At the end of an otherwise quiet night, we were paged to the emergency department for a stat trauma. A man with multiple gunshot wounds was wheeled by paramedics into the trauma bay, his blood pressure perilously low. The surgeons searched his body for blood. They cut off his clothes and rolled his body onto its side. Using an ultrasound probe, they looked in the cavities and potential spaces where blood can hide: the abdomen, the chest, the sack around the heart. They palpated his thighs for a massive hematoma. This coordinated, frantic search revealed no source of hemorrhage. Oddly, though the patient’s blood pressure was still dangerously low, his heart beat slowly. Had he been bleeding out, his heart should have been frenetically pumping whatever blood remained in his circulation into his aorta and pulmonary arteries.
“Has anyone seen him move his feet?” the attending barked. “Has anyone seen him move his feet?” The pack of residents said nothing. With each millisecond of silence, the possibility that this man’s spinal cord had been severed by a bullet, and that his low blood pressure was the response of a stunned nervous system, seemed to increase exponentially. The attending shouted the question a third time while a resident aggressively scratched along the bottom of the man’s feet. But his legs did not so much as twitch. It had barely been ten minutes since he arrived in the emergency room and we all knew this man would never walk again.
Like so much of what I witnessed in my third year of medical school—my first year in the hospital—this scene was buried somewhere in my memory.
The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.