Things I will never do

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I keep in the back of my mind somewhere a list of things that I will not ever do. Some things are obvious, like smoking a cigarette while siphoning gasoline (saw it yesterday) but others are less apparent.

For example, I do not ever want to take up woodworking or own a table saw, band saw or planer (three different finger amputations in the same day)--it is much more cost effective and less mutilating to buy furniture made by other people with missing digits. I will never re-load my own ammunition lest I blow off my little finger and leave it hanging by a tendon. I will avoid at all costs using bungee cords to tie down things in the back of my pickup truck lest a cord snap back and hit me in the eye rupturing my globe (eyeball) and giving me an orbital (eye socket) blowout fracture. If I ever do snowboard (and for the record I have seen about ten snowboarding injuries for every one skiing injury) I will never reach down to adjust a buckle on my snowboard binding while sitting on a chairlift lest I fall off.

The list gets longer with each shift I work, and I have to admit it has changed the way I live. I drive much more carefully now. After my general surgery month at Harborview, I bought a helmet. I originally intended to wear it skiing but I am starting to think that it might be a good idea to wear it around the house as well, perhaps with some eye protection.

Last night was the most brutal night I’ve worked yet. We had trauma code after code from midnight until six-thirty in the morning, and this is after already having worked the 18 hours prior. I did four central lines and a chest tube, we did two open thoracotomies (opening the chest to get access to the heart) and had three deaths. I don’t even know how many resuscitations there were in all because often there was more than one going on at a time and it was impossible to participate in them all. The most horrific one was a young man who had been in a high-speed motor vehicle accident and had caved his face in. I put my hand in his mouth to put a tube into his stomach and could feel pieces of what used to be jaw and maxilla (the bone holding your upper teeth) loose in his mouth. We worked on him for an hour until an OR opened up for him—the surgeons were still busy working on a gunshot wound to chest and this guy’s friend, also in the accident. We did all of the things you see in the most dramatic resuscitations on TV, putting paddles directly on the heart and shocking it. It worked each time we did it, for a while anyway, I think we must have shocked him six times or more during the code. It was completely exhausting. He died in the OR.

Two of the other codes that night were for a 70-year-old and a 20-something that had been hit by a car in separate incidents. I don’t know what eventually happened to the 70 year old but the young guy died in the ER. I put in two femoral lines on him--one my side and one on the other resident’s side because she couldn’t get it. I would have been proud of myself except that at that point all of the carnage was starting to get to me. My supervising resident went out to tell his family that the patient had died. He said that the guy’s fiancé fainted at the news. I felt sick when I heard that.

Occasionally, when I’m watching someone die in front of me, I am caught by nuances of their personal appearance that now seem so ephemeral and trivial. For a second or two I am fixed on some detail and I think what it might have meant to them: carefully trimmed sideburns, now matted and covered with blood; an elaborate tattoo, now burned or incised out of medical necessity; stylish or provocative clothing, now cut to pieces to provide exposure. A kind of melancholy comes to me, and I think of a verse from Ecclesiastes: “I have seen all the works that are done under the sun; and, behold, all is vanity and vexation of spirit.”


I was searching the internet for information on gun shot wounds to the chest and came across this story of yours. I found it very interesting and I was wondering if you had any stories about gunshot wounds to the chest. I have to write a paper on it for a class that I am taking. I am a radiography student and a personal story would make my presentation much more interesting. Let me know if you can help me out. Thanks, Andrea

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This page contains a single entry by John published on February 24, 2003 6:22 AM.

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