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2004-02-15 - 12:58 a.m.

15 February 2004

Another day in the trenches�

Hello to one and all in Diary-land and beyond. I hope that this finds you all well and relatively sane, all things considered.

I just got off of work, and my day is finally coming to a close. It has been a day for the memory books, a day of contemplation, and a day of learning that the world can be a confusing, cold, and unforgiving place.

For your esteemed consideration:

My day started by getting my girlfriend Bonney out the door to go to work. She leaves at roughly six A.M. to get to work twenty miles away. I saw her out the door and went back to bed for an hour.

I woke again and continued my reading of �Blankets�, a graphic novel by Craig Thompson.(Which, by the way, you should make every possible effort to read: It�s poignancy and insight into the human heart is achingly beautiful.)

I read until it was time to pick up flowers for Bonney for Valentine�s Day. After coming home and assembling Bonney�s gifts, my phone rang. It was her.

She was returning my call I had made earlier that morning to wish her a �Happy Valentine�s Day�. She also called to remind me to call my Dad.

My dad, step-mom, and youngest brother and sister were heading out today for Phoenix, AZ for my step-mom�s surgery. My stepmother was diagnosed with a glioma (a common type of brain tumor) about 6 months ago and was leaving for Phoenix today to get the surgery to remove the blasted thing.

I got a hold of them and wished them well. My dad thanked me and reminded me that he had sent a priority mail parcel to me that should be arriving at some point today. I promised I would keep a sharp eye out for it and would collect it immediately. I hung up and got ready for work.

I drove into work for my 11 A.M. to 11 P.M. shift in the Emergency Department. I was in Urgent Care today.

Urgent Care is were you go when you cut your hand slicing a bagel, when you sprain your ankle, when you bang your thumb with a hammer, and other various, non-lethal, minimally disfiguring accidents.

Today, Urgent Care was an education.

The day progressed as it is wont to do: Bunch of people, none, bunch of people, none, ect, ect. It was during one of these �bunch of people� rushes that things got educational.

We had a patient come in today with a five-day old human bite wound to the left index finger. It was her 3rd time into the ED this week and her hand was getting worse, not better. The nurse got her into the room and removed the bandage from her hot, mottled, grossly swollen hand to visually inspect the wound.

For those of you that do not yet know the scent of rotting human flesh, words do it no justice. The miasma that wafted off her dying hand to assault our noses, eyes, and stomachs was one of the worst I have ever encountered.

�She� is a young twenty-something immigrant to this country who doesn�t speak a word of English, speaks Arabic fluently, and had incurred the wrath of one of her �family members� earlier this week, and received the bite wound as a result. Words fail me.

Her condition being far and away beyond our entire department�s ability to address, we called in a specialist: A hand surgeon.

The young, composed, and supremely professional surgeon came in and, after some brief preparations, set to work to salvage the finger and hand.

After he numbed her hand with lidocaine (a process that entailed her screaming at the top of her lungs in fresh agony), he began to excise away the dead flesh to see what was salvageable.

When he made his first incision, several thimbles-full of greenish-brown pus oozed out of the wound. The stench grew stronger and worse. I watched, transfixed, but focused every ounce of willpower not to retch at that moment.

I looked on with clinical detachment as he cut more and more dead or dying flesh away from her finger. Soon, the tough, fibrous sheath of the finger bone gleamed whitely under the bright surgical lamps as he peeled her digit to get the filth away from her bloodstream. He fully removed 2/3rds of the flesh of her left index finger, and with the �help� of her brother translating, explained that she would most likely lose the finger.

After the surgeon finished, the �helpful� brother stated that he had to go home and would return soon. He left her with no one to talk to, frightened and alone, in a hospital staffed by people that do not speak her language, and having to face the very real prospect of losing part of her left hand. Some family.

After a snafu of a situation getting her admitted, I returned to Urgent Care to prepare to close that section of the ED. While I was closing, a trauma patient was being brought in by ambulance to another part of the ED and we scrambled the Trauma Team to respond, as it was a bad one: Automobile vs. Pedestrian.

The patient was the pedestrian, and was struck by the automobile in the kneecaps, and flew headfirst through the windshield, breaking his neck at the C2-C3 area (just below where your spine inserts into your skull) and having his spinal cord stretched past the breaking point, partially tearing inside what was left of his vertebral column. He didn�t have a prayer.

His family, a steadily growing knot of Indian (think Hindu) people, were distraught beyond my normal comprehension of the word and state of mind. They were wailing, screaming, crying, vomiting, fainting, and rocking back and forth.

They were begging and pleading with us to save their family member. �We will do anything you want, give you anything you want, Anything! We will even become your slaves for the rest of our lives! Please, just bring him back to us!�

They were prostrate on the floor, kissing the shoes of the charge nurse, begging him to save their brother/husband/father. The charge nurse, whose job it was to help the family understand after the doctors told them they had done everything they could but it wasn�t enough to save him, was in such a state that he could hardly speak.

I went home after that.

At home was the priority parcel that my dad had sent to me. Inside: a durable power of attorney for my younger brother and sister, a last will and testimony, and a medical power of attorney for my brother and sister, with me named as executor, should the worst befall my dad and stepmom during the trip.

What a day.

Thanks for hanging in there with me until the end, and oh, by the way�Happy Valentine�s Day.


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