FIVE BLIND MICE
Chapter One
Beginning shift at Ray Charles University Medical Center
Norco Roberts has just walked into Trauma Three where he will be treating the first patient of the day. Norco is so new that he still thinks Ray Charles is a good place to be in an emergency. He has a lot to learn.
How hard can it be? He’s got a cut, I have a band aid; perfect match.
The guy on the trauma table has a different take on the situation.
“Look doctor, you don’t really need to do anything per se. I just need a bit of Morphine for the pain and I’ll be on my way.”
Norco looks at the area of concern, trying to figure out where the actual injury is. He squints his eyes. He closes one eye. He looks at it cross-eyed. He scrunches up his nose and wrinkles his forehead; nothing. He uses the braille method. He opens his eyes; nada.
“Ahh…there it is. Look mister, I really don’t think this qualifies you for a dose of Morphine, or of any thing more potent than Midol actually.”
He opens the little package and pulls out a half inch wide band aid.
“Oh come on doc, you’re treating me like I came in with a paper cut or something.”
“Well, you did come in here with a paper cut…or something. I mean really, how much pain can you be in?”
“Hey it’s pain, it’s all relative. One dude may whack off his thumb and not so much as moan, while another with the same injury will be screaming and rolling around on the floor.”
“Okay, so you’re saying…what are you saying anyway?”
“Doc, I got a paper cut that hurts like a traumatic amputation.”
“And you need morphine…”
“Hey I’m just a regular guy here. Superman, or super human, I’m not. I’m just a normal hard working man with a very painful injury.”
“Really? Your file right there it says you have no insurance to bill due to being unemployed. How hard working can you be?”
I think I’ll stick with the band aid.
“Hey doc, you can’t do this to me.”
“I’m not a doctor, I am a nurse.”
“Okay, nurse, you can’t do this to me.”
“What do you mean I can’t?”
“Yeah, all the guys at the bar know I am here. If I show up with a band aid they are gonna laugh me out of the joint.”
“Yeah? Well, maybe next time you will think twice before handling paper so casually.”
“What? You want me to don a pair of rubber gloves next time I go to write a check?”
“Given your present situation, you might want to.”
“Oh come on…nurse…”
“So your recommendation is for morphine and a body cast then?” I ask, letting a bit of sarcasm seep into my voice.
“Well I don’t know that a body cast is necessary. That’s kinda extreme don’t ya think?”
“And you think handing out morphine for a paper cut isn’t extreme?”
“Well…”
“What would you suggest we do…say, if you had come in with a broken arm? Call the coroner?”
“Noooo…”
“Okay, here’s what I’ll do…”
Twenty minutes later the man crawls into a cab with his left arm encased in plaster from his finger tips to his elbow and a prescription for prescription strength ibuprofen. They speed off in the direction of his favorite pub.
Part Two
The Emergency Room can be a frightening place. The untrained person who has stumbled upon a cardiac arrest on a return trip from the bathroom, may think the guy pounding on the chest of the dude on the floor is doing anything but helping the situation.
Is he frustrated with the guy who had the bad grace to collapse on the floor in the only area of the waiting room that does not have a good view of the 49ers game on TV?
The reality of it is, is that the guy doing the pounding was the ER doc, and he was desperately trying to get the guy’s heart going again. But try and tell that to the guy who has been waiting in trauma room eight for five hours.
No, the goings on in the emergency room are akin to a flawless ballet. Everyone has their area of expertise and knows the limitations of his coworkers. When a man comes in bleeding out like a fire hose, everyone knows what to do without having to explain to the others.
The problem here is that when you arrive for a show at eight in the morning you expect it to start then. What you don’t know is your little problem with your missing pinky finger merits about as much import as the charge nurse and her, ‘dammit, now its cold again’, coffee problem. And, if she can get away with it, she will resolve the coffee issue before resolves your missing digit issue.
Things are different at Ray Charles University Medical Center (no relation to the entertainer). If you do see some guy thumping on another you should call someone’s attention to it. That is probably a mugging and not a medical procedure.
Things at Ray Charles had gotten so bad that people began to refer to the emergency personnel there as the three blind mice.
At Ray Charles it was easier to find a janitor to unplug one of the department’s toilets than it was to locate the on duty ER doc.
Why just last week when Jenny the ER nurse began having chest pains while at work, an ambulance crew was called in to transport her to the real hospital clear across town.
Part Three
Having gotten rid of Mr. Paper cut, Norco takes off in search of an empty room for a bit of shut eye. He is waylaid though by the new ER doc in room seven.
“Hey you, come in here a second.”
I look back to see who he is talking to.
“Uh…who are you talking to?”
“I’m talking to you of course. I need you to suture this laceration so I can go check on our cardiac patient in trauma one.”
“Wait a second, doc…”
Too late, Dr. Preen is already half way down the hall.
Norco walks over to the man on the table in the middle of the room. On a small table on his right side is what looks to be a sterile suture kit.
“Uh, sir, I’d like you to turn and look the other way. Some people get a bit nauseated when they watch this.”
