Monday, December 21, 2015
A Christmas Trauma Tale
rival teen gangs, the Aristocrats and Latin Kings. Luckily, for local residents, their gang culture viewed firearms as not cool or macho. Gang fights usually resulted in knife inflicted trauma of varying levels of acuity. If a gang member could walk away from a knife fight, they would often go home and attempt to sleep it off as one would do with a hangover. The end result was an emergency room visit the next day when the sleeping it off routine failed. I was always mystified by the thought process behind the "sleeping it off routine."
Stab wounds were a fairly common trauma at our hospital. These wounds could really be deceptive because once the blade of the knife was withdrawn, the skin retracted and something minor in appearance could hide serious injury. Single edged knives caused the least trauma because they would push bowel and organs away from the blade as they were inserted. Double edged blades caused more trauma because they perforated rather than pushed structures out of the way.
When these young gang members were anesthetized and on the OR table they presented a sad picture. It was then that it sunk in. These were just children, little kids caught up in an urban nightmare. They looked so menacing on the street and so vulnerable lying on the table. I used to feel really bad for them.
I was on call, Christmas Day 1974 when the phone rang in the call room. We were getting a case. It was a 15 year old gang member, Sam that had been stabbed in the abdomen on Christmas Eve. He tried sleeping it off, but by Christmas morning the pain was so severe he reported to the ER. After a cursory exam in the ER, it was off to the OR to patch up Sam's abdomen.
I would be working with Dr. Slambow one of my favorite surgeons. He liked to make scrub nurses feel important by asking them what kind of suture to use and really getting them engaged. He opened up Sam's abdomen and began exploring, everything was pretty much intact and without major organ or vascular damage. He meticulously sutured several stab wounds in the small bowel and then engaged the scrub nurse by asking me to return the section of small bowel to the abdomen. He even taught us how to follow along the small bowel to find the cecum. I was always amazed at how slippery and difficult it was to handle bowel. The abdominal organs always felt so fragile like a glob of jello and pushing the bowel back into the wound always reminded me of when I worked as a grocery bagger as a teen. When I thought of the abdomen as a paper bag filled with gobs of Jello, it made me realize how fragile we all are. We did one final irrigation of Sam's abdomen and Dr. Slambow closed. It was an uneventful and straightforward case which ended well.
A few days after Sam's surgery Dr. Slambow approached me and suggested I visit Sam on the ward because he was such a pleasant youngster. I had never visited a post-op patient and was hesitant, but Dr. Slambow was insistent.
Sam was in a 4 bed ward and sitting up in bed when I approached. I explained who I was and he was profoundly grateful. He thanked me profusely for helping him and we began chatting. I mentioned to him that I was sometimes fearful walking the 1/2 block distance to the hospital from my apartment. There was an area under the elevated tracks that had an abandoned old station wagon which was overturned. It was heavily tagged with the Aristocrats circled "A" symbol. Sam told me the station wagon was on of the Aristocrats favorite haunts, but that I had nothing to worry about.
Months went by and my thoughts of Sam had subsided. One Spring evening I was walking to the hospital at about 11:00PM. As I approached the junk car under the elevated tracks a shadowy figure poked his head out from behind the rear fender of the rusted hulk and offered a friendly salute. It was Sam guarding my way on the walk to the hospital late at night. Keeping me safe.
Christmas tales like this reflect something meaningful about the season. Two people helping each other with whatever resources they had available. Merry Christmas and if you are working in a hospital this holiday season, I think you are doing something very special.