When you work in a hospital, you get to see the true nature of human beings, raw and uncut. It’s often not a pretty sight. I’m not even talking about the gore. By now, I’m basically immune to blood, vomit, and other unpleasant excrements. No, I’m talking about human behavior. The horrible things people do to other people. I can’t tell you how many shot-up gangbangers and bloodied rape victims I cared for in the ER. I never got used to that part.
Other animals kill for food or disputes over territory or mates. But humans seem to be the only species to harm their own kind, not accidentally, or out of necessity, or because they feel threatened, but just for the sheer sport of it. Perhaps that is why only humans were affected. Perhaps it was an act of God, an act of punishment for all the sins His “children” have committed since Noah’s time.
Or perhaps it really was just another act of mass murder by another group of godless people.
Friday, April 13, 2012
1:00 a.m.
“We’ve got two rigs pulling up with a couple of college kids involved in a bar brawl.”
“ETA?” asked Jo, wondering if she had time to use the bathroom before the ambulances arrived. The coffee she guzzled to get her through night shifts always went right through her.
Mike, the unit coordinator, smirked. “Now.”
Jo sighed. Her bladder would have to wait. She joined the team of emergency physicians and nurses assembling by the doors that led out to the ambulance bay. She could see the two ambulances already pulling up, one after the other. The EMTs wheeled in two men on stretchers. One was strapped down and motionless; the other wasn’t strapped down and needed to be. “He started it!” shouted the second guy, whose t-shirt was screen-printed with the Greek letters of some fraternity. “He threw the first punch! I was just defending myself!”
Jo looked from him back to the other guy, who was unconscious, and knew he’d gone past the point of self-defense. She also knew which one she wanted to work on. She grabbed the rail of the first stretcher and helped wheel the unconscious man into one of the trauma rooms, as the EMTs brought the doctor up to speed.
“Nick Carter, twenty-eight years old, found unconscious on scene, probable head trauma. Witnesses said he was hit over the head with a bar stool. GCS 12, BP 90/50, heart rate 120, resps shallow.”
In the trauma room, Jo started a new chart and jotted down the information from the paramedics, while the rest of her team slid the patient over onto the gurney and began to cut off his clothes. She watched the doctor, a resident named Tavarez, lift the blood-soaked gauze from the side of the man’s head to check the laceration underneath. It was still bleeding freely, as head wounds had a tendency to do. The man’s blonde hair was plastered to his scalp, tinged pink with the blood. His right eye was practically swollen shut, the skin around it bruised and bloodied.
Dr. Tavarez drew in an audible breath. “This looks pretty ugly,” she commented. “Grace, call radiology for a CT. He may have an orbital fracture, and I want to rule out a skull fracture. Jo, would you get him on a monitor and then start the IV?”
Jo nodded, setting to work. She clipped a pulse oximeter the end of his index finger and stuck leads to his chest to monitor his vital signs. When the wires were hooked up, she turned on the monitor and checked its numbers against the earlier figures she’d noted on his chart. He was a little shocky, she thought, but otherwise normal, given his head injury and loss of consciousness.
As she was starting the IV line in his arm, the patient came to. She held down his arm, to keep him from thrashing, and leaned over the gurney so he could see her face. “Hi there. My name is Jo,” she spoke to him calmly. “Can you tell me your name?”
The man’s blue eyes looked blank, dazed. They moved sluggishly from side to side as he looked around the room. “Nick… Carter,” he mumbled. “Where’m I?” He looked more confused than combative, which was a relief.
She took his hand and held it. “You’re in the emergency room at Tampa General, Nick. Do you remember what happened?”
He moved his head from side to side, wincing at the pain it caused him.
“Apparently, you were involved in a fight at a bar near campus,” Jo told him, watching his face closely for signs of recollection. “You took a blow to the head. You’ve got a pretty bad gash there. Do you remember now?”
“Not really. Explains why my head hurts like a mother though,” he muttered, chuckling humorlessly. “Sorry,” he added, catching her eye.
