REAL EMERGENCY MEDICINE
What’s Next? Drying the Ammo in the Microwave?
Medical misadventures with machines
“Wayh uuuul, ah wuz in a motorcycle crash.”
This in response to my query “What brings you to Duke’s Emergency Department this evening.
All Duke University ED patient replies seemed to start with the word “well” often drawn out so long, that to my California-bred ears it sounded like two syllables, wayh uuuul.
“OK” I said. “Please tell me more.”
“Wayh uuuul, ah wuz working on mah bike in the livin’ room.”
Of course you were, working on your motorcycle in your living room, I thought. It’s the only reasonable place to do motorcycle repair.
The overly logical mind of an ER Doc at work.
“An’ ah had a beer ‘r two to drink.”
Of course you had, I thought, mentally multiplying by a 6-pack. What self-respecting amateur mechanic wouldn’t be drinking/drunk while working on a machine that could kill you if it malfunctioned, or even just functioned.
“Then what happened?” I asked.
“Wayh uuuul ah started ‘r ep, an’ the dang thing just took off with me on it, raht through the living room window and out into the backyard.”
“OK, got it.”
That explains the trip in with the paramedics, the broken glass, and all the cuts.
“Anything else you care to tell me about your accident?” I inquired.
“Nah that’s about it.”
I left to gather suture material and other supplies, write some orders for a lab screen, and a variety of CAT scans and x/rays.
“So what did that guy tell ya, doc?” This asked of me in the hallway by one of the paramedics who’d transported my patient.
I related the essentials of the story above.
“There’s a few things he left out.” the medic continued.
“Like what?” I asked.
“His apartment is on the second floor of his building.”
“It’s in a heavily forested area of town. So he shot out of his living room, through a plate glass sliding door, across his deck and out into the forest, all while on his bike. We found him and his bike about 50 feet from his place, jammed into some trees.”
In the end, aside from a bunch of cuts, scrapes and bruises, and a sky-high blood alcohol level, my latter-day Knievil, minus the evil, was fine.
Jus’ a good ol’ boy with a(nother) great story to tell all his buds.
I’ll probably bleed to death from a razor nick.
Just a small dot dead center in his forehead. Not a red dot, but a silver one with a thin irregular red halo.
“What happened to you.” I asked, after identifying myself to my patient as a Duke Emergency Physician.
“No hablo ingles. No entiendo.” My patient replied. “I don’t speak English. I don’t understand.”
As I paused, waiting for an interpreter’s arrival, I assessed.
My fit and healthy-looking patient had walked into triage, then walked from the lobby to his gurney. I’d watched. He moved normally. His speech was fluid and clear. He was unperturbed and seemed to be pain-free.
Then the Spanish-English back-and-forth.
In short, my patient, a roofer by trade had been following a co-worker up a ladder, apparently following closely. In the co-worker’s hand, a nail gun, set to fire on contact, indiscriminately. So when the nail gun swung backward and contacted my patient’s forehead, he got “nailed,” right in the center of his forehead. The roughly 3.5 inch roofing nail pierced skin, skull, frontal sinus and brain, instantaneously.
So how was he normal? With a nail in his brain!
I suspected, and the neurosurgeons who yanked out the nail later confirmed, that the nail had “only” pierced the patient’s corpus callosum, the myriad fibers connecting the brain’s two hemispheres.
Bottom line, my roofer-patient’s right hand may not know what the left hand is doing (metaphorically), but he’ll be an otherwise stone-cold “normal” North Carolinian roofer.
As an aside, for whatever reason, it was an unspoken institutional “policy” to test all workplace injury patients for drugs. In my experience, Durham, NC roofers tested meth positive 100% of the time. I didn’t test this individual but he was slightly jittery and had dilated pupils as I recall.
Given the incident leading up to his arrival in the ED, I might have been jittery and a bit bug-eyed too. Meth or an adrenaline surge, I’ll never know. Either way, I wasn’t 25 feet in the air building houses, walking on partially finished slick slanted surfaces and using power tools. I was just that guy’s doctor. No problema.
I’ll tell you the microwave story another day. Maybe.