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.

#TheIsolationJournals - Write about when you were dead wrong about somebody

Coming to America 1

The Welcoming Committee:
I had completed the college requirements to be a Registered Nurse in Toronto Canada, and was looking forward to my first nursing position.

Unfortunately a hiring freeze was in effect for area hospitals and my graduating class was facing a bleak job market. I was nineteen and one of the youngest graduates in my class. A poor college student, I was ready to start making some cold, hard cash.

The light at the end of the tunnel appeared when a group of nurse recruiters from Fort Smith, Arkansas arrived at our nursing school. They regaled our graduating class with facts, figures and a slide presentation that showed nurses water skiing, disco dancing and sunbathing.

We were hooked.

The ‘sunbathing’ part was the biggest draw as we Canadian nurses typically spent six months of the year in snow and another three months in rain.

Twenty-six of us signed up to work at Sparks Regional Medical Center on the spot. We had no idea where Fort Smith was - but it was in “the states” and the weather had to be a whole lot better.

Our flight to Fort Smith was in August and included three airplane changes. I suppose that should have clued me into what could lay ahead of us but my nineteen-year-old “city-fied’ brain only had visions of handsome men in three piece suits, Wall Street, palm trees. Rodeo Drive and cocktails in fancy glasses.

As the plane was preparing to land in Fort Smith, we were looking out the window of our aircraft and could see nothing but trees. "What did we get ourselves into?” Stepping out of the airplane, the blanket of heat was like no other I’ve ever experienced.

We had never stepped onto a “tarmac” before and (for some unknown reason) really got a kick out of it.

Hospital representatives from Nursing, Dietary, Housekeeping, etc. were waiting for us and standing in a receiving line began introducing themselves. Soon, we were traveling with them to our new apartment complex, “The El Conquistador”.

As we approached "El Con" - we couldn't help but notice the numbers of people lining the driveway with lawn chairs and beer coolers, ‘horseshoe’ games in full tilt. Apparently, they had been waiting for our arrival. They were all men and we were the attraction. Word had gotten out that twenty-six single Canadian nurses were arriving and it looked as though every single guy within a fifty-mile radius was there to check us out.  Part 2: The Welcoming Committee

Coming to America 2

It Could Be Worse...
The Welcoming Committee couldn’t have been nicer. Several of the guys came by our apartments with handwritten “business cards” detailing their names, addresses and phone numbers accompanied with offers to show us around town. The hospital had provided us with sheets and towels, a fruit basket and disposable cutlery and dishware. We were set.

None of us had cars so we became regulars with ‘The Razorback Cab Company’. A “Razorback” is the University of Arkansas’ mascot – a really big mean-looking red pig and oh my God, It gets worse. The pig was so popular that everyone (except for us) knew what ‘calling the hogs’ meant and ‘Pig-Calling Contests’ were fairly popular. ‘Calling the Hogs’ wasn’t very pretty but after a few drinks, it was easy. Ahem.

According to a University of Arkansas Website...."Although historians aren’t exactly sure of the exact date, a group of Arkansas football fans at some point during the 1920s are believed to have been the first to “call the Hogs” during a game. Spontaneous “hog calls” have been known to break out in airports, malls, restaurants and hotels all across the country. The words to the Hog call are simple: 'Woooooooooo, Pig! Sooie! “Woooooooooo, Pig! Sooie! “Woooooooooo, Pig! Sooie! Razorbacks!' Correctly calling the Hogs takes some practice. It starts with [a little alcohol and] both hands raised high into the air, fingers waving as the volume increases during the word Woooooooooo. The arms pump down on the word Pig and then back into the air on the word Sooie."
Speaking of drinking, I ran into a little snag when I first tried to gain entry into one of Fort Smith’s discos. For starters, it was law that you had to be a ‘member’ of any place that offered mixed drinks. For some reason, “Redneck Bars” were exempt. I guess it was because they only served beer. Secondly, the legal drinking age in Arkansas was twenty-one. I, being a Registered Nurse, responsible for the care of cardiac patients and licensed to administer narcotics had to provide fake I.D. to gain admission.

