible, and their thoughtless act endangered not only their own lives but the lives of everyone around them. In case you can't tell, I have a canned speech in my head that I've used several hundred times, and it keeps getting better every time I give it.
Unfortunately I don't always get to give The Speech. Sometimes the bad guys leave before I get the chance, and rarely there just isn't time. Even more rarely, however, I don't need to.
Like with Edwin (not his real name™).
Being awakened in the middle of the night is a pain in the ass. Not only do I have to shake out the mental cobwebs to make sure I am alert enough to deal with whatever is coming in, I also have to rinse my mouth a bit and make sure my hair doesn't look completely insane. Don't misunderstand, I don't care if I look a bit like Albert Einstein, but trust me when I say you absolutely do not want your trauma surgeon looking like Yahoo Serious. Anyway, when my pager goes off at 3 AM on a Friday night telling me I have a car accident victim on the way, I can be well assured it's a drunk driver.
Enter Edwin the Drunk Driver.
I like to think that Edwin, who was 22-years-stupid, would have been a Type I Drunk had he not been quite as intoxicated as he was. However, with the amount of alcohol in his system, he could barely keep his eyes open let alone yell at people coherently. Everything that did come out of his mouth was mumbled worse than Muttley. I was absolutely astounded he had even been able to find his car keys let alone drive. Though he couldn't really speak, what he could do was fight: with the medics, with us, with literally anyone who came within arm's reach. He had blood on his face which clearly came from somewhere, but he was completely unable to cooperate with any sort of workup. We were therefore forced to sedate him and intubate him to complete (or start) our evaluation.
Once he was sedated the entire team let out a collective huge sigh of relief as the trauma bay immediately quieted. What was most obvious was the relatively small laceration on his forehead which had already stopped bleeding. What hadn't stopped bleeding, however, was his spleen.
His splenic laceration was first diagnosed by a bedside ultrasound and was then confirmed by CT scan. It wasn't the worst I'd ever seen, but it was certainly there. He also had a few minor fractures in his pelvis, none of which would be anything more than really annoying for the next few weeks. But as I was going through his blood work, one number stood out that caused my ire to rise. It was a foregone conclusion that his blood alcohol would be elevated (it was about 4 times the legal limit), but even though the number didn't really surprise me, for some unknown reason it still made me angry.
Actually, no it isn't an unknown reason. The reason is very known. It's because my wife drives my children around on the very roadway Edwin was screaming his way through that night. Edwin put everyone's lives around him at risk, and he was incredibly lucky that only he was injured, luckier still his injuries did not end up being life-threatening.
The Speech was already being prepared in my mind. I just needed to let him sober up overnight. No sense in wasting it on a slurring puddle of whiskey or beer or whatever the hell he had been drinking.
By the following morning, Edwin was sober, awake, and breathing on his own, and the breathing tube had been removed. I stood outside his room readying The Speech with steely resolve, hoping his mother/wife/girlfriend/anyone would be there to hear my scathing lecture. I took one final breath, turned around, and walked in.
What greeted me was not at all what I expected: Edwin, the loud, brash, obnoxious, out-of-control drunk from the night before was talking softly, almost meekly, with his mother, who looked mildly anxious though not angry.
Well . . . that was unexpected.
After perfunctorily asking him how he was feeling ("Sore, doctor"), if he was having any new pain ("No, sir"), and if he remembered anything from the previous night ("No, sir"), I was about to launch into The Speech when he cut across me gently.
"Doctor, did I hurt anyone last night? Is everyone ok?" Tears started to well in his eyes.
My steely resolve was starting to turn into oatmeal.
It only took a minute or two of talking with Edwin to discover that he was truly and genuinely mortified at what he had done and what could have been. The last thing he remembered from the previous night was drinking at the pub, and the next thing he remembered was waking up in his hospital bed this morning. He was terrified he had hurt someone, and he had nothing but regret and remorse behind his eyes.
Yeah yeah, I can already hear a lot of you cynics screaming "But Doc, come on! He was faking it! How could you fall for it? He just feels bad because he wrecked his car!" No. I saw his eyes. This was no act. I see a lot of drunk drivers and I've heard the lot of them tell me how they've never done it before, they'll never do it again, blah blah blah blah. I can see right through the charade, and it doesn't impress me in the least. But Edwin was different. Edwin impressed me. He looked instantly relieved when I told him it no one else was hurt, but he was still visibly shaken.
"That just isn't me, Doc. I don't know why I did that. I just have no idea." The tears continued, real tears of penitence. "I swear that just isn't me. I just have to learn from this, learn from this mistake. Never again. NEVER. This is a real turning point for me, Doc. It has to be. I just don't know what I would have done if I had hurt someone."
And I absolutely believed him.
Edwin was stealing my opportunity to give The Speech, and I let him. He went on for several minutes beating himself up much more effectively than I possibly could have. His mother sat behind him, nodding here and there, wiping a tear away every so often. When he was done he looked up at me.
"At least I didn't hurt anyone. Right?"
I saw Edwin in my office about a week later. He was limping slightly and the swelling around his right eye had almost disappeared, though his black eye had not yet. His laceration had healed well and I removed his sutures. Before I could even bring it up, Edwin said, "Doctor, thank you for taking care of me. I've given up alcohol completely. This was a real wake-up call for me. I just, well, I just wanted to say thank you. Thank you." True remorse is a rare thing for me. But learning from a mistake that quickly is even rarer.
Now before any of you just on my case for being a big softy, don't worry - I got to give The Speech just 2 days later. And I let it rip with no hesitation.