And you certainly don’t need to see me bumbling my way through my first ever suture job. The last time I sewed anything it was a patch on my Kung Fu uniform and it had taken the better part of three hours. It didn’t help that I sewed the back of the Gi to the front part. Then I had to cut off the patch and do it again. I have no business sewing anything.
Wisely his patient turns his head to the side and closes his eyes.
With great care so as not to break sterile procedure, Norco opens the suture package and promptly sneezes on it. In a panic he grabs up the tools and begins to wipe them off on his scrubs, then decides to just lay them out on the small tray in front of him. He picks up the strangely curved needle and promptly pricks his finger. He jerks his hand back shaking his finger and strikes the tray with his elbow knocking the whole set up on the floor with a metallic crash.
His patient jumps and nearly falls off the gurney.
“What the hell?” he asks, seeing the mess on the floor.
Norco is hastily picking up the errant objects, wondering if the five second rule applies to the ER. He settles on the oddly shaped needle and a small spool of thread and goes to work.
After a bit of trial and error, punctuated by little yelps from his patient, he manages to tie one knot. Satisfied, Norco holds up the man’s arm to examine his handiwork. He see’s his patient straining to look so he shows him his handiwork.
“Doc, tell me your not gonna make every stitch a miniature bow tie are you?”
“I’m no doc.”
“Uh, okay…you sound like your proud of that.”
“Obviously you haven’t met the ER doc yet.”
The man lapses into silence and Norco takes another look at his work. Okay, I guess I can dispence with the fancy nots in interest of saving time…
It takes the better part of an hour but he finally does it. When his patient walks out of here he will be the proud owner of the most unusual suturing job ever. Norco uses bow ties right up until the twelvth stitch then reverts to a much faster and easier square knot.
Norco walks back up to the triage desk to see if anything interesting was going on in any of the trauma rooms. After poking his head in some of the rooms it becomes obvious that his help is not needed so he plops himself down at the triage desk and loses himself in thought. Not for the first time he wonders if a career change is in order. Too often he finds himself sitting here wondering if life in the ER still does it for him or if being an adrenaline junky is not all that it is cracked up to be.
While pondering the thought of a career change he remembers when he was a tiny lad bouncing on his daddy’s knee while his father extols the virtues of becoming a doctor. Norco had romanced the idea of becoming a janitor when he grew up; he just liked pushing a broom.
The first time he voiced his career decision he got bounced off his knee in a flash. Daddy said it was an accident but he wondered if it really was?
Norco’s father is a doctor, and his mother a dentist. Of course they want him to follow in their footsteps and choose a professional career. You can imagine their excitement when he told them he just landed a job at a hospital. You can imagine as well the precipice they dropped off of when they heard what job he’d had taken and where. Norco’s father used to say that the janitor at the Stanford University Medical Center had more brains that the surgeons that roamed the dingy halls at Ray Charles. We won’t even speak of the janitors there.
As for Norco, he still likes the sound of the swish of a broom.
Another kind of swish snaps him out of his reverie as the sliding glass doors to the ER open and in stumbles a very distraut man, favoring his left foot.
Norco turns to the triage nurse, then stops himself short. Evidently she has gone on another coffee run.
“I guess I will have to field this one myself,” mutters Norco to no one in particular.
He meets the man at the entrance with a wheelchair which he immediately collapses into. Norco wheels the moaning man into Trauma Five, and over to the table in the middle of the room. It will take some doing, getting the guy up on the table, and with no one there to help.
Fortunately he’d done enough transfers like this before so he has a pretty good idea of how to do this without either of them sustaining an injury.
Norco parks the chair parallel to the table, stands in front of his patient, and extends my hand for a shake.
“Hi there, I’m Norco, Norco Roberts, what’s your name?”
“Names Ty, now can we get on with this?”
“Is that Ty, as in Tylenol, or Tie as in tie my shoe?”
“No, it’s Ti, as in TIME to kick your ass if you don’t get me on that table in a hurry.”
Touchy.
Norco stands in front of him and reaches out, placing his hands underneath the other’s arm pits. All he has to do is rock back on his heels which will bring him up and out of the chair. Having gotten him up, Norco just pivots to his left, swinging his patient around and sliding his butt up and on to the trauma table. At least that is how it’s supposed to work.
He goes about explaining to his patient the procedure, then takes a deep breath and lifts. As Norco lifts him up, his thighs knock against the seat of the chair and sends it skittering backwards far and away from them both.
For a brief span of time, Norco’s actually holding up a sack of potatoes that outweighs him by a good fifty pounds. Gravity is about to make itself known, and in a big and very disappointing way.
He’d read somewhere that a stone dropped from a very high bridge will fall at the rate of thirty-three feet per second.
When you’re alone in a room doing a transfer that you never should have started, your patient will fall at a much faster and more damaging rate.
And…they fall. He now has a large man lying on him in the missionary position. Norco’s head hurts like hell from bouncing off the floor. He looks like a squashed bug under a beached whale. His arms and legs are sticking out and wiggling around frantically.
He wonders, and not for the first time, had he made the wrong career move? Pushing a broom is definitely less risky.