Now, I am the first to admit that the typical shift in the ER is nothing like on TV. The life of the typical ER doctor (as dashing and attractive as I am notwithstanding) is nothing like Dr’s Green, Carter, or Benson. Yes, there are lots of rumors about who is sleeping with who (most ER doctors are presumed to have had sex with multiple staff members if they are moderately good looking and friendly and joking with female staff), but there usually is not much sexual drama. However, when people ask me about this I always say that ONCE AND A WHILE, things are like the show “ER” (or just about any other medical drama with scenes in the Emergency Department).
Fairly recently, there was a day that was out of a show. It was a typically busy weekday in the mid afternoon. Nothing particularly exciting except that someone was having their going away party. Whoopie. Anyway, suddenly the (relative) calm was torn asunder by the sound of a shrieking female. Now, this sound is not really that uncommon but it seemed to be coming from the triage/main entrance area so it garnered more attention than that which typically emanates from the ETOH/psych rooms. After about a minute of this, I decided to go investigate. I was nearly bowled over by a stretcher hurtling forward at unsustainable speed, being pushed by a nurse, a volunteer, and a security guard. On it lay a man, splayed out half off of it, with lets say “obvious signs of trauma”. He was covered with blood and his body had what appeared to be gashes, stab wounds, and other bayonet charge-style stuff. Apparently, he had somehow driven himself to our department and nearly crashed into the front door. Slumping out of the driver’s seat, he was dragged in and placed on a stretcher by staff not used to such sights (hence the screaming).
From there, he crashed into the trauma bay where the extent of his injuries became immediately apparent to all of us. In a moment, it was obvious he was now almost in arrest. His pulse was thready and he had no mental status. Also obvious were the stab wounds to his chest, his neck (he almost looked like a Pez dispenser), and his extremities. Everyone went to work – and although we are not a designated trauma center, we got him intubated, and big lines were placed in his arms in a minute or two. As I was putting in a chest tube (I volunteered for that), another colleague was ultrasounding his heart. Around this time, the family burst in accompanied by police and then everything amped up a notch. Blood curdling screams started, the police had to restrain the family, and curious staff who had no business being there of course squeezed through the mayhem to see the spectacle.
Unfortunately, despite the chest tube, big-assed 16 gauge peripheral lines, and getting flooded with fluids and packed cells, he went into cardiac arrest. Since he was young, we worked on him for a while, giving him multiple doses of Epi, and continuing CPR for much longer than we do for septic, demented 95 year olds. We considered a thoracotomy but since he had extensive neck slashings, we felt it would not help. Despite our efforts, he did not make it. We peeled off our gloves and let the police and medical examiner take over. It usually doesn’t end like on TV either.