Monday, January 1, 2018

Aortic Tears on New Years Day According to Dr. Slambow

New Years crashes sometimes resulted in torn aortas. Dr. Slambow
explains and acts out the mechanism.

When one year dissolves into the next, I often lapse into some serious retrospection of New Year's Days  past.  It's not the big time lifesaving trauma  surgeries  (I hate that all too common lifesaving balderdash. It's like a literate canker sore that shows up conjoined to it's favorite twin, trauma surgery.)  No, it's not those bigtime dramatic measures. It's the feckless and stupid little frivolities that come to mind like the way ratcheted instruments so neatly clicked in your hand or the way overhead lights glimmered and danced off a freshly prepped surgical site or being called in to work with my all time favorite surgeon, Dr. Slambow. I really miss him.

I've never been one to celebrate on New Year's Eve. Maybe it has to do with the fact that every one of these occasions resulted in a trauma call  when I was on duty.  I remember a variety of injuries; beer bottle broken over victims head and then stabbed with the left over glass shards, a young man that sustained a 12 gauge shotgun blast to his butt (not a good way to lose 20 pounds,) and of course the usual automobile wrecks on Lake Shore Drive with the victim sustaining an aortic tear that usually resulted in the poor souls  rapid demise.

One long night scrubbed with Dr. Slambow, I began asking questions as they popped into my young foolish, but curious brain, "Why do automobile mishaps cause torn aortas?" Dr. Slambow's eyes lit up like a New Year's Eve fire cracker and I knew I was in for a rare treat- the good doctor was going to act out his answerer. I could not wait.

He asked for a bloody 4X4 to use as a prop and as soon as I tossed down a needle holder that had been in play and fished around for the requested blood soaked  sponge it was show time. Just  as I expected, the rolled up sponge was going to play the part of the aorta and Dr. Slambow's partially closed fist was going to be a stand in for the chest cavity. This was going to be as good as his lecture on Sengstagen/Blakemore tubes when he inflated a used surgical glove (size 8)  that was partially filled with blood until the thumb portion of the glove exploded creating a colorful scene. The mess he created rivaled that of the grandma wrecked on  the Harley case we had last month. What a mess.

Dr. Slambow explained in his deliberate, eloquent tones that the great vessels in the chest were not tethered to anything and could rock back and forth in the mediastinum like a pendulum. He almost teeter- tottered of his booster stand as he rocked back and forth. Coleen, the circulating nurse was standing nearby to catch him in the event of a backward fall. OR nurses are taught to always anticipate the surgeon's action and we knew Dr. Slambow and his antics  all too well.

The good Dr. made a partially closed fist and suspended the twisted sponge between his index finger and thumb so that it resembled the tubular aorta hanging freely within the confines of his partially opened fist model of the chest. His next move was to make a punching motion with his fist just inches from my masked proboscis and suddenly arresting it's movement just before impact with one of the overhead lights. "There you have the mechanism of a torn aorta-the movement of the patients chest is suddenly stopped by impacting the steering column, but the heart is still moving forward a 65 MPH. The shear force tears the aorta."

Thanks for enlightening us Dr. Slambow, maybe next time you could explain why ostomy patients have so much trouble with excess gas. On second thought-never mind.


  1. I would have loved to have met your Dr. Slambow!

    Happy New Year!

  2. Nurses and cops walk many of the same paths. Holidays on duty were rarely pleasant, and often tragic. Inevitably, some family gathering would go south, and one beloved family member would be slapped, punched, kicked, stabbed, or shot by another beloved family member, and there we'd be. Then there were the traffic accidents, usually minor, but sometimes not, and often alcohol-related. Our job was to figure out what happened, and pick up what was left. And occasionally there'd be the individual so negatively impacted by the holiday, for whatever reasons, that they decided to end it all. Very often they weren't successful, but sometimes they were. Another fine mess.

  3. How true Officer Cynical, but with aging and the inevitable cognitive decline (Now...what the heck did I have for lunch?) the tragic and depressing holiday incidents become more distant.

    Now, I best remember some of the silly stuff we did back in the day to maintain our functionality in times of crisis. Whenever there was a trauma in the OR there was usually a friendly law enforcement official nearby. Some of my best memories include joking around with members of Chicago's finest. When I was circulating in the OR, I always offered the officer a set of scrubs so he could he could be in attendance in the room - about half of them accepted my invitation and Dr. Slambow just loved performing for the law enforcement audience. Thankfully there was no HIPPA nonsense or busybody administrators on duty late at night. Those were the days!

  4. Are seatbelts compulsory in the USA, OFRN? I was wondering if these would reduce this happening as you can't fall forwards very far? Sue

  5. I always thought people like your Dr. Slambow were the best teachers. Those were the types of moments you never forget.

  6. Seat belts were mandated in the USA in the mid 1980's but lots of folks refused to use them maybe the independent Yankee mentality at work. Anyhow, my Dad never used seatbelts, but whenever one of Officer Cynical's colleagues appeared on the horizon, my dad would pull his belt around to give the appearance of using it and release the belt as soon as the officer was out of sight.

    Thanks Jono, for taking the time to leave a comment. You are right about the best teachers. I
    will never forget Dr. Slambow and his educational shenanigans.