I knew that the head of this patient’s femur was going to need to go back into his pelvis. They would drill a hole through the bone and fix it in place to the bed frame until surgery could be performed. I had learned to steel myself for the brutal procedure, picturing it in my head before it actually happened in front of me, like I’d done countless times over the previous six months of my internship in Indianapolis’ public hospital. I remember idly wondering if they would need a spade bit.
This was the end of the semester and my last day of shadowing. After seeing and smelling infection upon infection and wound upon wound, after talking to federal prisoners in for life chained to their beds (no, I will not let you out, buddy), and after generally learning to cope with the cacophony of the ER, I considered myself unflappable. I was disdainful of anyone who hated needles or the sight of blood or who fainted for any reason.
When the trauma alert sounded, I donned a sterile gown and face mask and acted very much the part of the physician who dispassionately deals with the gruesome realities of every shift. With only a few hours to go in my internship, I thought my most shocking experiences were behind me. Thanks to a loose lawnmower and Newton’s first law, I would be proven entirely incorrect.
The man lying on the table in front of me in Shock Room 2, somehow managing to talk lucidly about his family and job, had been in a bad car crash. His hip had been obliterated, a fact that initially went unnoticed by the doctors, who were chiefly concerned with a gash on his head. That was before they tried to turn him over to check for more wounds and he let out a moan in a tone of unrestrained pain.
I overheard the account given by the paramedic and imagined the scene of the injury. In my head, the lawnmower that had hurtled up from the back of the car and hit the back of the driver’s seat became my family’s Craftsman model and the vehicle our old beige Caravan. The patient’s knee had hit the dashboard with such force that the ball joint of his femur had popped out the back of his pelvis. On the x-ray, I could see the injury, the first time all semester that I was able to discern what the hell the doctors were pointing at. One ball was about five inches higher than the other.
The physicians, support staff and especially the nurses care for these patients’ needs with an attitude that I grew to admire greatly. By the end of the semester, I appreciated just how severely I had underestimated how much their altruistic and psychological qualities impact the care of each patient, more than even the doctors’ empirical knowledge. The more obvious and glaring the injury, it turns out, the more the intangibles of being a doctor come into play. For me, though, tricking my mind out of being shocked by the sights, sounds and smells of the ER was a cheap ruse that was bound to fail sometime.
Meanwhile, Shock Room 2 inexplicably began darkening, and while not exactly spinning, it wasn’t exactly standing still either. I didn’t even make it to the drilling. Just watching the orthopedist, with an audible grind, force the bone back into place (much to the protest of the muscles, which reacted in wild spasm) amid the anguished groans of the patient, all while picturing exactly what was moving in the x-ray, did me in.
The x-ray in my mind changed to, of all things, my ultra-pale face, which I could feel being drained of every drop of blood. I extricated myself from between a ventilator and storage cabinet, and somehow made it out the door on wobbly legs. I shed various articles of clothing and collapsed into a chair in the hallway, now completely drenched in sweat. I was thankful that my meltdown seemed to have gone unnoticed, as no one had followed me out, despite my ghostly pallor and soaked scrubs. A few dry heaves later, the sweating stopped and I could see again, feeling, all at the same time, embarrassed, weak and, most of all, impressed.
