The thoughts and writings of a surgeon

Sample Chapter

Surgeons Hate Surpises

“Dr. Ruggieri, please come to the emergency room stat.”  I was in the middle of slicing through a buttock abcess the size of a tangerine on a young man when the overhead page spoke out.

“Damn, Doc, that hurts.”  I smiled, ignoring his cries.  The man let out a short howl.  “I thought you were going to numb it.”

Be quiet, will you!

A second page rang out from the ceiling speaker.  “Dr. Ruggieri, you are needed in the emergency room now.”

“Doc, this hurts.”  The young man was squirming.  I pretended to listen to him.

“Okay.  I need to go.  Nurse, can you pack this for me?  Have him see me in the office next week.”  I placed her hand on the gauze covering the oozing abcess.

By the time I entered the main trauma room in the E.R., the paramedics were already well into a round of C.P.R.  The crack, crack, crack of broken ribs with each chest compression greeted me at the door.  The death clock had started.

“Guys, easy on the ribs.  If he lives you’ll have some explaining to do.”  I got closer.  “Who is this?”  I glanced at the patient on the table.  My heart rate began to increase.  I had to look away then, and steel myself.  It was a little boy at the end of those chest compressions and cracked ribs.  A little boy with blond hair.  I couldn’t let my stirred-up emotions from seeing a child near death interfere with the decisions ahead.  I have to do this; otherwise I am no use to anyone.  An emotional heart is not welcome inside a trauma or operating room.  It has to be left at the door.  A surgeon can’t afford any distractions at a time like this.

“Hold compressions.”  The monitor was a flat line, asystolic.  No heart activity, no life.  “Keep pumping.  Go man, go!”  The seconds continued to slip away.  I glanced at his partially covered face, blue eyes wide open.  Another paramedic was trying to keep his lungs full of oxygen through a breathing tube.  The compressions continued.  “Does anyone know what happened here?”  More cracking.  I was looking for something, any clue as to why this patient arrived in my emergency room clinically dead. 

“All we know, Doc, is it was some accident at home with a knife.  It was found in another room with blood on it.”  The paramedic continued, “When we arrived, he was on the kitchen floor alone, no heartbeat, and white as a ghost.”  More seconds lost.  “I didn’t see any parents.  One of the neighbors said his name is Jason.”  More seconds were lost.  More brain cells were dying.  I did not have much time to figure this out.