Newton’s laws and flesh and blood


I went one night in the fall

To the ER because I had call.

Think of the drama

From significant trauma,

From a fall from a wall or brawl at the mall.

Synopsis:  I’m a family practitioner from Sioux City, Iowa.  In May 2010, I left my position of 23 years, and honoring my non-compete clause, traveled for a year doing locum tenens work.  In June of 2011 I joined up with the Community Health Center, which provides care for the underserved.  I’m now working part-time, which, for a doctor, means 48 hours a week.

When I lived and worked in northern New Mexico, in a hospital serving 3 Indian reservations, my context had a very low population density.  If I saw a strange face, I would talk about it for the rest of the week.  If I heard a siren, whether I was on call or not, I would go to my front porch to look for the incoming ambulance.  In an area with little news, an ambulance run always warranted a conversation with the doc on call the next day.

A helicopter meant only one thing, because helicopters never came our way except to pick up a patient in extreme distress.  The hospital sat walking distance from Interstate 40, and whirlybird making a round trip only beat our ambulance drivers making the straight shot by ten minutes.

I rode the ambulance a few times, and the drivers knew where they could safely go 90 and where they had to slow down to 60.

Nine times out of ten, a chopper call meant a trauma call. 

I didn’t get enough trauma experience in residency, and during my tenure in the Land of Enchantment, I got myself sent to University of New Mexico Medical Center for a trauma mini-residency.

People obey the laws of physics whether they want to or not.  Two bodies cannot occupy the same place at the same time.  Flesh, bone and blood lose when they go up against moving vehicles.

I have seen trauma related to guns, knives, buffalo, deer, horses, cattle, sheep, whales, bicycles, fishing, chain saws, rattlesnakes, boats, skis, snow machines, arrows, logs, bulls, dogs, cats, rocks, and seashells.  I took care of four people when a driverless Cadillac totaled their sedan. 

Trauma can come from a lot of causes, but cars trump when it comes to sheer numbers, and alcohol trumps when it comes to cause.

Tonight I attended a trauma patient, who came reluctantly under the rule of Newton’s Laws.  I suppose the vehicle in question sustained some damage, but dents in bumpers don’t mean nearly as much as broken bones.  Lives change forever in violence lasting less than a second.   People speak of their lives before the accident and after the accident, a defining, unplanned moment.   Sometimes it puts things into perspective or frightens someone from a destructive course, always unintended consequences follow, rippling through peoples’ lives across the years, sometimes across generations. 

I walked out of the hospital Emergency Room and into the parking lot and noted the arrival of drama and irony in two ambulances from different counties on my way out.  I wondered, as I did every time I heard a siren or helicopter in New Mexico, what happened?  Who did what?  How will the lives change, and how will the implications alter the people who weren’t even there?

Thinking in silence, on the way home in the dark, I pulled over to let another ambulance past, and I started to wonder all over again.

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