I’ve come to grips with the fact that in the proper setting, other people’s discomforts provided me with enjoyment. Don’t get me wrong. I don’t like seeing someone in pain, but without another‘s injury, I cannot do my job. The worse a person is injured, (up to a point), the more creative and exciting my work environment becomes. l have used the following statement to avoid being labeled a sadist. “I don’t wish anyone any harm, but if it happens, I want to be there”. This seems to get the point across fairly clearly.
Back to Jerry and the opportunity. A collapsed lung is a potentially life threatening injury and one which can present very quickly in an otherwise mildly injured patient. There are signs which, when recognized in time, can lead to a very exciting series of actions.
“Jerry, I need to put these ‘soft safety restraints’ around your wrists, you appear to have punctured your lung. I can help you but it won’t be very comfortable.”
I took a long strand of gauze bandage and doubled it over looping it around Jerry’s wrist and tying the end to the rail on the cot. I explained to Jerry what I was planning to do in between his increasing complaints of ‘I can’t breath’.
“I’m going to attempt to re-inflate your lung by releasing the air that has gotten trapped in your chest.” I informed him.
Jerry seemed to be listening; his half-closed eyes opened a little wider. I finished securing his other wrist to the cot and was checking the belts that held his body to the backboard and cot as I delivered the punch line.
“I’m going to have to put a needle between your ribs and into your chest. It’s going to hurt, but you will be able to breath easier when it’s done.”
Jerry had stopped telling me how hard it was to breath and was now just blowing the Sweet smelling air from his lungs in rapid shallow breaths, watching me.
held his body to the backboard and cot as I delivered the punch line. “I’m going to have to put a needle between your ribs and into your chest. It’s going to hurt, but you will be able to breath easier when it’s done.” Jerry had stopped telling me how hard it was to breath and was now just blowing the sweet smelling air from his lungs in rapid shallow breaths, watching me.
I was nervous as this was my first time performing this procedure. I tried to act calm and confident. I also kept the needle out of his sight, which was easy considering he was immobilized to a backboard with his head taped down tight and a stiff collar around his neck. I too began to sweat.
I cleaned the side of his chest with alcohol swabs and then with betadine antiseptic, staining the skin yellow brown. I removed the needle from its pack, two and a half inches long, a ten gauge, as big as a ten penny nail.
“You’re going to feel a sharp poke.” An understatement to be sure.
I could feel the sweat on my forehead. Jerry started screaming as I pierced the skin with the bright steel, remembering the words of all those who had attempted to prepare me for this day. Steady pressure. and as quickly as you can to lessen the discomfort.
Jerry yelled, “You’re killing me!! You’re killing me! !” Over and over he said this.
I pushed, marveling at how much pressure was actually required to push a round steel shank through a relatively thin area of tissue. As I pushed, Jerry continued yelled ‘you’re killing me! You’re killing me!’ over and over, as if I didn’t have enough going on, this guy has to yell at me!?. I stopped for a moment, the needle through the skin but not yet quite where it needed to be. I brought my face directly in front of his. The sweat on his brow mimicking my own.
“No sir,” I said with a calm I didn’t really feel, “I’m saving your life.” There are just some set-ups that are just too good to pass up.
Jerry stopped his screaming and concentrated on breathing, I returned to my tool protruding from between Jerry’s ribs, the 4th and 5th, axially, and pushed once again. A sudden decrease in pressure and a small bit of escaping air, not the high-pressure whoosh I had imagined. Jerry gave a grunt and then continued his breathing, which seemed to come easier over time. I secured the catheter to his chest with tape and gauze and fixed a one way valve to the end of it, allowing air to only escape and not enter, and allowing Jerry’s lung to re-inflate itself. No more yelling, no more complaints. We rode in relative silence as I monitored my patient for any changes.
Mary and I delivered Jerry to the emergency room and collected the pats and encouraging words we’d earned for doing that rarely performed and fearful procedure. Jerry was moved to another bed off our pram and we were given our leave of him after gathering all the necessary signatures and handing on the required reporting paperwork.
I still enjoy a good horse race from the stands. Though sometimes I feel like I’m missing something.