
I could write several chapters about my ER experiences, but I find it difficult to write them in a way to preserve the integrity of my patients' confidentiality. I try to be as generic as possible or wait for some time to pass before I share a story. This lapse of time rarely distorts my memory of the occasion since I carry most of them around in my brain for some time. A particular workplace incident will be stuck in my mind for any foreseeable future.
The recent rash of workplace shootings (or acts of terrorism) has forced me to recall my own workplace shooting, which occurred about 5 months ago.
Here it goes:
An older gentleman walks up to the front desk of the ER inquiring about how to go about donating his organs and body to science. The man was polite and calm and raised no "flags." The clerk gave him directions to the nearby college of medicine so that he could fill out the proper paperwork for donating his body. The man then thanked the clerk and apparently drove about a mile down to the college of medicine.
The man returned to the ER's front desk about 45 minutes later. He then emptied his pockets of keys and a long, hand-written letter. Next, he took about 20 steps back from the desk and pulled a semi-automatic pistol from his waistband. He immediately placed it just behind his ear and pulled the trigger.
At this moment, I had just finished drawing blood in the room closest to this guy, but I was separated by a set of wooden, double doors. Our automatic doors will sometimes make a popping noise when they come off track. I immediately though they had came off track again, but I quickly heard a lady scream "HE'S GOT A GUN!"
The wooden doors flew open and I saw two co-workers sprint by the doors. I followed suit. I first saw a pair of legs preventing a set of glass, automatic doors from closing. The bullet had ripped through the man's head with such force that it had spun him around. He shot himself in the hall way, but his body's momentum carried most of his body out onto the ambulance bay. All that was left in the building were his legs.
As soon as we saw the man on his back, his head wound was apparent, but we could not see the gun lying near his body. My immediate thought was that he was shot by another shooter. The security camera's caught my instinctive move to crouch behind a brick wall to make a quick scan of the ambulance bay. My boss is also prior military, a Ranger, he had an immediate defensive posture as well. It was then that we saw the 9mm by the guy's side. The slide was back and jammed. The gun was promptly kicked away.
We immediately when into lifesaving mode. My initial assessment was that this guy's chances were bleak. He had agonal respirations and a growing pool of blood heading towards a drain in the ambulance bay. I smacked a set of gloves on and took control of his cervical spine alignment and maintained his airway. Other ER staff poured onto the ambulance bay with a long-spine board, gauze, and an airway kit.
The ERMD secured an endotracheal tube on the first try and his cervical spine was supported by a c-collar. At this point, I began to breathe for the patient via a bag-valve mask. This gave the patient a lung full of air with each squeeze of a plastic bellow. His skin color began to improve, but he was still unresponsive.
EMS was called to the scene due to our current lack of neurosurgery coverage and the level of trauma support that was required. The man was to go to the nearby trauma center. The paramedics would have their hands full with this guy, so I jumped into the back of the ambulance to help them out. I traveled with them, continuing to assist his respirations. The guy never lost a pulse, but his mental status remained completely absent.
We arrived quickly at the trauma center and were met with a team of surgeons and nurses decked out in thin plastic gowns to protect them from the body fluids associated with high level traumas. They were able to stabilize the patient and get him to the OR and ICU. However, I heard that he was not able to make it into the next day.
I've dealt with a variety of traumas. Some have even been quite more brutal than this, but what has set this one apart in my mind is just how BAD it could have been. When I got back to the ER, the police had just wrapped up the "crime" scene. I was talking to an officer about my perspective of the day. He told me that the guy had 14 rounds remaining in his pistol. So as tragic as this event was, this guy could have taken a lot more people with him. It's a good thing no one gave him an excuse to do this.
As I learned more about the gentleman, who shot himself, I have to say I felt for him. Apparently, his wife committed suicide last year and his daughter had committed suicide several months before he chose to do the same. He had no other family. His intentions were to have his body donated to science. He figured that he would have the best chance of this happening if he shot himself just outside the medical school. Simply tragic.
There continues to be a daily reminder of this event. The bullet that traveled through this poor man's head went through drywall and lodged deep into some brick. The bullet was never recovered. The hole was plugged with plaster, but never painted. It's been almost 5 months, so I don't see this reminder going away anytime soon.