Do you hear when I hear? (or Tapping, Part II)

Pagers are funny things. I keep the volume on mine cranked up, so that if ever I do get a few moments of sleep while on call the thing will surely wake me. But during the day, when I am awake, the volume seems unnecessary. At any rate, this page started off like most others – a distressingly loud sound, getting progressively louder with each series of beeps, alerting me to an extension I didn’t recognize. A nurse answered. There had been an accident – a young man put his arm through a window and was being rushed to the OR. The attending surgeon would need assistance. OR #2 – hurry.

I hustled with excitement. Serving on the trauma service, this is what we live for – real emergencies that needed fast, definitive treatment. I began to gown up, preparing for the worst. Hat, mask, eye-protection, boot covers…the patient suddenly arrived. I was right – this was going to be messy.

The injury was to the right arm. It was in that soft area opposite the elbow, where they draw blood from (the antecubital fossa). The wound was jagged, and deep. There was blood everywhere. The upper arm had a tunicate around it, which, quite simply, was keeping our patient from exsanguinating.

We were repairing the bleeding, and when we though we had things under control we removed the turnicate. At that moment a gush of blood came pouring forth. We'd missed something big. I’ve seen plenty of bleeding before, but this was the first time I’ve ever heard bleeding. It’s rhythmic, pulsatile jets screamed to us – act fast. Act now. The life of this young man was literally rushing out of him. Instruments were handed to us immediately, their steal handles snapping shut one after the other. Sutures came next – blood drenched hands tying small knots. They have to be placed carefully, otherwise they will slip. Then scissors. Our movements were dance-like – well rehearsed and purposeful. And finally…silence. The bleeding had stopped. The only sound was coming from the monitors – a rhythmic beeping which reminded us the rhythmic bleeding we had heard for real just moments before.

And now it was back to the ICU. That pager of mine just wouldn’t stop.