Crazy Man Michael

Another night passes. The promised 'thundersnow' has not materialised, at least not this far South. The weather was pretty shite, tho. I approached the shift with significant trepidation; my nerves clawing at the inside of my belly all the way down, leading me to wonder, at one stage, if I really had cooked my pork chops properly...

I can't stop revisiting the cases from the night before, and head straight for the information superhighway that passes as the hospital intranet as soon as I arrive. The fitter has had all the investigations and treatment I didn't instigate. All to no avail, which is some consolation. Maybe I was right.

I mull this over, and chew the fat with the SHO I ran the case with. He is more robust in the defence of our management, and I wonder if that's because I know more, or just that age has made me more defensive, more afraid of error...

A punter is brought in from the rain, cold and shivering, his right arm swathed in what looks like acres of swaddling; held aloft, like a blood stained Statue of Liberty. He has, for reason known only to himself punched holes through some armoured glass windows. I am, briefly, impressed by the strength that must have taken. Then my inner cynic comes back from his coffee break.

We gingerly take the dressing down, and everyone gathers round, craning their necks, as if we are unveiling a lost Leonardo. His arm gapes wide, split skin grinning with glistening fat. His muscles are clearly visible, for an instant, then the wound wells up with dark blood, a rich burgundy, hot under the lights.

We pronounce it venous, and are pleased with ourselves. Shroom's blunt haemostat is applied, and the arm hoisted once more aloft, a mocking victory salute. While the search is on for more gauze, he shifts in his seat, uneasy suddenly, and I feel a warmth run over my hand. The dressing is soaked through, and a gush of bright red claret, almost impudent, announces an arterial bleed; I assume he's cut his brachial, and the spasm had held the floodgates closed until we started poking and prodding.

All attempts at subtlety go by the by, and we double the pressure on his arm. This is less than comfortable, but needs must. He is crying when he leaves for theatre, and I want to feel sympathy, but he has done this to himself, and I can't.

I wonder if this makes me less than I was, but the Department is heaving, and I have no more time for navel gazing...