Life imitates TV for once: drama-rama

I never watch the show "ER" anymore. I can't. It's like working all day and then going home and watching your job on TV. I need more distance than that. Plus, the show tends to be rather dramatic (a burning helicopter falling on the ER? Please. Although, a helicopter did crash in the East River a few months ago and everyone was brought to Manhattan County hospital). But anyway, it's considered malpractice to do some of the things they do on that series: Burr holes, craniotomies, emergent hemicolectomies right there in the E.R. But the fights and the affairs that happen on the show are, for the most part, real.

Anyways, in an odd cosmic twist, life imitated art tonight for once. This literally just happened about thirty minutes ago. Really.

I was just in the hospital library pulling articles to read and present for journal club. On my way out of the hospital, in the lobby of the main entrance, I saw a young man stumble in right off of First Avenue.

"I NEED A DOCTOR!!!" he screamed.

Usually I ignore those dramatic pleas if I hear them on NYC sidewalks for two reasons: 1) they're usually not sick at all; and 2) according to New York state law, if you're an M.D. and you initiate care, you cannot then transfer care to a non-M.D. Meaning, if you stop to help and then an ambulance pulls up, you cannot just let the patient get into the ambulance with the EMTs and go to the hospital -- you must go with them. And I don't think Good Samaritan laws apply to M.D.'s. Now, if someone REALLY needs a doctor on the street, I'll be the first to help. But one has to be judicious about stopping and helping in certain instances. I consider that to be more of a sad state of affairs of the current legal maelstrom surrounding healthcare rather than personal indictments of physicians who choose to avoid potentially legally disastrous situations.

At any rate, this guy screaming really did need help: he was clutching his chest, blood pouring through his fingers and streaming down his white t-shirt in a scarlet fervor.

"I NEED A DOCTOR!" he reiterated. "I CAN'T BREATHE!"

Drama was calling.

I ran over to him, bundled up in my coat/scarf/gloves and said, "Come with me right now sir." I grabbed his elbow and started running him towards the trauma slot.

"What is your name?" -- an important question to see if one has enough blood pressure to perfuse their brain.

"JOE," he said.

"What happened just now?!" I asked, all the while running him towards a stretcher.

"I GOT FUCKING STABBED ON 29TH!"

Drug deal gone bad. Right along my path home.

"How old are you?!" I'm speaking very loudly to make sure his attention is focused.

"19!"

"What medical problems do you have?" -- very important to know one's past medical history.

"A FUCKING STAB WOUND!" he retorted. Fair enough.

"What medications are you on?" Another important piece of information.

"COCAINE!" he shouted.

Hrmph. The ENT docs actually do use that to stop severe nosebleeds (and pharmaceutical-grade cocaine is actually pink), but I suspected that that was not his primary problem.

"Have you ever had surgery before?"

"YEAH I GOT STABBED A FEW YEARS AGO."

What a piece of work.

By that time, I had done a primary assessment on him, thrown him into the trauma slot on a stretcher and activated the trauma system. A slew of whitecoats rushed into the room, I told them his story, and we examined his abdominal stab wound that was spilling out feculent material. We cut his clothes off, threw some large IV's in him, put him to sleep, intubated him and off to the O.R. he went. I'll check on him tomorrow, and in a few months, I'll probably see him in the ER again for the same thing.

And hey, I still made it to dinner on time.