2300 hours— July 1. My very first night on emergency,
I play with my stethoscope; I listen to my heart, I take my pulse,
I check myself in the mirror. In my new white coat, I look
Like a real doctor
[my bubba would say].
Meanwhile, Lenny Glick, our emergency head, is nowhere to be seen,
Not in the halls, not in the nursing station, not in the cubicles.
Three patients wait in emergency — nobody looks sick, I tell myself.
I don’t have to do anything but it’s my first night and the silence is strange.
I sit in the nursing station and study the acute abdomen.
My head is full of
‘what if’ and ‘then what.’
I study how aortic aneurysms and kidney stones are different.
“Where is Dr. Glick?” I ask the emergency nurse.
”He’s taking a little nap.” She sips her coffee, nonchalant.
“Enjoy our beautiful quiet,” she says.
I close my eyes.
2345 hours— Sirens and the squeal of tires wake me, doors burst open,
A motorcyclist thrashes strapped to a gurney; he is pushed past me.
A dazed young woman, steadied by an ambulance attendant,
Holds a white towel to her nose, her hand glistens in blood, taffy-apple red,
“My nose hurts,” she smiles, afraid, almost crying. Gashes zigzag across her face.
“Are you the doctor?” she asks, all foggy. Her name is Melanie.
“I am the clinical clerk.”
Melanie stares at the man wheeled away. “He hit me.” She gags, retches,
I find a stainless steel basin and catch
ruby clots that spill from her lips like chunks of raw liver.
“That was in the back of my throat.”
2347 hours— A white curtain opens, the nurse beckons, inside we huddle tent-like,
“You were on the motorcycle?” the nurse asks Melanie.
“No — he switched lanes.”
“You mean the motorcyclist? You were his passenger?
“No — I drove the car. He hit me. Understand?”
I pull up the chart but cannot read the notes.
A date, time, place, the letters MVA. All else is illegible, chaos.
“Where are you hurt?” I ask.
“My face — he hit my window. He came out of nowhere.”
The nurse cleans, inspects Melanie’s face. “You need stitches,” the nurse says.
“We will check for glass fragments. We should call Plastics, don’t you think?”
“Yes,” I say. “We should do that.”
I act like I know, but it is all pretend.
The nurse lifts the towel; Melanie’s cheeks sparkle,
An angelic wounded face — you can tell this from just looking at her,
You can see crystal halos in her flesh — Melanie’s wedding is in two weeks.
“Will my face be okay?” Her smile fades.
2348 hours— Lenny Glick, the ER doc, storms into the next cubicle.
“Shit — what the hell happened here?”
The ambulance attendant tries to explain. And me, I’m useless,
No one knows exactly what happened.
No privacy, no isolation; our walls are white linen sheets,
This is what covers our beginning and our end. I exit Melanie’s cubicle.
Image courtesy of ©2010 Jupiterimages Corp.
Glick checks the man’s head, his pupils, his ears —
The left ear brims red, drops puddle on the sheets, the floor.
“Goddamn — why the hell was he not brought in sooner?”
I have no answers, only questions — why does he lie like that on the gurney?
Glick runs his fingers, lamenting under his breath,
Over arms and legs, he feels everywhere as if he works for airport security.
He pinches the man’s Achilles tendon; he pushes his finger into an eye socket —
No reaction. He pushes again, harder. The man is pretending not to respond,
Maybe, like me, he is acting the part.
His body writhes and then goes stiff. “Now what do we do?” I ask.
“Nothing — it’s too late. He’s already CONED. Look.”
2350 hours— Glick teaches me on the body. Did I tell you the boy is 19?
Muscled like Achilles, too strong to get hurt.
Once I fell off my tricycle, got a bloody nose,
I was no superman
[my bubba said].
See there, beside his ear, Glick lifts scalp easy as a flap-jack with his probe,
He can almost turn it over — skin and muscle are shorn by impact.
Under the pitiless surgical light, the skull is blue-white porcelain.
Still, the boy looks perfect to me.
He could still be pretending.
2355 hours—“See the fracture?”Glick asks.
I trace the ominous line over his skull.
“But can’t we do anything?”
All that night and day, I think there’s got to be a way,
To make him better — apart from a few scratches,
The only crack is in his skull.
Even now, years later, I see him lying under that electric sun,
No cry, no whimper, no movement, no breath.
Our beautiful quiet.
Image courtesy of ©2010 Jupiterimages Corp.
Footnotes
-
Previously published at www.cmaj.ca