The chronicle of a lonely do-gooder family doctor who survived.

Tuesday, December 18, 2007

Train wrecks

I've never shied away from taking care of difficult, complex patients. In fact, at my hospital, I am known for it. Some doctors won't take referrals from me any longer.

Of course, my acceptance of these challenges is not without some reluctance and it doesn't stop me from complaining about all the train wrecks that appear on my schedule daily. This year, we had a pumpkin carving contest and my clinic manager put an engineer's cap on top of my pumpkin. Chronic pain, out of control psychiatric problems, overweight diabetics that won't do a thing to help themselves, these are the things that keep my job interesting. But today I saw an actual train wreck.

Receptionist: "Dr. Sour Puss, I have Mrs. McLucky-as-hell on the phone. She said she was hit by a train."

Me: "Um, maybe we should refer her to the Emergency Room?"

Receptionist: "She says it happened last night."

Me, sighing: "Alright, work her into the afternoon."

Near Harbor Island in Seattle, there's a train that does nothing but move shipping containers back and forth, at about 5 miles per hour. Somewhere on Marginal Way, this train moves within 4 feet of a bus stop where my patient was standing talking on the cell phone, oblivious to the 30 tons that were bearing down on her. Fortunately, she only got knocked about 3 feet into the road and her injuries were limited to some nasty bruises on her back. She got a few more than her usual monthly allotment of Vicodin but there was no permanent damage.

When I was a resident in the county hospital ER, I saw a different sort of train wreck. Harborview Hospital is the only level one trauma center for Washington, Alaska, Idaho, Montana, and Wyoming. We got the radio call mid-day one Saturday that some poor depressed teenager in Idaho had tried to kill himself by laying down on a train track. He survived, and was basically fine, neurologically intact, but his face had been completely destroyed.

"They said 'destroyed'?"

"Yep, had to intubate by following the sound of the air bubbles. They're sending him up here by Airlift to have plastics take a look at him, he'll be here in 4 hours."

The ER was weirdly quiet for the next 4 hours, all of us I am sure wondering how we would handle seeing this kid when he arrived. Right before he landed, things picked up with the usual Saturday night shootings, car accidents, drug overdoses to keep us busy and since Mr. Faceless was "medically stable" I never got/had to see much of him before the Plastic Surgery team whisked him upstairs.

Getting hit by a train is sometimes a minor injury, but usually not.

1 comment:

bill said...

Keep up the good work. I rarely write anything down anymore but every so often the urge hits, and it's nice to have a place staked out and ready on the net.

I'm mostly amazed by how quickly what I put down becomes forgotten to me until I reread it and am then all the more glad I recorded it somewhere. Our job lends itself to often peculiar and humbling moments, I suppose.