vent rib

Chiappa Rhino 60DS

Designed by Emilio Ghisoni and Antonio Cudazzo, manufactured by Chiappa Firearms in Brescia, Italy c.2009-today.
.357 Magnum six-round fluted hexagonal cylinder, 6 o’clock firing ribbed and vented barrel, gold anodized Ergal aluminium alloy frame, external cocking lever with internal hammer, single and double action.
It’s like a weaponized bullion.

“How do you do this?”

…is a question I’m asked regularly. How do you see people in such states–  bruised, battered, broken, bleeding? How do you deal with frantic families, hopeless situations, and death?

Believe me, some days are hard. Some days I leave exhausted, wiped, and sometimes dejected. Sometimes I wonder what all of our efforts, our technology, our procedures, our methods – what’s the point if we can’t fix the unfixable?

On some days, though, our patients show us the point. Just recently I had a patient, a young guy, a few years younger than me, who had been hit by a car. At the scene he seized uncontrollably, pupils fixed and dilated. He was completely unresponsive. Family never left the bedside. It was heart-breaking. He wouldn’t wake up. We had decided to attempt extubation to see how he would fly, if he could protect his airway. I wasn’t sure that he could, and subsequenty questioned the doctors on this option. He barely breathed over the vent and had multiple rib fractures which certainly wouldn’t help the process. But on we went, extubating him and continuing on with our various tests and procedures. He flew and was protected his airway, but didn’t do much more than that. We weren’t sure why he wasn’t waking up, as his CTs were almost totally normal. He didn’t fit a metabolic picture. EEGs were inconclusive but showed something was clearly not right. Days went by and nothing happened. Many of us figured he would never wake up and would end up a veggie, being turned/watered and fed in a nursing home – certainly a quality of life none of us wanted for him.

Then suddenly, he woke up. He opened his eyes, tracking the movements of people in the room. He wouldn’t talk, but this alone was impressive. Then he was able to follow commands. Slowly but surely he was regaining consciousness and waking up to the rest of the world. Within a day he was talking and within another two he was able to sit up and walk.

I’m definitely a good ole Grinch when it comes to many of these stories. I wouldn’t say I’m a romantic and I don’t necessarily believe in miracles. But I will say that having this young man come back to the unit a week later as he was being discharged, giving me a hug, and thanking me for caring for him – it definitely made my heart grow a few sizes this Christmas/Holiday season.