It is a Wednesday night, and I just got home after a shift. I'm beat. My beautiful sofa beckons to me, while my TV seduces me with brainless images and sounds. I succumb to the temptation. I turn on Netflix. Too many movies, too many decisions. Nope. I didn't just finish a shift to have to make more decisions. I go to the “suggested for me” section of Netflix and up pops “End of Watch.” I shrug my shoulders. What the heck? Isn't Donny Darko in this movie? So I click play on my Apple TV remote, and the movie starts.
It is what I expected. I am not doing much thinking, just letting images enter my brain-dead mind. Then all of a sudden, I take notice: A group of gangsters is mounting up. They are clicking guns, cocking them, and loading up a van. The feel of the scene is nauseatingly dark. The next scene shows them rolling up on a backyard party, shooting up the place in a drive-by and driving off. A guy is shot in the leg. I sit there and stare at the TV. It doesn't really register.
I see gunshot wounds all the time. But being so removed from the action in the ED and not in the field has desensitized me. This scene brings me back to reality. That depiction of the drive-by was really terrifying. The fact that people in real life are out there shooting other people is crazy.
I reflected on my shift. It was a busy one. I was running around seeing a bunch of patients when I heard that a trauma was being activated. It was a GSW to the distal right leg.
We are taught to take all GSWs seriously. The protocol is clear. Roll the patient and look all over. Don't miss anything. Check the armpits, the gluteal crease, and any possible crevice. Be diligent; make sure you don't miss a puncture wound anywhere.
Working at a county trauma center, this intensive process eventually becomes routine. “Oh, another gunshot wound. Where is it? Extremity, weak. Send the junior resident. I'll stand by.” How could something like a GSW become so routine? What kind of place is this that GSWs happen so often that it is no big deal?
The ED norm by which we live is so extreme and vastly different from almost everyone else. The question, “Hi, honey, how was your day?” gets a different answer at everyone else's house. I guess it's a good thing that most people would not respond with, “It was a pretty good day. I just had a couple of extremity GSWs.”
I am back at the hospital for my next shift, and am chilling for a bit with a nurse. She's a seasoned veteran and has seen it all. We often throw down traumas together, and it seems like nothing really phases her anymore. I tell her about the movie and how disturbing that scene was. She shrugs her shoulders and smiles. She gives me a pat on the back, and tells me to pick up three more charts.
Dr. Basraiis an emergency physician practicing in Los Angeles. He is the creator of The Physician Grind (http://www.blog.numose.com/), a site for physicians to share the good, the bad, the beautiful, and the ugly in medicine, where this post was originally published. Connect with him on Facebook athttps://www.facebook.com/numosemed/and follow him on Twitter @nuMosemed.Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.