Friday, August 26, 2005

Alan Matthews hated being late for work. He was due at the ER at 10pm and had overslept. No wonder, as he hadn't laid down until about 6.

What a day! Started at 10pm last night, his third straight night and then his brother's annual lake bash today. It was stupid and he shouldn't have gone. He really needed the sleep. And getting slightly toasted when he had to be at work tonight was another bad idea. "Well, maybe more than slightly," he thought with a grin.

But, whatever, he was sure he had slept off the alcohol. Besides, this was a Thursday night and these were traditionally slow. Heck, he might even get a couple of hours of sleep, if he got lucky. "Anyway, even at 50% I'm better than most and I'm sure I can get through this, luck or no," he smirked to himself.

But, right now, he didn't feel lucky. His head was aching, despite the 800mg of Motrin he had gulped down on his way out the door.

"God, I hope it's a slow night," he swore softly, pulling onto the four-lane divided highway. "At least there isn't any traffic at this time of night, I can make up time on this stretch of road." He didn't see any lights ahead of him and pushed his little BMW to over 100 mph.

He always got a thrill from this car and enjoyed the feel of speed. "I work hard and I deserve this car."

With a start, he awoke and realized he had nodded off. There were a few other cars on the road now and he slowed to about 80. He slid smoothly into the left lane to move around a small Honda. Right at that moment a big Ford dually turned left from the median directly in front of him!

He slammed his car back into the right lane and slipped past the huge truck, noticing the startled expression of the driver and the squeal of tires behind him.

With that adrenaline rush on board, he made it to the ER just on time, without further incident. Relieved, he thought, "Man, if I hadn't had such a great car and such great reflexes, I might've been dead back there." Ignoring, of course, that if he hadn't been in a BMW sports car, he might not have been going that fast to begin with.

Strutting into the ER, he shouted, "All hail the great ME! Here at last!" He chuckled along with a few of the nursing staff. He didn't hear them whispering behind him as he went to relieve his partner. "What an asshole!" "Oh, man, if I had known he was going to be on tonight, I would have called in." "He really does think he's God's gift to medicine, doesn't he?"

"I don't have anything to sign out. There are a couple checking in and we got a call about a trauma coming in from the highway. Some kind of car wreck. One fatality and two others pretty severe. A rollover of some small car. Probably a drunk. Anyway, EMS was going to fly them to the trauma center, but the helicopter was out. Are you going to be OK, or do you want me to stay until they get here?" his partner offered.

"God, you asshole, I can handle ten before you could get your gloves on," he thought. "No, I can handle it. Thanks," he replied. "Go on home."

Katrina walked over by Martha. "Better get the trauma room ready and call x-ray, we're getting a bad one."

"Sure thing, Katrina. Hey, did you smell alcohol on Dr. Loveshimself over there?"

"Yeah. Wouldn't be the first time. You know, too, his brother's big party was today. Judy said he really made an ass of himself drinking! Not that he needed the alcohol to be an ass. I heard his wife left early after he started hitting on that new respiratory therapist. I just hope he's up to this. I wish Dr. Ray had stayed."

Hearing the sirens approaching, the ER team assembled in the trauma room, with built in x-ray and cabinets full of supplies. The mother was going to T5 but the daughter needed to come in here. She was in the worse shape.

Moving the boarded patient over to the trauma table, Katrina called for a chest xray, c-spine and pelvis. Martha prepped to draw blood.

Registration called out, "The woman's brother is in the waiting room. I'll put him in the family conference room. The chaplain is on his way in. EMS reported the driver, an adult male, was DOA with an almost complete decaptiation."

"Doctor, she's not breathing and her BP is 80 over palp. Can you get her intubated?" prompted Martha.

"I know what I'm doing, nurse. Just do your job and let me do mine," he barked, moving to the head of the bed. "Someone find out what happened. Type and cross for 2 and get in two large bore IV's. And someone hold her still. Jeez, turn off some of those alarms, my head is killing me!"

Their eyes meeting in an unspoken message of concern, Martha and Katrina moved to get "fingers and tubes in every orifice" and tried to restrain the increasingly combative teenage girl.

The secretary came in. "Her mother said someone in a little sports car was driving like a drunken maniac and tried to pass them. He swerved to avoid a truck and forced them off the road. They flipped into the ditch."

Matthews' head whipped up. "Did the truck stop?" he asked, his voice quavering. "Did they catch the driver of the car?"

"No, not yet," came the voice of the sheriff's deputy in the corner. "We do know it was a small convertible, something like a BMW."

"God, I can't see anything with this damn collar in the way. Here, you, respiratory therapy chick, hold her head while I take this collar off. I can't do everything myself. Do I have to do my job and yours?" Anything to distract and change the subject.

"He's loosing it, just like last time," Martha whispered to Katrina. "This isn't going well. Have someone call in the surgeon on call."

Muttering and swearing, the doc probed with the laryngoscope, trying to get a clear view of the larynx. "Damn it, I've got to have better exposure!" he yelled as Katrina tried to pull the young woman's leg back to the table.

Dr. Matthews screamed, "I need more room, you idiot!" at the therapist and elbowed her in the chest. She slipped on a puddle of blood and fell backward, letting go of the patient's head. The head lifted from the table as the doc pulled up on the laryngoscope handle, trying to elevate the jaw.

Suddenly, there was a slap as the girl's leg fell to the table. She was no longer combative. There was an unnerving silence in the room as everyone realized just what had happened. Without proper support, and with the traction from the laryngoscope, the patient's c-spine fracture had separated, paralyzing her.

"You fool, look what you did, you incompetent buffoon!" boomed the ER doc. He blustered at the staff staring at him, "That wasn't my fault, this idiot...Well, anyway, it's up to me to save the day, again." He reached up to wipe away the sweat beaded across his forehead, leaving a crimson streak of blood.

"I'll have to do a surgical airway! Get me a scalpel!" he screeched at Katrina. As she hesitated, concerned, he reached across and grabbed a number 10 blade from the counter. Shaking and uncontrolled, he moved the shining silver to the smooth skin of the beautiful young girl's throat.

Tears streamed down his cheeks as he panicked. He had to get her breathing again!

"Please let me help," Katrina said calmly, reaching for the knife.

"Get away!" he brayed, slashing out. Katrina pulled her hand back just as the sharp surgical steel whispered past.

He reached out and cut. Blood the color of magenta squirted, jetting across his chest. With a look of terror, he dropped the knife and stared across the table at Katrina. She reached across to apply pressure, as the flow became a trickle and then just dripped slowly to the floor, the only sound in the room.

Horrorstruck, the staff watched as the doctor left, followed by the deputy.

In the call room, the doctor sat with his head in his hands, tears flowing freely. Sobbing, he looked up as the door opened and Deputy Johnson walked in.

"Uh, what just happened, doc?"

"I...I...I killed that girl."

"Twice."