- Joined
- Dec 6, 2010
- Messages
- 51
- Reaction score
- 24
Ahhh, grasshopper.
Thank you for thoughts, they tender shoot of new grass, in time rain and sun will make you strong bamboo, but meantime, listen careful little insect.
First though. Newman filthy masturbator on patient, he shame self, he shame EM specialty, he shame all doctor everywhere! Right thing for you Newman is put sword in gut and twist, die like dog on floor but save family from 10 generation of dishonor.
But for story from night long ago, I give you hairy barbarian with the funny eyes.
Thank you Mr. Miagi.
Kid, this is how it works, I know this is an EM forum, and this might count as a thread hijack to some degree but I still think there is at least a tangential relationship between David’s crimes and the way he behaved in the ER all those years ago.
With regard to that case and trauma in general, it’s all algorithms. You know the algorithm and you follow the algorithm. You got a guy with holes in him, you count the holes, you could care less who made them or what made them or if they are entrance or exit wounds. At that moment in the story, and in most penetrating trauma, the only real decision is go to the OR or not. Clock is ticking. If a vessel is rent then blood is bleeding. If you sit there and look at 80/40 come up twice on the screen and didn’t make your move then maybe you’re going to be standing in front of an audience next week hearing the chief of surgery ask the dreaded question is his soft southern accent:
“Dr X did that patient sleep with your wife?”
you will reply “No, sir”
and he will say “Then why did you kill him?
So you gonna stand there? You gonna look at that monitor and say gee, that 80/40 might be the opiate, but it also might be his splenic vein, I’ll just wait for another reading, then another one, then you say go, and then he arrests in the elevator.
And yes, it can only be the surgeon present who can say go, because it’s he or she who will, at that moment, accept the full responsibility of all that comes next. It’s sort of a big deal to open a person up, try it sometime and you’ll see. As such it is a responsibility that can never be pushed onto a person but which must be assumed by the one who will bear all of its attendant burdens. So yes, I know that this isn’t going to go over very well on an EM internet forum, sorry to have to articulate this thing that is usually left unspoken, but you should know early on that when there is an actual emergency the presence of EM staff at a trauma is about as helpful as a scale when you are trying to measure the length of a board. After a while all EM staff realize this, they are happy for it, and things work fine.
Unfortunately, at that point in his career Newman hadn’t gotten the memo. In those days he probably was watching Goose do his thing and thought he was ready to do a crany at the bedside. He was an Emergency doctor and this was a real genuine emergency! Every other ER guy I’ve ever known, even the young ones, would have said “sure, whatever” that night in that setting, but not David. He was different. He wanted power, the same way he wanted power as he sought to change the conversation in medicine through his writing and lectures, the same way he wanted power as he stood over that poor helpless women whom he had drugged as he pulled out his dick and prepared to humiliate her.
Speaking of giving your specialty a bad name...