America loves a good emergency-room drama on television. Just give us a few good-looking doctors and some romantic tension, plus a patient with a gardening tool stuck in his abdomen, and we are glued to the tube.
While the soap-opera plots and workplace flirtations help jack up the ratings, no viewer can deny a fascination with that patient in Exam Room 2. You know, the guy whose foot has gone missing, or the terrified pregnant immigrant explosion victim, or the amorous couple who literally can’t be parted. We’re at once repulsed and riveted by the horrors and medical mysteries that swing through the doors of TV’s waiting rooms.
Talk to a real emergency-room physician, however, and you’ll learn that reality trumps fiction every time.
Gut-wrenching realities
Strange and incredible scenarios greet the ER staff in hospitals across the country. Dr. Alasdair Conn, chief of emergency services at Massachusetts General Hospital in Boston, recalls a case from early in his career. When one very drunk driver couldn’t find the exit of a gated parking lot, he rammed the fence with his car.
“He ran straight into a metal post, and the pipe went through his belly button and out of his back, impaling him on the car seat. Help was dispatched by helicopter, but they didn’t want to pull him—a bit like a shish kebab—off the chair. So they cut off the tube in front of him and behind the chair. He arrived at the hospital completely conscious, still sitting in the car seat and still drunk. I remember looking at him and thinking, “This is absolutely crazy. He has big piece of metal sticking through him and he’s speaking to me, saying, ‘Get me off this chair!’”
Incredibly, the pipe missed the man’s spine, bowel and vital organs, and he recovered with only a nick to his liver.
If the whole scene sounds very much like a scene from TV, don’t be surprised to learn that the shows routinely draw on actual cases. Some ER physicians will even submit interesting case histories to television producers seeking material.
In other instances, real ER scenarios are loaded with all of the complexities—fatal wounds, psychosis, moral ambiguity—of an entire plot. Conn recounts one of several true stories in which both the victim and the perpetrator of a crime have been in his emergency ward at the same time.
“A psychiatrist here at Mass General was assaulted with a knife by a patient. An off-duty police officer who was carrying a weapon heard the screams, went in and saw the patient stabbing the psychiatrist multiple times. The officer warned the alleged perpetrator to drop his weapon but he continued to stab the psychiatrist, so the officer shot him.”
The staff made every attempt to resuscitate the assailant, but he died of his injuries. “It can be difficult to maintain professional composure and courtesy,” Conn says, “but you have to treat everyone and deliver the care a normal patient receives.” The psychiatrist went into emergency surgery and survived.
