I read a little story on the internet some time back (and because it was on the internet, it simply must be true) about a young man who was brought to the trauma bay (not mine) after being shot, and though he definitely looked like he was up to no good, he claimed he was shot while waiting for his grandmother to pick him up to take him to church. No one in the trauma bay believes his ludicrous story, of course, until Grandma shows up a short while later in her Sunday Best, looking for her grandson to take him to church.
We often joke about what nefarious deeds our trauma patients have been perpetrating immediately preceding their injuries, and I have no idea if that vignette is true, but whether you believe it or not, it makes for a great fucking story. This story is kind of like that.
Mondays are supposed to be slow, easy trauma days. After all, the Call Gods should be exhausted after harassing the unlucky weekend trauma surgeons for 72 straight hours (Friday counts as a weekday in the Call God Calendar for some damned reason), but this Monday was most definitely not easy. The chaos started exactly 2 minutes after I walked through the door (fall), and it continued with a new fall or car accident or motorcycle crash every 30 minutes or so for the next 10 hours. For a while it appeared that I would break my personal record for trauma patients in one shift, but finally right around dinner time it slowed down, giving me just enough time to shovel a cold hamburger (leftover from lunch) into my face before my pager started screaming again:
level 1 GSW 5 minutes
God damn it.
Exactly 12 minutes later (damned rush hour) Ryan (not his real name™) rolled through the door. Screaming.
"Hi Doc, this is Ryan. 19 years old. We've found 3 gunshot wounds - one to the right upper chest, looks like an exit wound in the right upper back, and one in the right hand. Vitals stable, decreased breath sounds on the right. Got two large bore IV's in his AC's."
"AH GOD DAMN MY HAND DAMN GOD DAMN"
I knew at once Ryan and I would get along swimmingly.
On my initial assessment, his breath sounds sounded clear and equal to me (I don't know how the hell the medics hear anything in those ambulances with the sirens wailing), so I doubted he had a pneumothorax (collapsed lung). He indeed had a gunshot wound to the anterior right shoulder and a corresponding wound (entry? exit?) in the back of the shoulder. Fortunately he was moving his shoulder and arm perfectly and had a bounding radial pulse, so I seriously doubted the bullet hit his humeral head or the neurovascular supply to the arm (which is much closer to the armpit). His hand, on the other hand (har har har) was Seriously Fucked Up.
X-rays confirmed that he had no injury to the bones of the shoulder and no pneumothorax, but what he did have were several broken bones and lacerated tendons in his hand. As I was consulting the hand specialist, I overheard Ryan giving his story to the police:
"I was sitting in my kitchen eating dinner when I heard a bunch of shots outside, and I guess a couple of them hit me."
Yeah, sure you were, Ryan. I wonder if they actually expect anyone to believe this bullshit story.
After I patched Ryan up temporarily until the hand specialist could come in, I went back to reassess the last 172 traumas (or so it seemed) who had come in that day, suture up some lacerations, and discharge a few who had managed to sober up. About 3 hours later I was finally nearly caught up when my pager went off again:
level 1 GSW 7 minutes
GOD DAMN IT. IT IS FUCKING MONDAY, CALL GODS!
We cleared the trauma bay and readied ourselves for the next young man who was about to arrive. Or at least we thought we did.
The 67-year-old woman who rolled through the door was not what we were expecting. Nor did she really look like she had been shot.
"Hey Doc, this is Doris (not her real name™). She was sitting in her kitchen eating dinner with her grandson a few hours ago when a bunch of bullets came through the window. I think her grandson was brought here earlier, wasn't he? Anyway, she has one gunshot wound to the left buttock. No exit wound. Bleeding is controlled."
Uh . . .
I assessed Doris while eating some serious crow, and all I found was a single wound with the bullet retained in her rather voluminous left buttock. A CT scan confirmed no serious injuries, and a short while later she was walking upstairs to visit her grandson. I, on the other hand, had several days of making rounds on Ryan and Doris (who was always there visiting) to remind me just how stupid and wrong my stupid and wrong preconceived notions usually are.
If you're wondering about the three hour delay, Doris initially decided to forgo medical treatment when the medics arrived to pick up Ryan because, as she explained it, her wound wasn't really bleeding, she was walking normally, and she thought a few paper towels would do the trick. And she was probably right.
Anyway, I guess this story proves once again what happens when you make an assumption: it makes an ass out of you and umption. Or something. Whatever, I just need to get some goddamned sleep. Fuck you, Call Gods.