The cry

Patey, Paul

When the motorcycle struck the immovable object the young man rose majestically from the back seat and flew gently through the black night air. His impact with the gravel shoulder on the opposite side of the road, however, was anything but gentle. Gravity and velocity hurled him to the ground. He lay still, but groaned loudly. The helmet saved his skull; luck saved his neck: the rest of his body shared the blow.

Later, when he's expertly fastened to a long board, his neck encased in a snug collar, a splint already on one leg, the emergency attendants bring him from the ambulance into the resuscitation room. Airway ok, breathing ok, pulse fast but strong. My quick survey confirms the obviously fractured and displaced femur and bleeding leg wound, most probably created when he hit the ground and a sharp end of broken bone momentarily stabbed out through muscle and skin. Pulses in the two main arteries in that foot are strong. He can move his toes on both feet on request. The two nurses busily cut away clothing, measure vital signs and oxygen saturation, and start two intravenous lines and the written medical record.

My second more detailed survey is a search for more subtle injuries and to identify what is not injured. The neck is secure in the collar. It will be X-rayed later, perhaps elsewhere. Knows name, date, place. Remembers motorcycle. Pupils equal and reactive. No severe skull tenderness. No blood in ears. No bloody spit. Jawbone intact. Good air entry bilaterally. No tender spots in ribs. Oxygen saturation still good. Good strong heart sounds. Blood pressure measurement by a nurse is normal. Active bowel sounds all four quadrants. Abdomen only slightly tender on deep palpation. No rebound tenderness, etc.

As I am proceeding through this review, a woman old enough to be his mother enters the room with terror in her eyes. It is his mother. At that moment an IV needle was being inserted into his hand, and in response the young man slightly jiggled his broken leg, causing pain: he gave a loud yell. The cry was strong. Like his first cry it told his mother that he was here, he was alive, he was conscious, he was strong. Instantly I saw some relief mingle with the terror on her face. I wanted to comfort her but I knew that at that moment I could serve her best by continuing my search for other life-threatening injuries in her son, her baby boy, who for a second or two earlier tonight flew like an angel but landed back on earth.

Theme: Patients | Patients

Stories in Family Medicine | Récits en médecine familiale [Internet] Mississauga ON: College of Family Physicians of Canada. 2008 --.




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