Wednesday 17 January 2018


Of all the stupid clichés about communication (Communication is key, communication is a two-way street, blah blah blah etc etc), my least favourite is "It isn't what you say but how you say it".  And before anyone says anything, yes I understand the irony of saying "blah blah blah" while complaining about communication.  Whatever.  Fuck it.  Anyway, don't misunderstand me - how you say something is indeed extremely important.  But really, I don't care what the cliché says, because what you say is infinitely more important.

Don't believe me?  Then let me tell you a short yet instructive story that should illustrate my point rather emphatically.

Bryan (not his real name™) was brought to my trauma bay one fine Sunday afternoon having been stabbed by his girlfriend about 10 times following an altercation.  I didn't ask about the details, because really, who the fuck wants to know why anyone would stab someone 10 times.

"Hey there Doc, we have Bryan here.  He was stabbed 9 or 10 times, we lost count.  Heh heh (no one laughed at his stupid attempt at a joke).  The worst one is the left chest.  Oh, and the neck.  Heh heh (again, no laughter).  All the others look pretty superficial.  Bleeding is controlled, and he's been stable for us the whole time."

The medics seemed to have gone through two or three boxes of gauze of various shapes and sizes while dressing all of Bryan's myriad wounds.  Fortunately Bryan's girlfriend's knowledge of vital anatomy was on par with Donald Trump's knowledge of, well, anything, because there were no life-threatening injuries.  A quick X-ray of his chest showed no penetration of the knife into the thoracic cavity, and on examination of his neck wound the platysma had not been violated.  Whew.  Still, he had an impressive series of lacerations on his left upper arm, left forearm, left chest, neck, left thigh, and right shoulder, all of which needed to be repaired.

I was obviously going to be busy for a while.  Sigh.

After gathering all the various accoutrements required for suturing his approximately 71 cm-worth of lacerations (yes, I counted), I started irrigating each individual wound, followed by cleansing with iodine solution (yes, we still do that).  As I was infiltrating the left arm wounds with lidocaine, he started mumbling something to himself.  I couldn't understand most of it, but there were a few words here and there that were unmistakable:

"Mumble mumble bitch, I mumble mumble believe she mumble mumble fucking mumble mumble bitch . . ."

In spite of myself, I said the one thing that I shouldn't have:


Of course, that's when the floodgates (also known as Bryan's mouth) opened.

"Man, fuck that bitch!  I can't believe she did this to me!"

God damn it!  Why the fuck did I say that?  Nooooooo!  Take it back!  TAKE IT BACK!

"What the fuck is wrong with her?  I'm gonna kill her.  That bitch stabbed me what, 20 times?  I'm gonna kill the bitch.  I'm gonna fucking kill her.  I'm gonna go home and kill her.  Dead.  Dead!"

He looked up right into my eyes.


At a loss for words, I looked imploringly over at the police officer who was standing right next to me and had been apparently waiting patiently to take Bryan's statement.  He returned my quizzical glance, both of us too stunned to speak.  But Bryan wasn't done.  Not remotely.

"Fucking bitch.  Gonna kill her.  Gonna fucking kill her.  Dead.  She's dead.  Bitch you want to stab me?  You're gonna die."

I took a break from suturing, inhaled deeply, and tried my best not to sound too patronising.

"Sir, you may want to curb your violent enthusiasm until after the police officer here is done questioning you and leaves."

Bryan, however, was not to be discouraged.

"I don't give a fuck who's here!  Let the police hear me!  She stabbed me, I'm gonna stab her back.  That bitch is GOING TO DIE."

I looked back at the police officer who simply smirked, shook his head, and wrote something in his little notebook, which I have to assume was something resembling "HOMICIDAL PSYCHOPATH, DO NOT LET NEAR GIRLFRIEND".

About an hour and 2,401 sutures later (I may be exaggerating slightly), Bryan was all fixed up and ready to go.  I briefly went to check on another patient, and when I came back a few minutes later to give Bryan his discharge instructions ("1. Come see me in a week to get your sutures out, 2. Apply antibiotic ointment 2-3 times a day, 3) Don't kill your girlfriend"), he had a very fancy set of matching stainless steel bracelets on his wrists.  I tried to question one of the other police officers who had come to take Bryan away, but all he would tell me was that "the official story had changed".

I decided to accept that and move on.

Had Bryan actually done something that warranted a moderate bloodletting?  I don't know, and I will likely never find out.  And to be perfectly honest, it doesn't matter one bit, because my job is to fix holes.  Holes I can fix.  People . . . not so much.

Regardless, what Bryan said was bad enough, and the way he said it made his situation even worse.  But Bryan taught me a very important lesson: it isn't only what you say and how you say it, it's also to whom you say it.


  1. To be fair, though, he WAS stabbed twenty times by his girlfriend.

    1. Yeah, but what did he do to warrant it? There’s a lot to the story and both people have violent issues.

  2. "He ran into my knife. He ran into my knife 9 times"~ Chicago movie
    Good point on the 'who' - including the batshit crazy folks who are a waste of time trying to discuss a serious topic with for any length of time.

    1. 10 times, not 9 :) love that song and movie

    2. He had it coming, he had it coming, he had only himself to blame. If you'd have been there, if you've have seen it, I betcha you would have done the same!

    3. Pop. Six. Squish. Uh uh. Cicero. Lipschitz!

      And now, the six merry murderesses of the Cook County Jail in their rendition of the Cell Block Tango.

  3. I have had a time I've told a prospective patient, "I'm only interested in the mechanics of the injury. not in the legal aspects."

    but there was still the time the driver told me "alcohol was involved." and then voluntarily went to be assessed by the police officer, who determined it was not the alcohol consumed by the DRIVER that caused the accident.

  4. I would be interested to know whether you would have felt it appropriate/necessary to report what he had said to the police had they not intervened.

    We all say immoderate things at times, especially when we are distressed, but it sounds like he was pretty determined to do his GF a serious injury and whatever the provocation, that is always going to be bad.

    Great post as ever Doc'.


  5. Smh I actually find these kinds of people refreshing. because most people would only be too eager to call the police for "threats" or allow someone to get arrested while keeping their mouth shut

    1. could you elaborate, please? your cryptic comment seems to be a non sequitur.

    2. The people I grew up around would never make such a comment with witnesses or a record. The fact of not leaving evidence would be a consideration at all times. If you even said "I wish you were dead" they would say they could call the police for threatening them. If you said you were weary of life they would say they would have you committed. Therefore I find it refreshing yet still dumb for anyone to make comments that could be taken for death threats with witnesses and not care about the consequences.


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