Monday, December 19, 2011
The Thin Line Between Tragedy and Comedy
At sixteen years old, Mr. Athlete was already a man. He was tall; his waist was wiry and muscular in the way that only youth can sculpt. His arms and legs were sinewy and had obviously been very active and athletic. However, as he was wheeling into my trauma room, Mr. Athlete was not moving.
A trauma to his curly head had left only a little blood, but his Glasgow Coma Score (http://en.wikipedia.org/wiki/Glasgow_Coma_Scale) was between 5 and 6. His eyes were half-open and not moving. He made no sign of recognition to his name and rubbing hard on his chest only produced a spasm. I pulled his neon sneakers off his callous-less feet. The perfect body lay in front of me and it lay terrifyingly still.
There is something so terrible about a scene like the one before me. The potential strength of the body before me was meted by the delicacy and specificity of biology. Everything must be "just so" for us to function as we do; there are uncountable details that must be heeded to form the elegance of a merely functional being, let alone the highly sophisticated and elegant people we are and encounter every day. I realized I was scared for him. In that moment, I wished fervently- nay, prayed- that he would come back and instinctively grabbed his hand. It was ice-cold as he had been laying out in the cold until the ambulance brought him to us. His neurological state qualified him to be intubated, but the doctors fortunately stayed their hands as we called out to him one last time and his lips moved almost imperceptibly. He could hear us.
His friends, still dressed in full gear, came in to keep him company. They were cut from the same cloth- tall, slim, athletic, but with all the long-lashed, clear-skinned visage of children. They were horrified to see their comrade thus. It was worse when his parents arrived, however, seeing their son with his eyes unmoving.
Hour by hour, however, he began to move a little more and his voice began to come back- words incomprehensible at first. His remarkable transformation in the hours under our care was heartening. His scans showed no bleeding. He became fully awake when a nurse tried to give him a urinary catheter.
By the time he left, ten hours later, he made a remarkable transformation. Because we cut off his clothes, I fetched him some paper scrubs and mesh underwear. His friends laughed uncontrollably at the mesh underwear. He grinned sheepishly and made a crass joke about feminine hygiene products. His tragedy suddenly turned into a comedy.
All was well and they- parents, child athlete and friends- walked together into the night.