Features

Real life in the ER

National | But in this hospital, faith in God is not left out of the script

Issue: "Lyons thrown to Baptists," Sept. 20, 1997

During shift change at St. John's Mercy Medical Center in St. Louis County, doctors meet in the locker room where they change either into or out of scrubs and white jackets. There are wizened senior surgeons and sun- and sleep-deprived interns. A pediatrician just going off chats with a resident just going on.

In many ways it's not unlike the NBC television series ER, with its cast of concerned doctors, competent nurses, and gurneys full of comic/tragic patients. There are little personal dramas played out against the backdrop of larger ethical and cultural questions. There are crash carts and gallows humor.

It's a Friday night and Steve Smith, an anesthesiologist, changes from his turtleneck and jeans into ill-fitting scrubs. The 40-year-old has a runner's build and a goatee, and he wears tweed jackets with patches at the elbows. He speaks deeply and quickly and he smiles often.

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"I wanted to be an orthopedic surgeon," Dr. Smith explains as he slips the paper booties over his sneakers. "I've always been a hands-on guy. My first car, got it when I was 15, was a '63 MG. I fixed it up myself. But surgeons yell at each other too much. Something about surgeons."

Dr. Smith covers his hair with a pretty blue flowery scrub hat and knots a mask around his neck. He greets an older surgeon (who doesn't yell, but he's not in a good mood, either). They talk a little politics, they talk a little managed care.

"I'm not a physician anymore," grumbles Dr. Arthur Auer, who wears a snazzy tweed driving hat and trench coat. "I'm a healthcare provider. I'm a business entity. Well, have a nice night."

[CUT TO: INTERIOR, OPERATING ROOM.]

It's bright and loud and crowded, with green-clad doctors, nurses, and OR techs. A 27-year-old woman is on the table. Her knee and face are being rebuilt after an automobile accident. The patient is hidden under sheets and equipment, with only her right knee artfully exposed. The skin around the knee is folded aside, leaving the muscle and bone open to the surgeon, Dr. Jesse Susi, and the anesthesiologist, Dr. Don Arnold.

Steely Dan plays softly on a battered stereo system in the background. It fails to drown out the pings and hisses of the OR equipment. The doctors are talking among themselves, while the nurses and techs listen on. So far they've talked about cars, they've compared wreck victims of the past, and they've discussed tattoos (this young woman has a rose-and-heart design on her hip; the surgeons admire the work). Dr. Smith enters, wearing scrubs and a surgical mask. He joins the conversation.

STEVE SMITH: We had a bad one recently, an 18-year-old girl, in her brand new Camaro. A bank robber was being chased by the cops, he pulled out in front of her. An airbag saved her life, but the force of the impact was concentrated on her femurs. Split her pelvis in two.

JESSE SUSI: Mmmmph. Know what I get a lot of? Guys putting up Christmas lights. Every single year, I get someone who has been doing Christmas decorations. Last week, guy came in, he fell off the ladder, blew out both his knees. Something I'd been doing that day, too.

DR. SMITH: (Shaking his head) Same with deer stands. I get a lot of deer stands. Guys just fall out of the trees. In fact, I think that's the most common hunting accident. Forget the guns. The real problem is gravity.

DR. SUSI: With spring coming up, we'll start seeing motorcycles. First good day, they'll start rolling in the guys who just had to take their motorcycles out for a spin.

DR. SMITH: And the rollerblades. Nice spring day, they'll be in here with wrist and elbow fractures.

DON ARNOLD: Don't forget the "Dude Brothers." They're my favorite. You know, "Some dude shot me, I was just sitting there." Weekend comes up, we'll get some of those. (Doctors laugh knowingly). [FADE TO BLACK.]

It's 9:05 p.m., and Steve Smith approaches the crash victim's father in the OR recovery room. The dad is a thin, middle-aged man wearing slacks and a golf shirt under a blazer. He seems successful; his clothes are expensive, and he wears a pager, but it's turned off. He calls to mind the Roman centurion whose servant was ill. The book of Matthew recounts how the centurion, though a man of some authority himself, humbled himself to Christ's authority out of love for his servant.

That's the temptation here, to draw too many parallels between ER physicians who save lives, and the God who gives life. Dr. Smith recognizes this and tries to redirect praise.

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