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Surgeon's Choice

By Richard L. Mabry, MD

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In the emergency room, Dr. Ben Merrick worked feverishly over the middle-aged Caucasian male. He glanced up briefly at the anesthesiologist. “Got him intubated yet?”
Dr. Rick Hinshaw answered from his position at the patient’s head. “Just got the tube in and hooked him up to positive pressure.” The rhythmic chuff of the machine pumping oxygenated air into the patient’s lungs underscored the statement. “Now I’m about to put in a second IV with a large bore needle.”
“Blood status?” Ben asked.
“A cross-match is going for six units,” the head emergency room nurse said.
Dr. Carl Rosser, the ER doctor, looked at Ben. “What would you like to do until that’s ready?”
Ben’s gaze never strayed from the man on the gurney. “More O negative blood.”
Dr. Rosser gave the order to a nurse. Then he took a penlight from the breast pocket of his white coat and shined it into the man’s eyes. He ran his gloved fingers over the patient’s bloody skull. “I’m pretty sure he has a depressed skull fracture, and it looks like his pupil’s blown on that side.”
Ben spared a moment to glance at the patient. “We need a neurosurgeon stat. See if you can get one here ASAP.”
With a nod, another nurse turned from the group gathered around the gurney and headed for the phone.
Ben turned back to his work and put his stethoscope on the patient’s abdomen, then percussed the area with his fingers. “He’s most likely got free air under the diaphragm. I’ll need a film to confirm it, but that can wait. A ruptured bowel is probably the least of his problems.”
For maybe an hour, possibly more, the doctors and the nurses assisting them worked to save the man’s life. But at last a sad look painted Ben’s countenance. He shook his head and looked at the two other doctors gathered around the gurney—first at Rosser, then at Hinshaw. They grudgingly nodded their agreement with the decision everyone had worked so hard to prevent. “That’s it,” Ben said. “He’s gone.”
Ben’s shirt was plastered to his body with sweat. He felt weak. He held out his hands and saw the fine tremor there, the effect of adrenaline pouring into his body. He took a deep breath and tried to shut down for a moment, but his mind wouldn’t leave the problem. Had he done all he could? Was there something more?
And then, as he’d done countless nights in the months since Lawton Harrison died in the ER, Ben awoke suddenly from the nightmare. Sometimes he screamed, sometimes not. This time his dream ended in a silence that was somehow more terrible than any noise he could utter.

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