3 Lessons I Learned From My First Trauma Patient (And So Can You)
I remember it like it was yesterday.
It was my first day in The Trauma Service as a med student on my surgery rotation. For those of you that do not know, The Trauma Service consists of people who get into car accidents, get shot, run over by cars, motorcycle accidents, falling off ladders, etc. – you get the drift.
Now I had worked in the emergency room before and had seen a couple of cases and patients. But I had never officially been on The Trauma Service, where you are on 24 hour call at the hospital, and every time a trauma patient comes in you go down to the trauma bay to help out the team in managing the patient.
Now back to this day…. Our first day, it was my classmate Jessica and I on the service, and we were excited. It was around 7 A.M. we had a good ole fashion trauma shears ready (to cut off the clothes of whatever patient comes in) and we were sitting in the room waiting for a patient to come in.
Just kidding.. Trauma shears actually look like this:
Next thing you know, BEEP BEEP BEEP, (it’s almost like a darn alarm clock), “level 1 trauma, MVC, ETA 8 minutes”. GCS of 3… And these are the old school pagers (MVC = motor vehicle collision. ETA= Estimated Time for Arrival).
GCS (Glascow Coma Scale – http://www.glasgowcomascale.org/ ) is a system that you use to tell the patients level of consciousness. Whether they can open their eyes, move their limbs, or speak.. And as you can guess… A 3 is the lowest score you can have.
They were getting helicopter flown in . We rush downstairs like good medical students, in the room waiting for the patient to be rolled in.
It seemed like we were waiting there forever.
Then, finally, you could hear the commotion as the paramedics were rushing the patient in. When the patient finally got there, they rolled her in and it was a 19 year old white female. Now, this caught me a little off guard and stunned me for a bit. Because I had normally been used to seeing minority patients in the ED, older African Americans, Hispanics, etc., I wasn’t expecting a young white female to come in, I mean… They are supposed to have a longer life expectancy than most..
Anyways…
She comes in unconscious, not responding to any verbal stimulation, not moving any limbs.. Nothing. The story was that she was driving and made a left turn when another car hit her driving 40 mph or so.
So as good med students, we start cutting off the garments while the trauma team is doing their assessment. Checking her airways, breathing, and circulation… seeing if she has any internal bleeding. So far nothing is coming back positive, no bleeding in the stomach, and still no response.
The trauma team captain said, we need to consult neurosurgery ASAP, we think she may have a brain bleed from the accident. Which was a good idea as you’ll see why…
Not more than 2 minutes pass and the neurosurgery residents are in there assessing her. Checking her responses, reflexes, squeezing her fingernails to elicit some type of response.. But still nothing.
What happens next was crazy…
The room got really quiet, if a grasshopper was there you could would be able to hear the crickets.… I mean you could hear cotton fall on to a pillow.
Then they said…
“If we don’t get this girl upstairs to the OR (operating room) in the next 5 minutes SHE IS GOING TO DIE.”
They figured that she was having a bleed in her brain, and with the pressure increasing by the second she could die any moment. So now all efforts are focused on getting this 19 year old female upstairs ASAP so they can do what’s called an emergency craniotomy, aka they remove part of the skull to relieve the pressure on the brain.
Now they are rushing her to the special set of elevators.. Made for these kinds of situations… And get her upstairs.
Us, wanting to see the case, ask our residents if we can go upstairs with them and just observe, and they so graciously let us.
We go into the operating room… And to this day… That scene was one the most organized chaos I’ve seen in an operating room. There are people transferring her to the bed, scrub techs are running around getting their equipment ready.. Blades… Saws… Items to prep the patient for surgery.
We are sitting there trying to help out wherever we can.. Picking up trash off the floor, handing supplies to techs, nurses.. Helping open gowns.
They had a saw ready to cut into her skull. This was called a heroic life saving procedure.
It was such a rush to hurry up and get this girls skull open, to save her life. The neurosurgeons were rushing and prepping her head, the surgeons gown wasn’t even halfway on when he began removing her skull. I swear all of this must have happened within a minute of her getting into the OR.
Her skull was off… We had a clear vision of her brain.
And as you can guess.. She did have a brain bleed.. Blood spilled everywhere. The surgeons were standing in a pool of blood with half of this teens skull in her hand. They had on black boots.. This wasn’t their first rodeo..
They relieved the pressure though.. They essentially saved her life.
I was sitting there like HOLY S***.. This is how we are going to start off the day huh? They later on put in a shunt to help drain the blood…
After the case we went back downstairs.. And found her parents sitting there in the room, crying, worried, and scared of not knowing what happened to their daughter..
Now thank god we weren’t the ones that would have to break the news about what just happened to their daughter.. That would have been a whole ‘nother story.
Now to fast forward
This patient was on our service all week, so every morning we would round on her, and every morning we would see her parents there. Then her friends.. And they would tell me how they just went to prom with her a couple of months ago and how they were all sad. She had a TON of support..
But within the week that I was following her.. She hadn’t recovered yet.
She was still intubated and non-responsive by the time I had to leave the trauma service and move on to the next..
I hope she ended up being ok…
3 Lessons I learned from that case
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Death doesn’t care who you are, it can happen to any of us at any time.
Now obviously, this is something we all “know” and is common knowledge. But not a lot of us don’t really know the impact of that statement. What caught me so off guard was the she was a young white girl that came in. It wasn’t what I was used to seeing. Theoretically, white women were supposed to have one of the longest life spans out there.
All she was doing was doing a normal activity which many of us do daily without thought. She was driving her car.
Death doesn’t care how old you are, whether you are young, white, black, red, purple, or yellow. Death doesn’t care that you aren’t ready yet. Death doesn’t care that you have people that love you and depend on you. Once it comes, it comes.
Each day that death hasn’t claimed you, life has claimed victory. Celebrate another day, and really enjoy it. All we have is today
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I’d been subconsciously trained to expect certain ethnicities to come into the ER.
It’s strange. I expected my first trauma patient to either be a gunshot wound from gang violence, or a motorcycle crash, or something cool like a mangled extremity (obviously not cool for the patient). But I had expected a minority to walk through the door.
If I had seen somebody that looked like me walk through the door, I doubt my reaction would have been the same.. Because I “expected” it. It was the so called “norm.” Living in Atlanta and working at Grady, you are used to seeing a majority of minority patients.
I remember when I was younger, Id tell my mom that I didn’t think i’d make it past age 18 as a black male, and she hated when I’d say this of course… But at the time, 18 seemed so far away.
I don’t know if its the media that portrayed certain ethnicites are the “help” or as the ones who get hurt. Or maybe that’s all that I’ve seen and been exposed to. But at that moment, my perception of a trauma patient changed- nobody is safe, we are all equal.
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Support, family, and friends
Life is about the relationships that we make and the peoples lives that we come across. Every day, she would have more flowers in her room, more get well soon boards, and new friends/family that would come and sit with her, in hopes that she would wake up at any moment and see them by her side. They would say how she was such a happy person and that they can’t believe that this happened to her.
She had a strong support system that was there.
When you are going through something in life, it’s easier to have someone by your side, rooting for you and supporting you. If somebody is going through something, be there for them, support them it goes a long way. and I know personally that i haven’t been the best at this and need to improve.
When it comes down to it, treat others as you would want to be treated yourself.
So there it is, the story of my first trauma patient.
If you like this post feel free to give it a like, and a share. Leave a comment below, I’d love to hear your responses/ opinions. If you’re a med student or a doctor, and have a story about how a patient changed your life or gave you some life lessons, feel free to post it below.
Adios mi gente! Te veo en la proxima ! (I’m working on my Spanish)
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