On our days off from work, we would hang out at the pool and/or go to ‘Central Mall” during the day, go disco dancing at night and drink ‘Wild Turkey’and coke. We were assimilating nicely to Fort Smith and soon started to make friends with native Arkansans. It was then that we learned of a few ‘peculiarities?’ I guess ‘squirrel-hunting’ was not peculiar to the natives but when you are raised in the city by a moose hunting Newfoundlander, I would think that those cute little squirrels would be completely obliterated with one rifle shot. When I asked a ‘squirrel-hunter’… “What is left of them after you shoot them?” He answered “Enough to make ‘Squirrel Chili”. Call me prissy but I have yet to eat a squirrel.

Considering the fact that we all spoke English, I noticed several differences. The expressions “Huh-uh and Uh-huh” were two very different things altogether. “Huh-uh means “No” and “Uh-huh” means “Yes” or if elongated “Uh-huhhhhh” means “You’re welcome”. ‘Fixin’ meant ‘preparing’, ‘coke’ was any kind of soft drink, as in…“I’m fixin’ to get me a Coke”. That same person would return with 7-Up. Despite our differences though, the people of Fort Smith will always hold a special place in my heart as they were so warm and welcoming to us, eh?  Part 3: Hang Around Fort Smith Awhile

Coming to America 3

Hang Around Fort Smith A While
We nurses could only do so much sunbathing and drinking without ending up looking like leather bags with bloodshot eyes so, on occasion we would ‘soak in’ the local culture.

Fort Smith was known for Judge Parker “The Hanging Judge”. Over the years, Judge Parker sentenced 160 men to death by hanging. The slogan, “Hang Around Fort Smith A While” was actually posted on billboards, T-shirts and mugs as part of the city’s ad campaign. Eww. Points of interest in Ft. Smith included The Courthouse and Gallows where there was room for three hangings to occur simultaneously. Nice. Another claim to fame was the fact that Belle Starr a notorious outlaw and sometime 'madam' owned a house of ill repute located on the train line conveniently very near to The Ft. Smith Train Depot. Reportedly, Jesse James and his gang frequented it regularly.The military base of Fort Chaffee also called Fort Smith home and was where a young Elvis Presley was inducted into the Army and recieved his military haircut.

So much for the culture and history of Fort Smith.


Elvis' haircut at Ft. Chaffee and the outlaw, Belle Starr

Alrighty then, back to drinking at the pool.

Sparks Regional Medical Center, was wonderful. We were given positions in the areas that interested us most and were oriented thoroughly. I was on a Telemetry floor and was caring for heart patients. One morning, during my orientation my preceptor (trainer) asked me to administer a mouthwash of hydrogen peroxide and water to a little old lady. She was unsure as to why this had to be done but that it was ordered none-the-less. When I explained to the patient that she was to swish the liquid around in her mouth and then spit it out, she did as I had instructed. When I saw what she had spat out – I panicked. The little lady was African-American and the contents in the basin were black! Did she have a tumor? Was the inside of her mouth sloughing off? I thought she looked OK - but at this rate, I just knew it was only a matter of time. I raced back to the nurse’s station with basin in hand showing the sludge to anyone who would look... my preceptor gently put her arm around me and sweetly said, “Honey, have you never seen snuff before?” Seen it? I had never even heard of it.

Ground Snuff Tobacco

My real education had begun.

My Arkansas nursing colleagues were so incredibly helpful and kind. They demonstrated as much care and compassion towards me as they did their patients. I thank them for being such incredible role models and setting a high standard for me during a very impressionable period of my life.  Part 4: Moving On

Coming to America 6

Twist of Fate
By the time I had started my new job at Baylor University Medical Center, I was becoming broker and lonelier by the day. I couldn’t afford taxi service anymore (so much for my new best friend, Earl). Fortunately, the assistant nurse manager of my unit offered to give me a lift to and from work. She was great but I didn’t want to take advantage of her kindness and ask her for any other favors (like driving me to the grocery store), so I became a 7-eleven junkie on my days off and ate at the hospital cafeteria when I worked. I was twenty years old with no friends, no money and with the exception of going to a job that I hated, I was stuck in my apartment day and night. What a loser.

Then through a twist of fate, things started to turn around.