She smiled patiently. “Is there anyone you’d like me to call?”
“Nah… How long do I gotta stay here?”
Jo looked to Dr. Tavarez, who took over. “Hi, Nick, I’m Dr. Tavarez. We’re going to need to run a couple of tests and probably keep you at least a few hours for observation. You lost consciousness, which means you almost certainly have a concussion, and you may have cracked your skull too. So relax and take it easy; you’re going to be here awhile yet.”
The doctor distracted Nick while Jo finished putting in the IV, halfway between the large collage of tattoos decorating his shoulder and the charming skull and crossbones on the inside of his wrist, emblazoned with the mantra, “Old habits die hard.” Habits like getting into fistfights in college pubs? she wondered, suppressing a smirk.
“Jo, when you’re finished with that, would you order a CBC, BAL, and type and cross his blood? His pressure’s still a little low; he’s lost a lot of blood from this head lac.”
“Sure.” Jo drew some blood and sent the sample to the lab for testing. Noting the time on the lab order, she realized it was well past midnight, making it officially Friday the thirteenth. She chuckled to herself, wondering what kind of stories she’d have to tell Gabby in the morning. Friday the thirteenth was right up there with Halloween, New Year’s Eve, St. Patrick’s Day, Cinco De Mayo, The Fourth of July, and any month’s full moon, in terms of how crazy it got in the ER, especially during the night shift. Her husband Luis had always looked forward to hearing about the “interesting” cases she saw on these nights. Jo could still picture his mischievous smile, his eyes sparkling wickedly as he asked her how her shift had been. Now that he was gone, she was glad her thirteen-year-old daughter was old enough to hear her stories – well, most of them.
Her shift half over, Jo ducked into the ladies’ room for a much-needed break. As she stood at the sink, washing her hands, she observed her tired reflection in the mirror and thought of Gabby, who had the same long nose as her, the same brown eyes. Her daughter was spending the night with Makayla again tonight. Jo wondered if the girls were still up at this hour. Knowing them, probably so, but it seemed too late to call and check. With a sigh, she rubbed at the dark circles under her eyes, part mascara and part fatigue, ran her hands under the tap once more, and reached for the paper towels.
With no major traumas in the last couple of hours, the lab was virtually dead, and it didn’t take long for them to complete Nick’s bloodwork. When Jo returned to her patient with the results, Dr. Tavarez was suturing his head. “His crit is low,” Jo told the doctor, showing her the lab results. “BAL is .11.”
“He’s also dehydrated and complaining of dizziness,” Dr. Tavarez added, studying the numbers, “but at least he doesn’t have a skull fracture. We just got him back from CT. Hairline fracture of the right orbit, but that’s all. Lucky guy.” Raising her voice, she added, “Mr. Carter, I’m sure the alcohol isn’t helping anything, but you’ve lost a decent amount of blood from this head wound. A blood transfusion and a good night’s sleep should have you back on your feet by morning… with a headache and a hangover, I’m sure. Oh, and a massive shiner around that eye of yours. It’s already turning lovely shades of black and blue.”
Beneath the sterile drape that covered his head, Jo heard Nick groan.
“Jo here can give you some more information before you consent.” Looking up from her work, Dr. Tavarez met Jo’s eyes. “Get the consent form, then push one unit, type-specific. That should do the trick.”
Jo smiled at the resident, fifteen years her junior, and nodded. “Right away, Dr. Tavarez.” To Nick, she said, “Don’t worry, hon. A macho guy like you… the blacker, the bluer, the better, right? It’ll give you some bragging rights.” This time, she heard him chuckle, as she left to get his paperwork.
In the hall, the EMTs were barreling by with a fresh patient on their stretcher. This woman was not just strapped down, but restrained, and screaming bloody murder, though there wasn’t a speck of actual blood anywhere on her that Jo could see. Cracked out of her mind on some combination of drugs, no doubt. Jumping out of their way, Jo shook her head.
Friday the thirteenth, indeed. The crazies were starting to arrive.
