It was an accident and let’s just leave it at that, she said.
My patient was feeling sheepish and guarded. It was Christmas Eve, 9pm. She had shot herself in the chest, but she didn’t mean to. It was maybe a dare or a rash indiscretion. Guns are tricky, as are relationships. Her boyfriend was provoking her, maybe. She wouldn’t say much. It doesn’t matter. After the trigger does its thing, the reasons seem, well, remote. When someone says let’s just leave it at that, we all know that there is more to the story. Also when someone says “just” they mean the opposite. I was just trying to help means that I was also trying to change who you are. I was just leaving means I was staying a little longer. Etc.
She was right handed. There were no powder burns on her left chest so I figured she was wearing clothes when she just pulled the trigger. She was trying to die when she came in. We put a tube in her chest to drain the blood and re-expand the lung. Her diaphragm was injured and that needed repair. She missed her stomach (5mm) spleen (5mm) and colon (10mm). The bullet left her under the left shoulder blade after tearing through her lung like a sponge, literally. Normally the blood travels in the walls of the little cells of the sponge of our lungs, but when the cells get broken, it is predictably messy.
This is not an anatomy lesson. It is not a lesson at all. I am seeing what is in front of me. I am a surgeon, I am seeing little bubbles of air gurgling. The difference between respirating and drowning is the difference between air and paper. The surface area of the little spongey bubbles our lungs is that of a tennis court. Massive, and contained. She was struggling for air, breath. Most people who fail at suicide, even those who start out wanting to do themselves in, are happy with the second chance. My patient was happy to be getting to the next breath, to the next