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Don’t do that any more…

January 17, 2013

Once upon a time, shortly after the discovery of fire, I was an EMT. Some time later I became an RN. Courtesy of the US Government I was stationed at a small hospital on a tropical island. Palm trees, beaches, warm water, sugar cane used for its most noble purpose…and some days just plain boring.

I was running the Operating Room and this day I was also the OOD. Steve, aka the “Guru of Gas” (the CDR who ran the anesthesia department) and I were leaving the hospital via the ER exit to bring back dinner and solving all the world’s problems as we went, waxing eloquent about politics, guns, trucks, rum (see sugar cane, above), motorcycles…all important stuff. Anyway, that’s when we both saw him. “Him” being the lone occupant of the ER waiting room. I was going to speak to him anyway, truly I was, but he flagged me down before I could open my mouth.
“Can you help me?” he asked.
“Sure” I replied, sticking out my hand. He shook it, though without much of a grip. We exchanged ranks and names and he seemed properly impressed at my immense rank. I was happy.
“I’ve been  here for over an hour and I haven’t been seen yet.”
Very patiently, I explained the triage process, emphasizing that the sickest or most severely injured were seen first while Steve stood back and chuckled because he wasn’t having to do this.
“I understand that” said the lone patient.” It’s just that there was no one here when I arrived and I’ve been sitting here waiting all this time.” Now, I was embarrassed and more than a little annoyed with the ER folks. But, hey, there was probably a reason he was still waiting. Right? I decided to triage right then. Make him feel better. Buy my colleagues some time right now and chew someone’s butt later. With that plan in mind I went into “clinical mode” while the Guru continued to chuckle happily to himself.
Since he was sitting, I knelt on the floor to look square in his eyes (doesn’t make the patient feel like you’re trying to overpower them, ya know?). “So, what’s going on?”
“Well, LT, a couple hours ago I was riding my ATV and it flipped over on me.”
This was going quickly from inconvenient to Not Good, I could tell. “Uh huh. You look pretty good. How are you feeling? Headache? Nausea?” (all this while checking his pupils…he didn’t look or present like a head injury, but ATV accidents can be bad)
“No. It’s just that when I turn my head like this (here he demonstrated ‘this’ by turning his head fully to the right) the left side of my body goes numb”. I should point out that it was at this point, out of the corner of my eye, that I saw Steve the Guru vault the ER desk and run into the clinical area.  Drawing upon my vast clinical knowledge I spoke clearly and calmly to the patient as he turned his head back to mid line.
“Well, I recommend you not do that. Don’t worry, the other guy has gone to get someone from the ER. They’ll be here in a moment to get you fixed up” (Where is the nurse/doc/corpsman with the c-collar!?) I moved smoothly into my keep-the-patient-calm routine. 
“You been here on the island long?” (Where’s the damn c-collar, already?)
“No, sir. Just about 3 months. Is it always this warm and humid?”
“Yeah, pretty much. It is the Caribbean after all. It cools off a little in the winter, but the water is still warm.” (Crap! I’m gonna have to do something…let’s see, I can lay him down on that bench and secure his head and neck with our belts and his shoes…Where is that c-collar?)
The Guru of Gas, and the entire complement of the ER came streaming out from the clinical area like a colony of ants bound for a piece of meat. Steve gave me his “you’re going to be so annoyed in just a minute” look. In seconds the patient was wearing a c-collar and secured to a backboard and whisked off to the trauma room…where he should have been immediately after he came in. The doc hung around for a moment as the patient was carted off.  “I guess we should have paid more attention before we started the ER potluck, huh?”
I don’t remember my exact words, but according to the Guru of Gas, there was some concern I was going to blow out a major cerebral vessel. There is also the slightest possibility I might have used “high impact language” that shouldn’t have been directed at a senior officer. That’s what the doc said the next day in the CO’s office.  I have to admit, it wasn’t often I wrote up an entire department. Did I mention how boring it is in the Caribbean?

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