I have been on duty for the past 30 hours with no sleep surviving on adrenaline and caffeine. The holiday weekends are always busy at our level-one trauma center partly because of distracted drivers and mostly because of driving under the influence of a favorite holiday concoction, whether it be eggnog or cheap wine. The gloomy housing market coupled with the stress of not having a job to buy Christmas for their kids compounds the problems even more. With all these factors considered; trauma one is a busy place to work. It is also the most exhilarating and the best job in the world. I do not think about the fact that I have not slept for a day and a half for the simple reason I do not have the time to think about anything else. Motor vehicle accidents, overdoses, gunshot wounds, stabbings, and the usual drunk who happens to think that he is wearing a red cape with a big letter S on his chest keeps my mind and my hands occupied. I just came out of surgical intensive care to check on a patient that I worked on last night. He is stable at this moment, although, that could change at any time. He was the driver of an SUV who had crossed the center line and collided with a family of four in a head on collision. There were no survivors of the family that was on their way home for the holidays and no need to bring them to the trauma center because their vehicle burst into flames trapping them inside. The lone survivor and driver of the car that crossed the line may not make it, as well. It would probably be best that he did not survive. How could someone live with themselves after that? That is for someone else to worry about. My job is to make sure he survives. Life and death is about winning and losing and I hate to lose. When he came wheeling in he had multiple facial fractures and severe chest trauma and he was talking to me telling me that he was having a hard time breathing. The lacerations on his face were not the reason of his apnea so it had to be internal. His vitals were stable but I was concerned with his low blood pressure. The loss of blood was not enough for hypovolemic shock. As I was pressing on his abdomen it did not feel hard ruling out a severe abdominal bleed. His pressure continued to drop slowly and I became concerned that he was bleeding somewhere. He could not take a large enough breath for me to hear any breath sounds on either side. It had to be a hemothorax. I did not want to put him under and put in an ET tube for fear of a TBI. His blood pressure had stopped dropping which gave me time to get him to CT. While he was taken for a cat scan another patient came in with severe bleeding from being stabbed three times by her ex-husband. I did not have the luxury of time on this one, I had to crack her chest to see what damage the knife blade had done. The wound was near her heart so time was of the essence. I found the problem once I got enough sponges in so I could see that the aorta was nicked. I clamped off both sides and told the nurse to call OR that we were on our way with a trail of blood following us all the way.
Finally, I had some time to catch my breath. The young lady that suffered at the hands of her ex-husband was stable after repairing her torn aorta and stitching some fascia on her other wounds. I was able to relay the good news to her family. As for the driver who was responsible for the loss of so many in one family his injuries were just too massive to give him a chance at a life that, in my opinion, he did not deserve. I say that because the test results showed that the 57 year old man had twice the legal limit of alcohol in his blood for operating a motor vehicle. I still hated to lose. The justice system would have punished him had I been able to save him. You win some and you lose some and I am a poor loser.
My shift, finally, has come to an end. I retrieve some papers and my laptop from my office and start to head home. As I was walking through the trauma center I looked up and saw someone out of the corner of my eye move hastily out of my sight. I turned around and looked down the corridor I had seen the man retreat. I caught a glimpse of him as he turned left down the hall towards the pathology department. It was well after clinic hours and the path department was closed, so, I was curious as to why he was here. He did not have a hospital uniform or a set of scrubs on and I picked up my pace to try and catch him. I spotted him ducking through a door. When I reached the door that I saw the stranger enter I paused. Should I call security, I was asking myself? I decided to go in and find out what, exactly, this man needed. I walked in the door and closed it behind me. I was in room 225 of Eglin Regional Hospital and there lay Col. Renold L. DeBarge. What the hell was happening? I was wearing whites and as I scanned myself I noticed the insignia of an airman 1st class on my collar. I had stepped through a time warp. I was back in the Air Force and it must have been early 1979 because the Col. did not look as bad as he did just before I killed him the first time. God has given me a chance to do the right thing, this time. This is incredible! The Col. then spoke to me. "And you are?" in a deep voice. I remember this. It was the first time I had met him. I was in shock. I bowed my head and closed my eyes and then heard a knock on the door. "Baby?" it was my wife. When I opened my eyes I was standing in my bathroom. "Baby, are you okay?" I was home. theblogmeister