Gunfight at the OK Corral

It's ten minutes before my shift ends and the trauma phone rings.

Shit.

Oh hey, whaddya know? My compatriot Anthony arrived ten minutes early for his shift. "No worries, Fletchy, you go home, I'll just start early and take this one coming in." Bless you, Anthony!

The notification: 24 year old male, gunshot victim, bullet apparently lodged in his arm, bone in pieces, open fracture, no other injuries, vitals stable. Easy enough. Make sure there's no other injuries and off he goes to the OR. I decided to peek in before leaving.

True enough, the EMS personnel bring him in, and he's one mad as hell mutha. A quick survey revealed no other injuries, and Anthony was standing at the head of the bed helping to run the trauma. Gross sight -- the bone in his forarm was splintered into pieces and sticking out of the skin, like a piece of old wood that broke off. Ewwww, I thought. Then, I was just about to leave when the paramedic says, "The other guy will be here in five minutes."

Huh? Other guy?

"Yeah, there was another guy shot at the scene, he got shot in the chest but I think his vitals are stable."

"You *think*?"

"I dunno. I just picked up this one who got shot in the arm; I just heard about the other one coming over the radio."

I looked over at Anthony. He tilted his head towards me and gave me that knowing, sympathetic look: I know, I'm sorry. I can't break away from this one, you have to help run the other one coming. Sigh. What was I going to do, leave? At least I had a second to make a phone call and let my friends know I wouldn't be joining them for dinner. Sometimes I lose perspective about what it is that I do, so the following conversation is a little funny now that I recollect it:

Me: "Sorry guys, I can't make dinner."

Them: "Why not?"

Me: "Sigh," I'm moping and pouting. "Somebody got shot in the chest and I have to help."

Them: "Ummm....I think the *rest* of us think that's a good excuse. Why are you even on the phone right now?"

That was really selfish, right? But it made me laugh.

Anyway, I set up everything in anticipation of a traumatic intubation, and then the EMS guys burst in the room with a young, skinny little thing who is scared shitless. "I GOT SHOT!" was all he could say, over and over. At least he was speaking. No inubation needed. And his vitals were stable. But no sign of a gunshot wound in the chest.

However, when we surveyed him and rolled him over, we saw a bullet hole over his left scapula. But no exit wound. The bullet was still there inside him, somewhere. Most of us thought that it was stuck in the bone or left lung, so we stabilized him and put in IVs and drew blood while the tech took a chest xray.

Twenty feet away, the other trauma was still going on. The two victims then saw each other and -- wouldn't you know it -- they were the two shooting at each other.

"MUTHAFUCKA! YOU AIN'T DEAD MUTHAFUCKA??!! YOU FINNA BE!"

Great. Just great. At least they were both talking, despite the fact they were riddled with bulletholes.

"BITCH ASS YOU WILL DIE WHEN I GET OUT OF HERE MUTHAFUCKA!!"

"FUCK YOU!"

"FUCK YOU PUNK!"

The first one was wheeled out and to the O.R. We rolled the second over and did our primary survey. Part of the survey is to stick a well-lubed finger in the ass to make sure there's no hidden rectal injury or bleeding that would indicate an intra-abdominal wound. So the surgery resident split his asscheeks apart and out popped two bags of crack and a bag of weed.

Later, I had to explain the anatomy of all this to the NYPD detective who showed up. ("No no, it wasn't IN his ass per se, it was in his asscrack proper. Get it? Not in his assHOLE, but trapped in his assCRACK.")

So the chest xray got done and there it was: the bullet. Lodged in the right lung. But he got shot in the left scapula. As it turns out, the bullet was deflected off the left scapula (it IS a very thick piece of bone), traversed his midline, somehow avoided the mediastinum and great vessels in the thoracic cavity (lucky dude), and ended up in the right lung. So he had a blood-filled left lung that collapsed (hemothorax) and a punctured right lung that collapsed (pneumothorax). But he had enough reserve lung capacity to breathe somewhat normally. However, he would need bilateral chest tubes.

So my friend Tran from surgery took the left side and I took the right side. We gently sedated the patient and gave him lots of morphine. Tran and I poked large holes in his chest from the side with the BMKs (short for what we call Big Mother Kelly Clamps) -- POW -- you can actually hear when you poke into the lung cavity. Blood poured out from Tran's side with the hemothorax, and a WHOOSH of air rushed out from my side with the pneumothorax. We slid the tubes in (Tran beat me, he finished first), tied them off, his lungs were nice and re-inflated, and off to the CT scanner he went. I just hoped that they would remember to put him and the other assailant in different rooms when they were done.

I collected the bags of crack and weed, handed them over to the NYPD, washed up, changed scrubs, threw the bloody ones away, and headed home since I missed dinner.

I did, however, get to flip on the TV for a minute and watch as Nellie Oleson (LOVE HER) tormented Laura. Then off to bed, too tired for food.