The page came over the old, outdated trauma pager, “Red Trauma, ETA 5 minutes. GSW to head, intubated, no further information.”
Also: Graphic Content WarningI wasn’t on call but saw the page on one of the PA’s pager and I went over to the trauma bay. The on call surgeon was already in the OR with another case and back-up was 20 minutes out, so I was in the bay when the patient arrived.
Report was quick: self-inflicted gunshot wound to the head, entry in the right parietal, exit left occiput; agonal respirations on scene, intubated; Blood pressure 60 palpable. No response to intubation or pain, GCS 3t. Blood and brain matter draining from the exit wound.
We hooked him up to the ventilator, got another IV started and did our primary survey. His airway was stable, we were moving air and his sats were good, blood pressure was low, pulse was in the low hundreds, he had no response to pain or other stimuli. Essentially, he was already dead, but his body didn’t know it. Think donor. The life you save may not be the one in the trauma bay.
We started pressors, got a chest x-ray to check the position of our breathing tube and started another IV getting him set up for CT. Then his blood pressure spiked, his heart rate dropped to 30 and then stopped. Rounds of CPR, epinephrine and calcium failed to bring him back. Time of death: 11:37.
Then I noticed the tattoo on his right arm: Globe and Anchor with the words Semper Fi in script under it. This man was a Marine.
I don’t know anything more about him. I don’t know what demons made him put that gun to his head. But I do regard him as my brother. I would never claim the title of United States Marine, but I had the privilege of serving with the Marines, some of the best men I have ever known. During the endless wars against terror I have always supported them.
This country has forgotten its warfighters in the interest of politics. There is much lip service to our ‘heroes’ but little enough actual support. I don’t know if this man sought help from the VA, but I know many others who have and have received less than adequate care. We have broken faith with the men and women who have pledged their lives and their honor to this country.
I dislike the word ‘hero’ as applied to our veterans. Many were actual heroes. Most were just men and women doing the best job they could. We joined for as many different reasons as there are veterans; some noble, some not. In my case, it was a simple matter of finance. The Navy would pay for college and medical school and I would owe them so many years of service. Something happened to me along the way. I learned the meaning of duty. Not a popular sentiment these days, but one that was impressed on me by the men who led me, who trained me, and ultimately trusted me to carry on the work that they had started.
Everyone’s experience of military service is different, I get that. For many, it was hardship. For just as many, it was formative, as it was for me. Who I am, what I have become in almost 70 years on this ball of dirt, was profoundly shaped by my time as a Naval Officer and surgeon.
So to the man who died in my trauma bay, to all the veterans who struggle day to day to hold it together, and to those of us who came home intact but profoundly affected by what we saw and what we did, remember that you are not alone. Your brothers in arms will have your back. I for one will stand by you. Call me.
ed note- Bruce originally posted this in Feb 2023