Run for Your Life; Who Said Medical Education Was Worth Dying For?

By Larry Puls @larrypulsauthor

Medical Education, A Brush with Death

Three AM. The witching hour. I was twenty-four, naïve, roaming the hallowed halls of Parkland Hospital, trying to piece together what I’d learned from my first two years of medical school. Living on short naps. Living on a hope that one day, all of this would make sense. Our team’s mantra was, "sleep is for the weak". I think that’s how it went. Such a different world back then.

We finished rounding. Yes, three AM. Did I say that already? Do patients really want to be seen then? Mine was not to reason why, mine was but to do and (?)... Concluding the floor work, I was hopeful I might slip off and sneak a little sleep before prepping for “morning” rounds. But that thought disappeared with a phone call, a pleading request. Help was needed down in the Emergency Department. A backlog of cases had been created by the nebulous Dallas Knife and Gun Club—or so it seemed. My next three hours had just been defined. Not going to be pretty.

I strolled downstairs for the first time into the famed location. The identical place they had taken President Kennedy on that fateful day. A sea of humans appeared before me, clustered tightly into a place they called a waiting area. Faces telling stories of trauma, of heartbreak, of desperation. I could not imagine being last in that line—a line frozen in slow motion. A collection of humans leaking blood, with broken body parts, the aftermath of what happens past midnight in bad places, or with bad people.

I met a resident. One I have never seen since. But our paths met in time and space, in the crosshairs of fear. Neither of us will ever forget the events that shaped that infamous night. I was given an assignment. Really, you want me to sew someone up? I thought smiling. Scared with a capital S, but no one could know that. All those years of dreaming about becoming a doctor and here I was—a wanna-be about to stitch up my first someone. A resident was actually going to let me be “the surgeon”. Really? Words cannot describe the elation, the fear, the worry, the smorgasbord of thoughts suddenly traveling through my mind.

The shape of said ER, my home for the next three hours, was shaped like a letter M. And in the farthest leg of the M, I am now setting up shop, not in a room, but in the only space left that night in the distant hallway performing my first "repair" job. There on a gurney lay Mr. X, a man caught on the wrong side of a knife. A big knife from how it looked. I’d never witnessed anything like that before. It was like the stuff you read about in papers, maybe see on TV shows, but never actually see up close. But there he was. My first patient with a knife wound—and since I did not become a trauma surgeon, my last. A huge gash across his forearm. The bleeding had slowed to a trickle.

I introduced myself. He moans his response. Probably too much alcohol, I decide. The resident hurries me along. "Clean the wound. Inject some numbing medicine," he said. My fears are rising up. Can I actually do this? Boldly, I take the needle driver, attach it to the suture and look to the resident for some encouragement. He shrugs his shoulders. So you are not concerned? Oh well. How hard can this be? Not hard, from where I sit, thirty-five years and twelve thousand surgeries later. But on that night, my wrist could not be stabilized. My heart could not slow down. I was about to sew up some poor unfortunate soul, not “poor unfortunate” because he had a knife wound, but “poor unfortunate” because he had Dr. Medical Student fixing him up. We all have to start somewhere.

The first stitch is thrown through his ragged skin. My hand shook uncontrollably. Come on, you have got to breathe. I tie the knot. It takes three minutes to do a simple act. The man before me is calm. Thank goodness for the lingering alcohol. I throw the second suture. Yes, that was easier. You can do this! My breathing truly slows. The wound says he will require another forty stitches. Slowly and patiently I work through the first twenty. Less shaking with each successive one. My confidence grows. More air in my lungs. Fatigued has been washed away by a tide of adrenaline… And then just when I thought I would succeed, it happened.

And what happened next, wasn’t what I bargained for that night. It was an event, laced in craziness, made from the stuff you see in your worst nightmares. A blood curdling scream. Someone from the front hall, at the top of the M-shaped emergency area is yelling. Why are they yelling? I look up. And then a sound, deafening, it blasts through the hallowed halls echoing in my ears. Followed by a crack. A thud. More screaming. Reverberating shivers shoot up my spine. Never before had such a terrifying sound been so close and audible—so real--so threatening. There was no debate about what it was. And there was no debate to the hundred or so desperate people, now in full sprint. A tsunami of individuals fleeing around the corner fifty feet from us. Panic written on their faces.

Kaboom… Kaboom… Kaboom… A gun. A really big gun, was in open fire.

Tune in next week to find out if I lived. Have you ever been in the wrong life-threatening place at the wrong time? 

Run For Your Life; Being in Harm's Way, Larry Puls, (Click to Tweet)