Trauma Kilo
She is beautiful. My only regret is I never found out the color of her eyes, or for that matter, the color of her hair. Perhaps if I heard her voice or saw her smile, I would like her even more. But she was bald because of countless efforts by neurosurgeons to relieve pressure on her brain. They shot barbiturates into her, took her off the machine and waited until her body was chock full of carbon dioxide. No breathing. They induced tissue hypoxia. Still no breathing. Time of death, 12/23/07 1:17 pm. 19 years old, on her way back from college for Christmas.
I think her name was Laura. She saw a car accident on the freeway and stopped to help, only to get hit by a semi. Over the past three nights spent in the surgical intensive care unit at Holmes Regional Hospital in Melbourne, Florida, I met many families like hers. African American family, 37 year old man with a fiancee who had a massive stroke. Seeing his brother, a former football player for the Florida Gators cry, well it didn't just break my heart, it sent shivers down my spine and made my entire body ache. Sympathy pains are referred pains. Just as real as the pain on your right shoulder during a heart attack.
It was all planned out. 16 hour marathon drive all night from Maryland to Miami, then leave on a cruise ship for the Bahamas. Of course we never got there. It was hard at first to distinguish between a dream and reality; I was napping at the time. But when the car swerved from one lane to the other and skidded into a tree, it was easy to dismiss the dream. When I opened my eyes, it was calm before a storm. Then came a moan, and a blood curling scream, and the rest was adrenaline operating my body. The 911 call, the EMT training that somehow lifted my body out of my seat into the back, checking the ABC's before I could think of what I was doing. Instincts for scene safety/BSI, natural to think about C-spine and oralpharyngeal airways even when it was my dad in front of me. In actuality, I did none of that. I just stood there, dumbfounded. The highway was closed off as two ambulances and two patrol cars came to the rescue, then the whole earth shook as the helicopter landed on the highway. They tagged my dad priority 1. Everybody thought he didn't speak English. No, actually he does speak English, he just wasn't able to speak at all. The only thing I was left with were his shoes. Just another car accident. Pity, they had to fly a helicopter in, must be serious. Oh, they are going to have an nice holiday. Wow will you look at that car? Junk yard material. Everyday somebody wins the lottery, everyday somebody also gets into a car accident. It's just never going to be you. How misleading.
ER doctor, trauma surgeon, orthopedic surgeon, cardiologist, anesthesiologist, physical therapist, attending physician, internal medicine, hematologist, lab techs, charge nurses, social workers. Even the notary public was involved. The advanced directive was shoved in my face along with consent forms and insurance approvals. They didn't know my dad's name, or his birthday. So they did what they usually do with trauma John Does and named him Trauma, Kilo. K for the 11th unnamed trauma patient that day (it was 8:30 am). 12/20/1950, for the average age of patients. Lacerative liver, torn aorta, right bundle branch block with left anterior hemiblock, broken ribs, lumbar fractures, sacrum fractures, transverse process fractures, pelvic fracture, and symphysis pubic fracture. I was at Sebastian River with my friend first, because that's as far as the trooper could take me. I honestly cannot remember how I got to Holmes Trauma 35 miles away. I guess that would be called a concussion. But when I got there, my dad was being wheeled to surgical intensive care. It was a long day. 48 hours without sleep made everything seem all right. Took the edge off. As for me, just a concussion and 5 hairline fractures in my lumbar/sacrum vertebras. It didn't start hurting until yesterday, when all the adrenaline finally wore off. And boy, did it hurt.
He's going to be okay. 3 months on a wheelchair, about half a year before he can run again. I'm going to be okay, obviously not paralysed. My friend is going to be okay, bruised and whiplashed, but alive. My step-sister was not injured, but the emotional burden of causing such a terrible accident certainly cannot be overlooked. My step-mom was not there, but she is shattered. Her husband is bed ridden in Florida, her sister is on a respirator in North Carolina. Ah, the story now takes a twist to another patient. My aunt is a 43 year old lung transplant patient with pneumonia and acute lung inflammation. Diagnosed with idiopathic pulmonary fibrosis four years ago, she received double lung transplantation at Duke University Hospital. Placed on immunosuppressants, she battled life-threatening colds and chronic dyspnea. Suddenly, three months ago, she developed a brain infection with the JC virus which led to the diagnosis of progressive multifocal leukoencephalopathy. PML is a fatal disease of severe immune deficiency, sometimes observed in full blown AIDS patients. PML demyelination led to a speech aphasia and motor weakness in my aunt. I was able to find a neurologist at Johns Hopkins who admitted her as a purely experimental case, and we worked together to search the literature to discover the clinical application of mirtazapine for not only depression but also PML. The virus was halted because it was not able to bind presynaptic serotonin receptors. I left for college thinking my aunt was doing better. Then, on November 20th, she had sudden and rapid onset lung failure, resulting in a drug induced coma in the ICU at Duke. That was the last time she was awake. Today, her lungs are completely useless. She has major edema in her limbs. The intubation has caused tissue necrosis in her mouth and esophagus. She cannot be awakened because the pain alone will kill her. Plus, without mirtazapine the JC virus has caused massive neuron death, leading to craters in her ventricles. My step-mom will be flying to Duke tomorrow. They plan on stopping the respirator on Christmas.
