Thursday 31 October 2019

Well armed

Violence is unfortunately part of my job. I'm not talking about workplace violence, though several of my trauma nurses have been victims of that. No, I mean just regular violence - stabbings, shootings, slashings, animal bites, human bites, and assaults with deadly weapons. And sometimes also assaults with not-so-deadly weapons.

Based on the title of this post you may think this story is about guns or the second amendment. I can assure you it is not.

I'll explain.

I sometimes get excited when I see "LEVEL 2 ASSAULT" on my pager, but rarely because of the injuries. Don't misunderstand me, serious injuries can happen with blunt assaults, but they are almost universally some combination of facial lacerations, facial fractures (especially the mandible), and brain injuries ranging from mild concussion to severe intracranial bleeding. I don't fix facial bones (facial reconstruction surgeons do that), and I obviously don't fix brains (brain surgeons do that), so all I can do initially is manage any initial life-threatening cerebral oedema until the brain surgeon arrives. Or apply ice to the face. Fucking wheeeeee. That isn't exactly why I spent {redacted} years training as a trauma surgeon.

No, the singular reason I get excited at blunt assaults is the story. Was this a drunken pub brawl? A fan of the opposing team? A fight with a guy over an ex-girlfriend? A fight with an ex-girlfriend? A robbery gone awry?

Or something even better? 

Rufus (not his real name™) was something even better. Don't worry, before you get concerned that I am a bit too excited over someone getting seriously injured, he wasn't. I don't celebrate serious injuries. Much.

Just before midnight on Saturday night is prime time for drunk assault victims to slosh into the trauma bay, usually having pissed off (or pissed on, occasionally) the wrong guy for the wrong reason. But 10 AM on a Tuesday is just slightly less common. However, that is exactly when Rufus decided to get the shit kicked out of him. The trauma bay immediately filled with the aroma of stale whiskey, old cigarettes, and mothballs (for some strange reason) when the medics rolled an extremely drunk Rufus through the doors just past Coffee Part II Time. They looked not-at-all-concerned (though obviously bemused), because while they were trying to give me their report, Rufus was continually, loudly, unashamedly, and slurredly singing:
He mussst have been an admiral a sssultan or a king, and to hisss praisssses we sall alwaysh sssing. . .
"Sigh. Hey Doc, this is Rufus.  He was assaulted about the face with some object, not sure what it was and he won't tell us because we can't get him to stop singing. He's 62, history of hypertension, untreated. Obvious swelling around his left eye, has a laceration there. Bleeding is controlled. No other injuries as far as we can tell."
Look what he hass done for us he'ss filled ussup with cheer. . .
Ugh. This was obviously not going to be one of those "fun" stories, just another drunk asshole who pissed off the wrong guy. A quick but thorough evaluation of a very slovenly Rufus showed no injuries below his neck, only what I could only assume was several years' worth of built up grime beneath his fingernails. Clean that shit up, people. Seriously.

It was becoming painfully obvious that this would be 1) a boring story, 2) a quick run through the CT scanner, 3) a few sutures, 4) a litre or four of saline to sober him up, and 5) a discharge to whatever cave Rufus called home.

Lord blessh Charlie Mopsh, the man who invented beer beer beer . . .

I was only 4/5 correct.

His CT scans showed no brain injury and no facial fractures, as expected.  He continued singing (he may have gotten one note on key, possibly as many as two) as I tried to renovate him to his former glory and place a few sutures in his creased face. Well, my Innter Pessimist reminded me, at least his singing career can continue, though his modeling days are clearly over.

My Inner Pessimist can be a bit of an asshole sometimes.

At 11 o'clocks we'll ssstop for 5 short sheconds, we'll remember Charlie Mopsh . . .

By the time the police arrived to take his statement, I was already filling out his discharge paperwork. I guess Rufus had finally sobered up to the point where he could speak rather than sing, because he told them a story I was not expecting:

"Well you see officer, there I was at the pub minding my own business when this guy comes over talking shit to me. Now I'm a little drunk {HA!}, but he's real drunk, REAL drunk you see, and I'm not the sort of man to take that kind of shit, so I talk shit right back to him. He gets up in my face real close, so naturally I take a swing at him. You know. Well, he takes his arm off and . . . "

He . . . wait, what?  

"Yeah, he takes his fake arm off and starts beating the hell out of me with it."

I'm glad I was on the other side of the room, because I somehow doubt my agape look was terribly becoming. Nor was the ensuing laughter from everyone within earshot of this conversation.

After Rufus was finished with his story, the police confirmed that they already had in custody both the suspect and his weapon of choice: his prosthetic arm. The next 20 minutes were filled with pretty much everyone over the age of 35 asking if Rufus' real name was Richard Kimble.

Alas, it wasn't. I only know that because, unbeknownst to me, I was about the 14th very uncreative and not-quite-as-clever-as-I-thought person who asked.


  1. "field anaesthetic on board"

    and boy do we like a story.

    1. here's your first assignment: find the guy who just spammed doc's blog and brick his computer.

  2. Ah Arm-Fall-Off Boy, the greatest of the DC comics superheroes!

    You think im kidding, im not.
    There really is a "superhero" called Arm-Fall-Off Boy whose power is to rip off his own arms and beat people with them.
    Comics are weird.

    1. Wait... if he rips off both his arms, how does he beat people with either of them? Healing factor?

    2. He rips off one and beats you with it, reattaches it, Then takes off the other arm

    3. *gratuitous comment about the right to bear arms*

  3. The Richard Kimble reference made me laugh.

  4. If it wasn't an arm, I'd say i know the assaulter...

    ...i have a friend who recently had his leg amputated below the knee. in addition to the (very nice) traditional prosthetic, he spent a little on the side to get a piratey wooden leg for historical events. Although his standard one would hurt if i were assaulted by it, the cleverly designed Concealed Club would hurt a Lot. you tend to forget how much weight a good piece of wood weighs...

  5. As I type this comment in class, I am trying to hold in my laughter from reading this post so my professor does not realize that I am not in fact, reading the article that I should be.

    Your stories never cease to entertain me and I certainly do not acknowledge your talent in writing enough but you truly have a way with words, Doc!

  6. I have never expected to find a Bard's Tale reference here, of all places!


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