Friday, August 8, 2008

Couple of Wise Guys

A young male trauma patient arrives by ambulance and quickly endures the poking, prodding, and rapid-fire questioning that comprises the trauma assessment.  Docs are searching for injury, the nurse is getting a BP, and I'm drawing labs.  The patient is asked about any drug or alcohol use, and glibly states "a bunch of crack this morning."  Everyone pauses for a second, not surprised at the combination of drug use and trauma, but the frankness and ease of the admission.  Then the patient starts laughing and explains, "No I don't use drugs, but I bet you guys see a lot of that, right?"  For the rest of the assessment, this guy had everyone in hysterics, cracking jokes and asking questions, and making it one of the most laid back traumas I've ever been in.

Sadly, patients like that are the exceptions, not the norm.  On another day, we receive a patch for an MVC.  The patient arrives, and when asked the same questions about drug use, is much less forthcoming.  After several false starts, the story comes out: this gentleman bought come crack that afternoon, only to discover that it was "bad" crack and returned to the dealer to demand his money back.  Negotiation proved unsuccessful, so the patient attacked the dealer, only to be punched repeatedly in the head and chased back to his car, which, while speeding away, the patient crashed into a (thankfully empty) school building.

No joke.

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