Tales from the ER #10

It is very bad to work a shift during a full moon. A full moon brings out the craziest and sickest patients. A full moon causes holes to spontaneously appear in people’s lungs. A full moon always brings dark magic.

One night shift I worked there was an enormous, full, blood orange harvest moon. It wasn’t that bad of a shift until the rain came and people started crashing their cars.

“Trauma this is County Rescue 4. We’re comin’ to you with an unknown male, probably late 60s, single car wreck on the highway. Car veered off the road and hit a tree. Extensive damage to vehicle, prolonged extrication. He was a GCS of 6 when we got to him. He’s intubated and fully packaged. We’ll be at your back door in 10 minutes.”

When the patient arrived he clearly had a brain bleed - his pupils were uneven and there was massive swelling to his forehead. His abdomen was bruised and one of his legs was bent the wrong way. A chest X-Ray showed a hole in his lung. I made quick work of cutting in between his ribs with a scalpel and inserting a large plastic tube. There was a loud whoosh sound as I hit the right spot and the air rushed out, letting his lung re-inflate.

The trauma surgeon and neurosurgeon arrived, took one look at the patient, and wheeled him off the OR. And just like that, he was gone.

I was foolish to think that a full moon shift could be that easy. While I saw more drunk schizophrenics and women with pelvic pain from untreated chlamydia, the car wreck patient was in surgery. The neurosurgeon drained a large hematoma that was pressing on the brain, and the trauma surgeon fixed damage to the liver. The patient emerged from surgery with a grim prognosis.

And the prognosis for his post-surgery ICU care was also grim – there were no ICU beds. Well, there were plenty of ICU beds, just no nurses to staff them. So in our hospital’s infinite wisdom the patient came back to the ER, where there are no limits on how many patients can be seen at one time.

I called the neurosurgeon who was already in his Tesla speeding away from the hospital.

“How’d the surgery go?”

“Bad epidural hematoma, guy’s a goner…You should find the family and talk to them.”

Considering brain surgery is really glorified plumbing and not as precise as most people think, I marveled at the amount of money this neurosurgeon made.

Now began the detective work for our jaded social worker. The medics had the man’s wallet – no ID, some $20 dollar bills, and a crumbled piece of paper with writing in a strange alphabet. Meanwhile, the state troopers working the crash were running the car’s plates.

The patient continued to deteriorate. He needed two blood transfusions as he kept bleeding from the injuries despite the surgery. He also was started to show signs of brain swelling – his heart rate and blood pressure were all over the place. We really needed to talk to his family ASAP.

About an hour later I heard a commotion coming from the waiting room. I walked over and saw at least 20 people, in all kinds of disheveled and mismatched clothing, yelling and shouting in a foreign language. At the center of the group was an older woman, wearing a fur coat despite the warm weather. I went to find the social worker.

“What’s going on?”

“Troopers found the family – they’re gypsies.”

“There are gypsies in America?”

“Yes, apparently they all work for an auto repair shop and live in tents in the field behind the shop. The patient was out joy riding in someone else’s car.”

“OK, well perhaps the trooper can figure out who is related to the patient and bring them back so we can talk with them.”

It turns out the woman in the fur coat was married, or partnered, or in whatever type of gypsy long-term relationship, with the patient. And two of the young men in the group were their sons. The social worker took them to see the patient for a few minutes, and then brought them back into what we ironically call the “quiet room,” where we tell families bad news that usually results in loud crying.

The gypsies spoke some English. I introduced myself and explained what had happened and the patient’s current condition. I asked if they had any questions. The two men stared back at me and said nothing. The older woman very slowly took out a carton of cigarettes and began rubbing a cigarette between her fingers.

“Will he be able to talk again?” Even speaking English, her accent and deeply resonant voice made the words unsettling.

“I’m not sure, we’ll have to do a special exam in the morning, and you all can talk with the neurosurgeon about what comes next.”

She stared back at me with piercing eyes for what seemed like an eternity. I was getting the sense that these people did not need the harsh truth sugar-coated. Perhaps my Western medicine way of “breaking bad news” was antithetical to their way of life.

“Will he ever walk again?”

Again, I equivocated,“I can’t tell you for sure…”

BAM! She slammed her fist on the table, crushing the cigarette. I jumped in my seat. The woman started rubbing bits of tobacco leaking from the cigarette in between her fingers. She started speaking softly in what I know now to be Romani. The men sat next to her, still silent.

She finally looked up at me and snarled, “White devil!”

She then spread the crumbled cigarette bits on the table, stood up, and left the room. The two men got up and one said to me, “You are cursed. You should tell the truth. We can see and feel that he is gone.”

And then they were gone too, the whole tribe just left the ER. The troopers told us it seemed that fur coat woman was the matron and held the one cell phone for the tribe. The social worker tried calling that phone but no one answered. Later in the shift the patient coded and died. Still no answer from the phone.

A few days later I worked with a colleague who was from Hungary. I asked him about the Roma. He told me the Roma consider death to be impure. I asked him about my curse. He laughed. “Maybe they felt you were disrespecting someone they considered dead by talking our usual BS…..anyways, I wouldn’t worry about it until you have another full moon shift.”