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Memo from the Editor's Guest: I know heroes

Memo from the Editor's Guest

There's been a lot of talk about heroes over the last six months and surprise that ordinary folks could rise to the occasion so magnificently. Well, it didn't surprise me. I've spent nearly 16 years caring for people in the small town where I grew up, but there was a time not long ago when they cared for me and my family. When many acts of kindness shown us by patients, friends, and even folks we didn't know sustained us through one of the worst experiences anyone can face.

It happened like this:

If I weren't on call, I thought as I pulled out of the grocery store parking lot one beautiful Saturday, I'd be out hunting, like Brian. Still, my friend Gary had asked if he could borrow my smoker and I had quickly agreed, deciding to add a brisket and some ribs of my own to the smoke. So, there I was, headed home with some potentially delicious barbecue when an ambulance passed me going the other direction. Not my problem, I grinned.

I'd just put the spices on the meat when the phone rang. "We need you; there's been a wreck," Cindy, the ED charge nurse, said.

"Got to run," I told my wife, Becky. "Tell Gary I'll be back and go ahead and put the meat on."

I got to the hospital to see virtually the entire hospital staff working feverishly over a teen-aged boy. There was one IV going and the nurses were starting another. He'd been intubated and was being bagged. Obvious fracture of the left humerus; abdomen flat; blood in the NG; good symmetrical breath sounds, but no BP.

I moved to check his pupils. The black, lifeless orbs were nothing like the sparkling blue eyes I was used to seeing dance out from my son's face. As I realized that Brian was probably brain dead, time seemed to stand still.

"What did you see?" asked Jerry, the ED doc that weekend. I just shook my head, walked over to a chair and sat down.

Brian and his friend Colt had gone hunting. Driving down a dirt road, the truck went out of control and rolled. Both boys were ejected. Colt—less seriously injured—had made it to a farmhouse. The road was isolated and it took almost half an hour to find Brian.

Soon the helicopter arrived to take Brian to Amarillo, 125 miles away. Becky's brother, Russell, lived in Amarillo and went to the hospital to await Brian's arrival. He met us at the SICU.

The news was not good. They'd done a quick CT of the head and then a trauma lap. The brain injury was catastrophic. The neurosurgeon described the swelling as incredible.

"Dr. Dove wants to see you," one of the SICU nurses summoned me.

"We've been around this block four times now, and we're not getting anywhere," Dr. Dove explained, referring to the full code they were running on Brian.

"Okay," I acknowledged. "Let me go get Becky." When I returned to the SICU with her, Brian was in sinus rhythm. The respite was brief. As the monitor pattern deteriorated, Dr. Dove looked at me. I slowly and gently shook my head. In a few minutes what I had known in our small rural ED was official. Brian was dead.

Would he have been any better off if he'd had his accident on a busy city street? I don't know. The boys went more than an hour before getting any help. Time may have been an important factor. But when I consider the richness of Brian's life in this rural area, I have no regrets. When I remember the people I care for and say hello to every day, I know I made the right decision by returning here to live and practice. These people are all heroes.

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© Mathematica - The Commonwealth Fund
© Mathematica - The Commonwealth Fund
© Mathematica - The Commonwealth Fund
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