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Real life in the ER

"Real life in the ER" Continued...

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

The punch-drunk dad is standing and fidgeting, watching his bruised daughter. She's sleeping now, next to a heart patient. The dad already has accident photos; he's showing them to doctors, to nurses, to anyone who will stand still. Steve reassures the dad, telling him the bruises will go away, and that his daughter looks worse than she feels. With some physical therapy for that knee, she'll be all right.

"I don't see how anyone could have lived through this," the dad responds, holding out photos. "Look at the way the car rolled. You doctors are magnificent."

Dr. Smith takes the pictures, shaking his head as he leafs through them. "God's hand was on her. He protected her. We're just mechanics."

In the staff lounge, a stack of pizza boxes stands as a greasy testament to Dr. Smith's staff-management principles. He bought the pizza, he explains with a grin, and the staff will suffer to be managed for at least one more shift.

Mike Keenan takes one of the last pieces; Mike is a bearded, beefy biker, who is sadly relegated to driving his old pickup, he tells Dr. Smith. His bike is down again. Maybe the fuel pump. Mike stands with one leg on a chair, laughing loudly; it's clear a little of Mike goes a long way, only there's not a little of him. He stands 6'5" and weighs in over 225. He roars out his pleasure to meet the guy writing a book-"article," Dr. Smith corrects him. "For a magazine." Mike nods, but then makes the mistake twice more during the next 15 minutes, though no one minds.

Mike tells stories as he eats. He ranges from his combat experiences to his theories about CIA drug trafficking. He tells of Panhead Fred, a biker buddy who was offended by someone while he (Fred) was fixing his (the friend's) bike. Fred took it all apart, "down to the last screw," then got up to leave.

"He says, I found what you need, man," Mike recounts. "You need an assembler!"

No one laughs harder at Mike's stories than Mike. He then cheerily talks about the grudge the former chief of nurses held, that kept him out of work for nine months. "Now I'm indispensible," he smiles.

Dr. Smith agrees. Mike is a surgical tech, an instrument-passer, and one of the best. He may not be a guy you want attending your daughter's wedding, but he's the guy you want handing the clamps when you wipe out on the interstate, Dr. Smith says.

Mike bows to the compliment.

Just after 10:30 p.m. Dr. Smith's beeper goes off, signaling him he's needed in the ER. As he enters the emergency wing, he encounters nurses and assistants who are suddenly all business.

A 12-year-old boy is horribly burned. He was sneaking a smoke in the garage, instead of outside in the below-freezing temperatures. Gasoline fumes had accumulated, and when he flicked the lighter, the garage went up.

Larry Ashby, a flight paramedic, outlines the injuries for Steve. One phrase is repeated by at least half a dozen doctors and nurses: "I hate burns."

At 10:40, the burn surgeon calls for intubation-that's where the anesthesiologist inserts a breathing tube down the patient's throat, prior to surgery. It keeps the windpipe open while the patient is under anesthesia.

At 10:41 Dr. Smith dons a thick gray robe (part of the "universal precautions" against the AIDS virus) and goes into the trauma room. The heat hits him first; the crowded room is hot, made so by body heat and the intense overhead halogen lights. Then there's the smell. Burned flesh mingles with antiseptic hospital smells.

The 12-year-old lies on a gurney, surrounded by masked people. His arms and hands twitch; charred and ruined skin hangs from his fingertips and face. He took the blast of flames in the face, hands, chest, and legs. He's burned over 50 percent of his body. "Watch my arms!" he shouts at a nurse who is trying to start an IV. And it suddenly becomes disturbingly clear the boy is conscious.

In the corner, his overwhelmed mother shakes, too. She looks lost as she watches them treat her son. She's a pretty, young woman, but her clothes are soaking wet (from the fire hoses) and her face is tear-streaked.

The boy flails as Dr. Smith goes in with the breathing tube; something goes momentarily wrong and the boy's gag reflex is triggered. Now the stench of vomit mixes with the other smells. Finally the tube goes in and the other doctors administer the drugs that will bring sleep and relief from the pain.

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