New stories from another rotation—the surgical intensive care unit (SICU pronounced sick-you for short). It is a daunting and often depressing place. I’ve never been around this many sick patients. This time of year, the SICU is full of patients that have been in really bad traumas, some due to back luck, some due to carelessness.
A few quick examples of the heart-wrenching stories of some of our patients. We’ve got a teenager who was riding in the car with one of his buddies. He happened to be hanging his arm out the window as many of us probably do on hot summer days. They were T-boned by another car that ran a light and this kid lost his arm from the elbow down. Some of the best surgeons in the western US tried for 10+ hours to save his arm—no dice. Unbelievably sucky. I suppose you can always be a glass-half-full kind of guy and think that he’s lucky to be alive, but I would not recommend saying that to a teenager who’s just lost his dominant hand. Life-changing is a gross understatement.
We had another man who rolled a tractor. His injuries were pretty devastating. He was in a coma on a ventilator while the family gathered. His injuries were inoperable and, ultimately fatal. The docs and nurses I work with were able to keep him alive long enough for his children to fly in from various parts of the country. When they arrived, he was taken off the ventilator and died within the hour. It was a rather unsavory experience for the first day of a rotation.
We’ve got another lady who’s in her 30s. She rolled her car recently and was not wearing a seat belt. She and her young daughter were ejected from the car. She fractured a vertebra and is now paralyzed from about the belly button down. I was in the room when she asked my attending when she would be able to feel her feet again. He did his best to gently but directly inform her that she wouldn’t. I’ve rarely heard cries like the ones that ensued. She was, understandably, inconsolable.
Fortunately, her daughter had surprisingly few injuries. She did have some, but she should recover completely. This woman is now tasked with taking care of 3 kids under the age of 10 without the use of her legs. For the love of God, buckle your damn seatbelt folks—EVERY TIME you ride in a car. I don’t care if you’re driving 200 feet to the neighbor’s house. It is simply not worth it. I always forget or It’s uncomfortable are phrases that must seem pretty ridiculous to the paralyzed.
I got a little teary-eyed as we stood there and watched this woman wail as she tried to wrap her head around the fact that she will not be able to use her legs again. And she’s a complete stranger. I don’t think I could handle it if someone I know shows up in the ICU, so please buckle up and stay off of motorcycles and ATVs. I can’t even put into words how dangerous those things can be. ICUs all over the US will fill up this month and next with patients whose lives will never be the same because of motorcycles and ATVs. So dangerous. No one thinks it will happen to them. It happens, and it's devastating to the whole family. You can do everything right and still get killed or permanently maimed. Not worth it if you ask me.
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8 comments:
Sigh. My boyfriend rides a motorcycle. He's very careful, but so was my dad when he got hit by another car while riding a motorcycle 40 years ago. My dad nearly lost his leg.
Also, people don't realize, if they're not wearing their seatbelts, they can become a 150+ pound projectile object that could seriously injure other people in the car. There's no justification for not wearing a seatbelt.
i i eee: agreed, absolutely no justification. We had another trauma come in--father of 6+ children was driving with most of his family, wrecked, one of his children (who wasn't buckled up) was ejected and killed, 2 other kids were injured as was his wife. He has a serious head injury and will likely be disabled, to some degree, permanently. I have no idea how you could ever cope with something like this--assuming he recovers. I also have no idea what his other children that weren't injured are going to do. Seatbelts, can't say it enough.
My wife about got her arm ripped off by a diesel passing us today. It was way close. I love putting my arm out the window on hot days too, but it can be really dangerous.
Amen on the motorcycles. I about got killed a couple of years ago when a drunk pulled in front of me at an intersection. I got thrown way high and landed hard on the road, and it fricking killed. I had a pocket of separated plasma and blood in my butt, and it has since solidified, but there is still a bump there. The rest of my body was really sore for a week, and I couldn't even stand up (I tried), so I got an ambulance ride. I was really lucky though. My cousin lost his life in a motorcycle accident a year ago, and my brother had a really bad accident on one as well. Motorcycles are really dangerous. People riding them are usually pretty safe (there are exceptions), but other people just don't notice you.
A great reminder indeed. I always feel awkward telling people in my car to buckle up because I feel like they have to make that decision on their own, but that's still not an excuse. I'd hate to live with the thought of someone dying in my car, regardless of the circumstances. New rules in my car.
Here in the Japans, it's illegal for ANYONE in the car to not have a seatbelt on, and the driver will get ticketed and fined for it if caught. Is there anything like that in the US? That's another good excuse to tell people to stop being frickin' idiots and buckle up.
i i eee and Doyle make a good point about motorcycles: you can do everything right and still get hurt or killed. The human body versus concrete or steel at high speeds will lose every time. Even with a helmet it's usually pretty ugly.
Mike, not only would it be hard to live with if one of your passengers were killed, as i i eee points out, anyone not buckled up becomes a projectile in an accident. Maybe the steering wheel, the windshield, and the concrete won't get you if you're buckled up, but someone else's skull/knee/elbow might.
If you'd like some pictures of what windshields can do to unrestrained passengers (not pretty) to show to people who are hesitant to buckle up, I'm sure I can round up some from my dad's collection. He used to keep one rubber banded to the visor of the passenger's seat of his car and he'd flip it down and reveal someone's bloody, mangled face as a reminder if we forgot to buckle up.
I realize that right now I have a biased sample, but I wish I could show people the hospital floor full of people with wrecked faces and devastating injuries. Driving will always be dangerous, but less so in an enclosed vehicle with a seatbelt.
Having pictures like that on hand is a genius idea. It pisses me off when people don't want to buckle up. Genius idea indeed... I'll have to get my hands on something like that.
Two more bad rollovers recently (not there are good rollovers, but some are worse than others). 20 year old guy, no seat belt, ejected. There were at least 25 people in the waiting room, tears in their eyes, hoping for a miracle. It did not happen. Within 18 hours of the accident, his brain was pronounced dead. If his heart, lungs, kidneys, liver, pancreas, and corneas aren't already in other people's bodies, they will be soon. Not buckling up affects a lot of people.
Another woman rolled her car 5 times with two of her kids in car seats in the back seat. The kids had only minor injuries. She was also buckled up. She broke some vertebrae, but does not have a spinal cord injury. She found out in the emergency room that she is newly pregnant. She got an ultrasound and the baby appears to be okay. She was obviously still very fortunate, but it's not a coincidence. Seatbelts give you better odds.
This is a horse I'll likely be beating for the duration of this rotation.
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