Do I still want to be a doctor? The shock, the trauma, the emotions, the inevitable sadness and the misery of the sick and dying? I can give a certain, definitive yes. I was given another chance this past weekend. I was supposed to be sitting where my dad was sitting. He told me to go nap in the back seat 20 minutes before the accident, and any other day I would have done just that. But I didn't on this Friday. Hairline fractures are nothing compared to what my dad is going through, what my aunt is going through, and what Laura and all those other people in the ICU waiting room painfully experienced.
I think her name was Laura. She saw a car accident on the freeway and stopped to help, only to get hit by a semi. Over the past three nights spent in the surgical intensive care unit at Holmes Regional Hospital in Melbourne, Florida, I met many families like hers. African American family, 37 year old man with a fiancee who had a massive stroke. Seeing his brother, a former football player for the Florida Gators cry, well it didn't just break my heart, it sent shivers down my spine and made my entire body ache. Sympathy pains are referred pains. Just as real as the pain on your right shoulder during a heart attack.
It was all planned out. 16 hour marathon drive all night from Maryland to Miami, then leave on a cruise ship for the Bahamas. Of course we never got there. It was hard at first to distinguish between a dream and reality; I was napping at the time. But when the car swerved from one lane to the other and skidded into a tree, it was easy to dismiss the dream. When I opened my eyes, it was calm before a storm. Then came a moan, and a blood curling scream, and the rest was adrenaline operating my body. The 911 call, the EMT training that somehow lifted my body out of my seat into the back, checking the ABC's before I could think of what I was doing. Instincts for scene safety/BSI, natural to think about C-spine and oralpharyngeal airways even when it was my dad in front of me. In actuality, I did none of that. I just stood there, dumbfounded. The highway was closed off as two ambulances and two patrol cars came to the rescue, then the whole earth shook as the helicopter landed on the highway. They tagged my dad priority 1. Everybody thought he didn't speak English. No, actually he does speak English, he just wasn't able to speak at all. The only thing I was left with were his shoes. Just another car accident. Pity, they had to fly a helicopter in, must be serious. Oh, they are going to have an nice holiday. Wow will you look at that car? Junk yard material. Everyday somebody wins the lottery, everyday somebody also gets into a car accident. It's just never going to be you. How misleading.
ER doctor, trauma surgeon, orthopedic surgeon, cardiologist, anesthesiologist, physical therapist, attending physician, internal medicine, hematologist, lab techs, charge nurses, social workers. Even the notary public was involved. The advanced directive was shoved in my face along with consent forms and insurance approvals. They didn't know my dad's name, or his birthday. So they did what they usually do with trauma John Does and named him Trauma, Kilo. K for the 11th unnamed trauma patient that day (it was 8:30 am). 12/20/1950, for the average age of patients. Lacerative liver, torn aorta, right bundle branch block with left anterior hemiblock, broken ribs, lumbar fractures, sacrum fractures, transverse process fractures, pelvic fracture, and symphysis pubic fracture. I was at Sebastian River with my friend first, because that's as far as the trooper could take me. I honestly cannot remember how I got to Holmes Trauma 35 miles away. I guess that would be called a concussion. But when I got there, my dad was being wheeled to surgical intensive care. It was a long day. 48 hours without sleep made everything seem all right. Took the edge off. As for me, just a concussion and 5 hairline fractures in my lumbar/sacrum vertebras. It didn't start hurting until yesterday, when all the adrenaline finally wore off. And boy, did it hurt.
He's going to be okay. 3 months on a wheelchair, about half a year before he can run again. I'm going to be okay, obviously not paralysed. My friend is going to be okay, bruised and whiplashed, but alive. My step-sister was not injured, but the emotional burden of causing such a terrible accident certainly cannot be overlooked. My step-mom was not there, but she is shattered. Her husband is bed ridden in Florida, her sister is on a respirator in North Carolina. Ah, the story now takes a twist to another patient. My aunt is a 43 year old lung transplant patient with pneumonia and acute lung inflammation. Diagnosed with idiopathic pulmonary fibrosis four years ago, she received double lung transplantation at Duke University Hospital. Placed on immunosuppressants, she battled life-threatening colds and chronic dyspnea. Suddenly, three months ago, she developed a brain infection with the JC virus which led to the diagnosis of progressive multifocal leukoencephalopathy. PML is a fatal disease of severe immune deficiency, sometimes observed in full blown AIDS patients. PML demyelination led to a speech aphasia and motor weakness in my aunt. I was able to find a neurologist at Johns Hopkins who admitted her as a purely experimental case, and we worked together to search the literature to discover the clinical application of mirtazapine for not only depression but also PML. The virus was halted because it was not able to bind presynaptic serotonin receptors. I left for college thinking my aunt was doing better. Then, on November 20th, she had sudden and rapid onset lung failure, resulting in a drug induced coma in the ICU at Duke. That was the last time she was awake. Today, her lungs are completely useless. She has major edema in her limbs. The intubation has caused tissue necrosis in her mouth and esophagus. She cannot be awakened because the pain alone will kill her. Plus, without mirtazapine the JC virus has caused massive neuron death, leading to craters in her ventricles. My step-mom will be flying to Duke tomorrow. They plan on stopping the respirator on Christmas.
Do I still want to be a doctor? The shock, the trauma, the emotions, the inevitable sadness and the misery of the sick and dying? I can give a certain, definitive yes. I was given another chance this past weekend. I was supposed to be sitting where my dad was sitting. He told me to go nap in the back seat 20 minutes before the accident, and any other day I would have done just that. But I didn't on this Friday. Hairline fractures are nothing compared to what my dad is going through, what my aunt is going through, and what Laura and all those other people in the ICU waiting room painfully experienced.