Not Always Enough to Have a Good Heart

One evening at Frick Hospital, the emergency room received a call from an ambulance crew that they were bringing in a gunshot wound to the chest. When something unusual, it was Dr. Vance who happened to be on duty as emergency room doctor. Dr Vance was a surgeon at our hospital who also did rotations in the emergency department. When this patient arrived, the man had a self inflicted wound to his thorax near his heart. We immediately recognized the person as a local political celebrity.

Doctor Vance had us call the laboratory for multiple units of unmatched blood, when he heard the ambulance call and set up a chest trauma tray, placing on a bedside table ready to be opened if needed. After assessing that he might still be able to save the man, he tore open the pack and called for the rib spreaders. He quickly gowned and gloved. As he reached for a scalpel, we splashed Betadine disinfectant on the man. He planned on opening the man’s chest in the emergency room cubicle.

Making an incision between the ribs, he allowed the accumulated blood to escape. It rushed out in a crimson torrent that covered the doctor’s shoes, splashing him to about ankle high on his pant legs. Inserting the rib spreaders, he widened the opening to allow access to the heart.

We suctioned the blood from the cavity so that the doctor could see what he was doing. He started to repair the holes in the heart quickly with large, looping stitches. With the wounds temporarily closed, he began to do open heart massage trying to restore the circulation. The doctor’s sutures held leaking slightly, but all of his heroics came to naught. He could not undo the severe damage to the man’s heart muscles.

Dr. Vance stood dejected with blood halfway up his arms in the middle of a congealing pool of blood. The toes of his shoes were covered and the red splatters dotted up his lower pant legs. Even though Dr. Vance had done his best sometimes a person’s best is not good enough.