”Trauma Stat, GSW abdomen, 12 y.o. female, 5 min.”
GSW: gun shot wound.
This page shattered a quiet Sunday morning. My guts turned to water. That was the last emotion I had for hours. Within moments my mind let fall the amazing partition that allows me (and most other surgeons) to enter purified chaos with the ability intact to think and to take extreme actions. When I see this kind of message I know that I will match and surpass the brutal invasiveness of the injuring bullet. It takes so much more trauma to repair these injuries. I knew this then and I know it now, but in that moment, I don’t think in this way. There is no reflection. There is doing.
I met Jess in the trauma bay, pale as rice, and almost as thin. If a surgeon quietly turns to the person next to him and says, ”She is sick,” he is not talking the same language as the sickness that might describe what keeps a person from work. It is understatement weighted with the gravitational pull of death. Jess was sick, in shock, dying. Her blood pressure was low, her pulse racing. The accidental bullet hole was small. It looked unassuming; not like on TV. All the blood was on the inside.
A world of activity was in play when I got to her bedside. Dr. W, anesthesia, was actively saving Jess’ life–giving her iv fluid, warmed blood, placing big lines in veins and getting her ready to move to the OR. Within minutes a team had scrambled and the room was ready, heated to prevent her temperature from falling too much which makes bleeding much worse. There was little talking. Everyone was working. I would like to say that I never hold ambivalence about doing operations, but I sometimes do. I could give examples of when this happens, but I don’t think I need to. If you are human, like me, you get it. When a 12 year old girl rolls in, all hearts beat together. All hands work at separate jobs but the result is more than the sum of those jobs. A healing environment is created. It is honorable work.
Once I was in her abdomen, I knew I needed more expertise. I called in the vascular surgeon to repair her aorta and the vessel to her left leg. I held a sponge on the vessel until he got there. There were multiple holes in the intestines. It was dire and it stayed dire. We eventually got her to the intensive care unit and then on to the university, by plane. She stayed there weeks, almost dying several times. Eventually Jess made it home. I operated on her over the next few years several times for hernias, scars, pain. She never lost her smile.
When I walked out of the operating room to the waiting room on that Sunday morning, I was met by a throng. It was like a hive, all gathered around the one injured member. There is no time like the endless minutes survived by a parent in the waiting room of a dying child. Their faces change, the lines deepen. All the emotions (and many more) I held at bay, they were swimming in, drowning in. I don’t remember the conversation really. She is sick, this is as serious as it gets, we are minute to minute, she is fighting, we are working–I probably said all these things. She is a wonder, a beauty, the morning light, my heart is breaking, this is wrong on every level–I said none of these things, but, as I was starting to reunite my heart and body with my mind, I was starting to feel them. I was affected. Her parents turned and got ready to go to Portland, to the university. They finally had something to do. How to balance the truth of the desperation of the situation with the need for hope? There were no words for it. My hand on her mom’s shaking hands, her father standing by, drawn and withering.
Not only did Jess survive, she thrived. It did take a while, but one of the gifts of youth is the almost unstoppable tendency to heal. I have taken care of many children who don’t end up healing, who are devastated and who die. But even in these cases, the child’s physiology yearns for life in a way that the adult just doesn’t. I don’t know how else to describe it.
It is rare to hear from people after surgery and the healing is in process (and the bill has arrived). I don’t expect it, but when a thank you comes, it is great. It reminds me I should be thanking my mechanic, my farmer, my dentist, better than I do. This family made me a part of their lives. I was getting miraculous invitations to dance recitals, updates from softball games. We went. I cried to see her dance. The wreckage of her injuries had been transformed into a lithe, normal teenager. I got invitaitons to volleyball games. Jess and her mom would drop by the office to introduce her boyfriend, and we joked about my approving or not. I got the invitation to graduation from high school. She walked across that stage, a poised, assured, lovely and most of all, alive, young woman.
Today I got another page about Jess. ”Jess has had a baby and wants to know if you can see her today.” Meet Benton Archer DeVore (italics mine). !!
So there is the story: this perfect 8 day old boy in my arms and already wrapped around my heart. When someone dies we sometimes say that the wheel has turned. In this case, I am deeply happy (seriously, happy) to say that the circle is unbroken, my soul is clapping, I love my job, and I am so profoundly grateful to be Jess’ friend.
Photo credit: Kim Glaspie–nice work, grandma!