Shotgun Trauma: Whodunit?

Receiving a Trauma patient...back in the day.

It was 1991-ish at around 5:30 am when the 'Bat Phone' rang. The phone itself was red with teensy photographs of a gun and knife taped to the handset and it was our hotline to Biotel - a centralized Emergency Dispatch center. in Dallas, Texas. " male, multiple gunshot wounds, Code 1, Priority 4, five minutes out”, cautioned dispatch. This was bad.

A five-minute ‘heads up’ was a blessing.

Our patient arrived alive. Oxygen, fluid resuscitation, blood and diagnostics were all being done simultaneously. He was shot with was not just a simple handgun but, a shotgun. A shotgun typically uses a ‘shell’ and when fired, shoots a number of pellets which is why his abdominal x-rays looked like stars in the night sky - almost too many pellets to count from the multiple shots. His injuries were devastating and he was drifting in and out of consciousness. The ER doc made it clear to me that he would not survive.

Suddenly it seemed as though everyone lost interest in this case except for me and a cop who was left sitting in the corner of the room, making notes. He told me that when our victim left for work that morning, someone was waiting for him, across the street, with a shotgun.

My patient would most likely die soon. I maintained his blood pressure (and consciousness) with blood transfusions and oxygen, while waiting for the surgeons arrival. This was before we had designated Trauma Response Teams, Trauma Centers, Trauma Case Managers and the like. This was how it was done. Hard to believe.

I didn’t know how much longer my patient would remain conscious, so it was critical to me that family be given the opportunity to be with him. I opened the door to 'The Family Room' where it was filled with distraught family members and friends. The doctor had explained the gravity of the situation and they were clearly heartbroken. His parents. siblings and friends came forward to be at his bedside. Recalling the tearful, anguished sobs, followed by prayers of strength and validations of love, it was a powerful moment and told me how much this man meant to everyone. The only person who had not stepped forward was his wife. She, still in her nightgown, wearing pink sponge curlers in her hair and staring blankly overwhelmed by grief.  I asked everyone to leave his room in order to provide the couple privacy. 

She stood beside him with tears streaming down her face. She didn’t speak a word and barely moved. He told her that he loved her. She did not respond. After a few minutes I brought her back out to the waiting room where she was comforted by her friends and family.

My patient died that morning. He was 28.

A few weeks later, while out shopping, I saw a familiar face in the store but just couldn’t place him. So, I approached him and said…”You look so familiar, do we know each other?” He paused for a moment and then said, “You’re the nurse.” I nodded. He said, “I’m the cop.” The cop from my patient's trauma room.  I asked, “So did ya'll find out who did it?”

I was totally unprepared for his response,

“His wife", he said.

A promise of  $500.00 to kill her husband - to be paid when she collected from his Life Insurance policy.

It just affirms the fact that you can't judge someone in our business.

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