Sex and Trauma, or, Love in the Fast lane

Ok, so a day or two ago, I promised tales of trauma from days old. So, I'm gonna dig deep into my repressed memories from my residency for a story of love (sorta) in the fast lane.



I need to expand on the trauma experience a little to make this a better story, first. Medical students LOVE trauma. It is exciting! There's blood, and violence, and fast past action -- all the making of a great hollywood movie. Nurses LOVE trauma. See above explanation. Residents..... HATE trauma. that's becuase after the med students go off rotation, and the nurses go home after shift, the resident is still stuck babysitting the trauma patient. And while, on occassion, a clean, wholesome, pleasant person comes through the doors of the trauma bay, the majority, at a ratio of about 20 to 1, are drunk, obnoxious, rude Assholes. They are uncooperative and belligerent in the trauma room, usually stink to high heaven with booze and tobacco, and, now a days with CAT scans and other imaging techniques, not even a good chance for an operation. Additionally, once they get to the floor, they tend to be demanding and rude, telling you about all that "they" are paying for the hospitalization (Oh, Ooops, you're on Medicaid, or, more likely, not even insured, so NO pay) and how they're going to "sue your ass" because they didn't get the breakfast of their choice. There was also the charmer who lay on the backboard bucking and thrashing and telling me he was "gonna get me. I got friends. We're gonna get you." This settled down when I leaned over real close and personal like, and explained that one more buck, or one more threat, and I was paralyzin' his ass and stuffin a tube down his throat. Amazin how nicely that worked. And on and on and on. Attending level surgeons either love or hate trauma, it just depends on whether they have residents or not. You can guess which group loves it. So, as a resident, a rotation on trauma is pretty much just a detour through hell, with all the unsavory characters and then some in Dante's Classic Road Trip Novel.
So enough ground work. Suffice to say, Trauma sucks. So here it was, a lovely spring morning, with morning rounds done, and settling into chasing down Xrays, CAT scans, and the various reports thereof from the previous nights customers, when the trauma pager went off. (On an aside, we kept all of the trauma pagers set to the same tone, and threatened other residents who used it for their personal pagers-- I still hate that tone. It causes flashbacks for me) It was a class 2 trauma from a motor vehicle accident. The patient was a direct flight from the scene, and, by report, was already intubated. There was a death at the scene, always a bad sign. When he hit the table, it was clear he had a pretty significant head injury, but really no other life threatening injuries. We drew blood, got in the appropriate lines and tubes, and prepared to get the whole body CAT scan to determine how bad the coconut was cracked, and see if anything else was damaged. 'Bout that time, the social worker came in. The social workers showed up for all the traumas, their job was to round up the family, friends, posse, whatever, and keep them informed what we were doing, and assist us with communications. Well, this one was a doozy. She let us know that his mother, along with his wife, girlfriend, and mother of his baby, were in the waiting room. "Ummm, how many people is that, exactly?" Yep. Four different people. "Oh, they all know each other? And get along?" OK. Needless to say, there was great wailing at the fall of the patriarch. We explained the plan of action, and promised to keep them updated.
Back in the trauma room, the State Police had arrived. It turned out that the death at the scene was actually the girlfriend's roommate. We, the collective trauma team quickly peppered the trooper for details of the accident, so as to better predict our patient's injuries. As it turns out, our patient was moving at a high rate of speed (in more than one way), when he drifted across the centerline to go head to head with a Semi. He had survived only because of an "airbag" Turns out, his pants were around his ankles (I don't recommend this when driving), and the girl was naked on his lap (I really don't recommend this while driving), when he became,,,, ummmm,, distracted, and lost control of the vehicle. The story, as it developed, was that apparently the girl was "auditioning," for a place in the family. Apparently, parking on a quiet street, or just renting a room, wasn't an option. Pity. As the story went on, after the initial show of great concern and caring, and as it became apparent that he was not going to snap out of the acute brain injury too quickly, all of these ladies disappeared. Patient X did come off the vent, and even woke up to some extent. He spent several months with us, as he had no home with out the ladies, and no extended care facility or nursing home would take him (did I mention, no insurance?) After about six months living in the hospital, as the nursing staff and residents became more and more aware he was faking a good deal of his deficit, he finally was sent home. The police dropped the vehicular homicide charges, since he was deemed incompetent to stand trial.
Makes for a kinda crappy ending, huh? Well there is a post script to the story. Around 3 years later, as I was finishing up my residency, one of the floor nurses who had cared for/put up with him showed me a newspaper clipping. It turned out that Patient X had continued to have "problems" after his return home, thereby avoiding the homicide charge. He had no memory of the event, couldn't comprehend the seriousness of the charges, and apparently even had significant problems with short term memory. This all collapsed one day when he was out walking his dog, who showed little respect for the neighbor's lawn, this let to a shouting match between the two men, followed by threats by Pt. X, who then went home to get a gun to carry out his threat. He returned, with said gun in pocket, to be met by a couple of the local law enforcement officers, and was promptly tossed in jail. The last I heard, this was the event the law had been looking for to prove competency, and he was headed to trial. And so too, ends my tale of Sex and Love in the fastlane.
Seein' as I'm on call tonight, I'm gonna hit the sack, as it's likely I will get woke up about once an hour for the rest of the night.

Sweet dreams, all.