January 1st
“Hey, Bledsoe,” said my chief, “go into Room One and sew up that patient’s thumb.”
It was January 1, 2000, and I was an intern in emergency medicine—halfway through my first year of training.
I had gone to sleep the night before listening to celebratory fireworks and congratulating myself on surviving Y2K.
Now I was walking into the Emergency Department (ED) of our large, Level I trauma center where I was furthering my medical education. Like most urban EDs, this one was a busy place filled with the sights and sounds of the organized medical chaos that occurs in these locations, and as a young trainee, I was reveling in the opportunity to learn the skills of my trade.
As soon as I walked through the door I was assigned my first patient.
“Hey, Bledsoe,” said my chief, “go into Room One and sew up that patient’s thumb.”
I made my way into the room and found a middle-aged woman sitting on the stretcher. She had a large laceration to one of her thumbs. She was quiet, and sniffling a bit, an emotive state that I assumed was from the pain and shock of receiving a significant cut. We exchanged pleasantries and I began to close the wound.
During the course of the procedure I made small talk with her.
“How’d you get cut?” I asked.
“My husband,” she replied in a very matter-of-fact manner. She didn’t seem too eager to discuss the situation so I avoided it and talked about other things.
When I was finished she thanked me, and I said something about hoping the rest of her year turned out better than her first day.
She didn’t reply.
I left her room and made my way back to where my chief was working on some charts. En route I happened to pass by the large trauma rooms in our ED where we resuscitated our most ill and critical patients. From the doorway I could see a body lying on the resuscitation table covered by a sheet.
“Did you get the thumb closed?,” my chief asked me.
“Yeah, I did,” I replied.
Curious about the body in the trauma room, I couldn’t help asking, “Who’s the guy in there?”
“Oh, him? That’s her husband. He came at her with a clever, but she got him with an icepick right to the heart. He was dead when he got here,” he said.
My first patient of the new century was a woman who killed her own husband with an icepick to the heart. By all accounts it was an act of self-defense—so I wasn’t blaming my patient for doing what she had to do to protect herself—but it did serve as a memorable testimony to this young physician of the level of dysfunction we had going on around us.