Friday, May 31, 2019

28 years old, 1970 Vascular Surgery, ER and Trauma

The head of surgery was a vascular surgeon. I’d do a rotation in predominantly vascular surgery under his direct tutelage. An honor really. I was considered a good assistant so it might well have been self serving.  I think all the time helping my father and brother under cars taught me anticipation.

We did lots of aortic aneurysms but the surgery I remember most was the 12 gauge buckshot abdominal shooting. There were other shootings but this was the one I fell asleep pulling back on a liver retractor.

“Gunshot surgery not exciting enough for you, Doctor?’  Hearing my name I startled awake. 

 “No sir. It’s not that.”  We’d been at it for 8 or 9 hours. He’d been carefully removing every lead pellet from the intestinesand then carefully closing up the intestine. We’d already taken out the spleen and stopped what seemed like a hundred bleeders. Now he was delicately moving along the small intestine and integument feeling with his fingers to get all the lead out. It was 5 or 6 in the morning and we’d started the night before.  I had already peed in my scrubs. With all the smell of piss and shit I’m sure no one noticed.   Falling asleep was noticed. I’d been on the retractor for hours.

“I just wouldn’t want you to fall over backwards and hit your head causing the nurse to feel she had to take care of you,  leaving me alone with the patient.” The nurse smiled over the mask at the twinkling eyes of the master surgeon.


A couple of more hours later we closed up.  Sponges were counted carefully. All the tools were counted and doubled checked.  Then he used a staple gun to close the abdomen, a long incision from chest to pelvis, to have the best view in an emergency operation.  

The man lived to go to jail. The other criminal had died.  I came away thinking that anyone who shoots another human being should be required to clean up the mess and assist in the surgical repairs.  Let him hold the retractor. 

I come from a ranching, hunting family so grew up surrounded by guns and had begun competition shooting in early teens. I shot rifles and shot guns. I shot birds and ducks.  In my family we also had a rule if you shoot something you had to eat it. So that was a good reason for me not shooting bad men. Te must taste rancid.

 But really bullets make a mess and the laws against criminals who use guns are so terribly weak in Canada. When I lived in England the criminals were afraid to use guns because the laws against them were terrific but in Canada the law was easy on gun wielding criminals.  I didn’t like it. Any of us who worked trauma had little respect for the bleeding heart judges who’d go easy on gun wielding criminals.  

I never saw any gun  accidents. Even when I worked in the country I didn’t see gun ‘accidents’. I continued to see criminals shooting each other and doctors like me cleaning up the mess and judges going easy on them. Fact is judges should be required to stand in OR’s holding retractors 12 hours so maybe they wake up and stop playing politics and do their jobs.  

I did a month in the Emergency where I”d see knife wounds.  My favourite memory is this poor old guy who came in with a long bread knife stuck his abdomen.  The police had found him on the side of the street and called the ambulance. The ambulance had correctly not touched the knife that looked like Excalibur standing out of the guys abdomen just begging to be pulled out.  The head of emergency told us not to and called the trauma surgeon. All the nurses and staff were so solicitious with this poor guy moaning with this knife sticking out of his abdomen.

Well , next thing the police have found another guy and he’s brought in on a gurney with half a bag of groceries with him.  He was found unconscious and had been bashed about the head with a baseball bat. His face was all swollen.  The police and ambulance had picked him up nearly delirious collapsed but insisting he wasn’t going to let anyone steal his groceries hence the bag of groceries on the gurney.

Now this guy looks up and sees the other guy with the knife and is almost on him pulling out the knife. 

“You bugger that’s my knife’ he’s screaming. 

The guy with the knife in his belly is holding onto it and swinging his free arm to keep the other guy away from it. Thankfully the police hadn’t left.  So they come back in and hand cuff both guys to their gurneys till trauma, called to hurry, comes and takes the first guy away, The second guy goose necking as he sees the other gurney leaving, keeps screaming  “that’s my knife”.

Well, the story unfolds. The first old bloke with the knife in his belly had attacked the second old guy with a baseball bat attempting to steal his bag of groceries. He almost did and would have if the second old guy hadn’t bought a bread knife that day. So when the first guy is winding up to whack him again with his baseball bat the second guy  pulls out the bread knife and plunges it into the  guy abdomen above him. The first guy falls in the road. The second guy picks up his groceries forgetting his knife and staggered off home not making it because he’s now got a head injury that causes his collapse.  Neurology finally arrived to find him and take him from the emergency. They had to bring the bag of groceries or he wasn’t going to go with them despite being still handcuffed to the gurney.

Apparently the two old guys knew each other from the Legion too. The nice first guy was the actual bad guy with  while the second guy really was an  victim who was lucky to be a live .He had a small hematoma and both guys had surgery later that day with the different services. They were in their 80’s and did their recovery on different wards. No further battles were reported, the nurses taking special care to keep the two old raging bulls apart.




No comments: