when i wrote the third principle, i was reminded of another incident. then i couldn't laugh. now i shouldn't.
i was working a casualty shift in a private hospital to make a bit of extra money (a registrar barely made enough to survive). it had been a standard night of treating the aches and pains of people who had been sick for weeks but had decided that once the sun set on friday evening they could no longer endure. maybe they just wanted to torture me.
anyway, finally a real casualty case came in. it was a young lady who had fallen and hit her head. she was fine except for an unsightly gash on her forehead just at the hairline. i prepared to clean and suture the wound. being a state doctor i had hardly sutured any face wounds on sober people, so i remember telling myself to make a point of chatting to her during the procedure to ease her fears. usually good old ethanol did all the fear easing and i was left to my own thoughts while placing the sutures.
so there i was at the head of the patient being as friendly as i could. i'd cleaned the wound and had placed the first suture. the second was going in when an ambulance pulled up. two paramedics brought a guy in on a stretcher. i had my back to them so i wasn't really watching them too closely. then the sister shouted,
"this man is not breathing!"
i left my suture just where it was and ran. as i changed my gloves the ambulance men were asking the patient to shift to the next bed. he wasn't listening to them. they seemed indignant. the sister grabbed him and dragged him over as i arrived.
there was no sign of life whatsoever. he was extremely pale. his trousers were bloodied. he had no drip. we commenced a full resus. after going through all the motions, i called it. the man was dead. i then looked over his body. he had a massive laceration in his groin. his femoral artery was visibly transected. that could be why he didn't respond when the ambulance chaps had asked him to move across to the resus bed. i asked my usual question.
"when you picked him up, was he bleeding?"
"no." they answered. that is why they didn't put up a drip, apparently.
"was there blood at the scene?"
"yes." the one man replied. "he was lying in a puddle of blood."
"was it maybe about five liters of blood?" i wondered aloud.