most of the time you do your job. sometimes it means something.
when i was still a registrar, rotating through vascular we had an incident that meant something in my life. i'd like to think it meant something in the other guy's life too. yes, i'd like to think i made a difference.
it was early one saturday morning. a cop came out of his office in plain clothes carrying a laptop. 3 guys asked him if they could have his laptop.
he said no.
they asked again, this time brandishing their knives. the old saying about not bringing knives to a gunfight became appropriate in their lives at about that point.
exactly how the next few moments played out i don't know. what i do know is he shot them all. one guy he winged in the hand. i briefly saw him in casualties. not because he was my patient, but because the story interested me. (as usual he swore he was out selling bibles. a very dangerous passtime if you ask me). one guy he shot through the chest. intercostal drain and the guy was ready to steal again.
but my guy... he got it bad. this incident happened within spitting distance of the hospital. (admittedly the wind would have to be behind you and you'd have to put your back into it.) yet even though my guy was in casualties within ten minutes of the incident, he had bled to shock and was quickly progressing towards death. he took it through his common femoral artery just below the inguinal ligament. (for movie buffs, roughly where hannibal lector stabbs the cop's informant).
without going into too much detail and without even touching on the point that my consultant wasn't available for some reason, we took him to theater, patched him up and pulled him through. of course he did the obligatory icu time, due to massive blood transfusion. (i've seen enough of these to wonder if it could be employed as a cure for aids. bleed out the infected blood and replace it with uninfected blood. wait, i didn't say that!!!)
and then i got to thinking. you see in the state, most of these gunshot wounds are criminals, but this one was brought in by the cop. he was caught red handed (when i saw him, almost everything was red). the others deny everything. this guy could not. i felt a strong sense that i had a chance to say something that might change the course of his life. i might indirectly save some other guy's life a few years from now who would otherwise take a bullet from my patient. i decided i must.
when he came out of icu i approached him on rounds. i meant to say something. i'd even thought about what to say. i couldn't. i thought of my car that was stolen. i thought of my house that had been broken into. i thought of being robbed in town. i was too angry. this guy was the representative of the men that did those things to me. i walked on by. the next day was the same. the following day i realised the guy was going to go home soon and the opportunity would be lost. i had to try.
in the morning i did my usual evaluation of his leg and pulse etc. then i turned to him and started speaking. i spoke fast and almost aggressively, my anger lying very close to the surface. i told him his life was no longer his own. he had been shot dead and yet he was alive. he was alive because a stranger had saved him. (i never told him i was the one that operated on him and he never asked, so the concept of a 'stranger' hung meaningfully in the air...i hope). i told him therefore his life belonged to a stranger and he had to now go into the world, find a stranger and repay the debt. he listened. he said he heard and he would turn his life around. i wanted to say "yea right!!" but i kept quiet. i was still angry at him in proxy.
he went home.
some time later i followed him up. i was surprised to see he was not in prison (ok south africans...i wasn't surprised...shees give a guy a break). i asked him why. as it turns out he listened to my words and decided to make something of his life. he turned state witness and swore to me he was also going to go back to school to get matric.
he was probably lying, but, often, when i'm alone with my thoughts, i like to think he wasn't and that i did in fact once make a difference.