My apartment faced a fairly busy street but the sounds of cars passing didn’t bother me as I was a heavy sleeper. One night I was awakened by the sound of a loud “BOOM”. I rolled over and went back to sleep. A little while later I was awakened yet again by the sound of sirens. When I opened my eyes, flashing red lights were outside my bedroom window. Whatever. I went back to sleep. Loud voices and what sounded like 2-way radio communication woke me up again.

I got up to see what all the ruckus was about when I walked into my living room and tripped over one of my sofa chairs that was normally located about four feet away from my bedroom door. I hadn’t turned any lights on yet so I couldn’t quite figure out what the bright white light was coming from my living room wall. When I did turn on the light I could see that my wall was crushed in and my sofa chairs were thrown across the room. Earthquake? I carefully opened the door to my apartment, fearful of what devastation I would witness on the other side when I heard someone say “Hey! There's somebody in there!” They were referring to me. Clad in my scrubs, sleepy-eyed, bed-headed and barefoot, I stepped outside of my apartment to a round of applause, gaining quasi 'celebrity status' at my apartment complex immediately. They may not have learned my name but I was known as "the girl who slept through a car slamming into her living room."

I guess Dallas wasn’t so bad after all. I may still be broke and car-less but at least I had someone to talk to at the pool. Part 7: Banking American-Style

(..the lady who ran into my apartment was fine – minor cuts and bruises only.)

Coming to America 7

Banking, American Style
Payday. I thought it would never get here. I didn’t have a bank account yet so I asked around and a couple of the new Filipino nurses told me that a banker had just given them a class on "American Banking". His bank was within walking distance of Baylor (a definite bonus) so they gave me his card.

That afternoon, I told my 'ride' not to wait for me as I planned on walking to the bank, opening an account and cashing my check. I would take a cab back home. When I made it to the bank, I couldn't find an entrance door for the life of me. Well crap, it was a 'drive-thru' bank. So, with my head held high and shoulders back, I walked up to a car bay and pressed the red 'call' button. "I would like to open an account" I said. The teller (who had to be stifling a laugh) said "I'm sorry ma'am, but this bank is a drive-thru only. If you would like to open an account, you will need to visit our bank office." There were two cars now, lining up behind me. I pretended not to notice. "Where might that be?" I asked. Trying my best not to sound sarcastic. "Just turn left on Hall then make a left on Elm. It's about 3/4 miles up on Elm" she said. - Easy for her to say, she was not the one walking alone in downtown Dallas.

That weekend, with cash in my handbag and a smile in my heart, I began my search for wheels. The used car section of The Dallas Morning News had pages of car ads and many dealerships were offering “No Money Down!” Perfect! I had no money to put down on a car anyway so, I’m thinking that this type of deal will work well for me. After calling several of the “No Money Down” dealerships, I soon learned that the “No Money Down” deals were for people who had an established credit history in Texas. My bubble burst. Was it a sign? Should I just pack up and go back to Canada?

On Monday, I contacted the banker whose card I had recieved earlier - 'Mr. Lou Bittner, Vice President, The Texas Bank'. I made an appointment to see him that afternoon "about a loan". The way I looked at it, if he was kind enough to help Filipino nurses learn the American banking system, maybe he would have a soft spot in his heart for a Canadian.

Mr. Bittner was a well-groomed, older man who looked very much the part of ‘the banker’. He invited me into his office and seemed genuinely interested in what I had to say. I took a deep breath and began my semi-rehearsed pitch… “Mr. Bittner, I am twenty years old, I am not an American citizen, I have no collateral and I have only been a nurse at Baylor for three weeks but I am trustworthy and could provide you with personal and professional references from Canada and Arkansas, I don't know anyone here. Anyway, I would like to apply for an unsecured loan to buy a car.” I had remembered being told by my dad that a loan without collateral was called an 'unsecured loan' and I thought that using 'banker-speak' would make me sound like I knew what I was talking about.

Mr. Bittner paused for a few seconds then looked at me intensely and said slowly, “I’ll tell you what... I will loan you $3,000.00. But first, you have to come up with $1000.00 on your own. When you do that, call me and you'll have your loan. Your car cannot amount to more than $4,000.00 including tax and title.”

We had ourselves a deal!   Part 8: Wheels!