We walked into chaos.
We quickly found out that although we had only been paged about one accident, there had actually been three completely unrelated traumas.
- A MVA (motor vehicle accident) in which an unrestrained passenger in a taxi smacked his head on the partition separating the taxi driver from the passenger, and was now complaining of headache and confusion.
- A "motorcycle vs auto" in which the motorcyclist, trying to avoid a collision with a car, skidded across 3 very busy freeway lanes, before falling off and smacking his head against the asphalt, leaving behind a sizable puddle of blood.
- And then a "pedestrian vs auto," in which a student jay-walking across a street got hit by a woman who was texting while driving, here with likely multiple fractures.
They all occurred so quickly and so close together, that by the time the trauma team had gone to meet the first patient, the other two patients were rolling in the door. There was no need to page them again.
We were so shocked, we just stood there, mouths agape. And then the trauma attending saw us. "What are you doing! We need all the help we can get! Each of you, take a patient and start getting the history! Michelle! Bed 1. That's the motorcycle accident. Sarah! Bed 2! That's the student. GO! GO!" She nudged us, as though to provide us with the momentum to start moving.
I tore off my coat and put on a mask and gloves and stepped inside the curtains.
And then I saw him. One of the nicest attendings I had ever worked with previously, was now my trauma patient. I gasped, and the resident who was trying to stop all the blood gushing from his ear, looked up. "Oh man! Er, um, he was my attending!" I said, trying to figure out if it was okay that I was now taking care of him. "Don't worry," the resident reassured me, "he's completely amnesic right now, and won't remember a thing. Here, hold up his head for me."
I held my attending's head, trying to stay calm and get a history all at the same time. "Hello sir, do you remember what happened? Did you fall off your motorcycle or were you hit by a car? What's the last thing you remember? Do you know who you are? Where you are?"
He didn't remember anything from after he left the hospital, he told me, alarmed that he couldn't remember the last 2 hours of his life. "Has someone called my wife?" he kept asking, finally turning to me and pleading, "please make sure my wife knows I'm here."
His scalp laceration now closed, my resident shooed me away to get more details from the paramedics who were still milling about, waiting to give report to someone.
I wish I could say that everything worked out and everyone went home okay. After all, all's well that ends well, right? The student ended up having a lot of bruises and just a minor ankle fracture, and was sent home with crutches. The taxicab passenger had a slight brain contusion, but was back to baseline, and could probably go home after another couple of hours of observation in the ED.
But my patient - my attending! - ended up being transfered to the neurosurgical ICU, where he would get constant monitoring and CT scans every 4 hours, because he had a subarachnoid hemorrhage, an epidural hemorrhage, a temporal bone fracture, and a deep 7 inch laceration above his right ear.
The neurosurgical team took over and sent me home, even though I wanted to stay, wanted to help, wanted to know what was going on, wanted to comfort his wife.
I did as I was told and walked home, but I couldn't help but remember all the things my mother had taught me when I was little. Look both ways before you cross the street. Wear your seatbelt. Put on a helmet.
Listen to your mama and do all of those things. Be careful. Be cautious. Because you never know. You just never know when those mama-isms will end up saving your life.
