Trauma: Life in the ER

CHAPTER ONE

8 May, 1997
16:45 MDT
Las Cruces, NM

“Mr. Davis, stay with us! Mr. Davis, keep breathing! Sir, can you hear me? Can you tell us what hurts?”

Sirens blaring, engine roaring, paramedics busily and professionally performing their life-saving work: I always wondered what went on inside an ambulance. Now aware from an eyewitness point of view, I was in shock and in way too much pain to be fully cognizant of what was happening. The Paramedics - just as the EMT first responders had done - did their jobs with a grim and determined sense of urgency. At the same time they remained professonal, calm and efficient. IV drips were running. An oxygen mask was placed over my face. A blood pressure cuff was wrapped securely around my immobile right arm as my rapidly dropping blood pressure was regularly checked and written down. It was way too low. My respirations and pulse – way too high. This had to be a quick trip diagonally across town to get to Memorial Medical Center; Las Cruces and Dona Ana County’s only hospital.

In one sense, the trip by ambulance seemed to take no time at all. From the concerned tone in the voices of those attending to me I assumed I was drifting in and out of conscious awareness. At the same time, the pain from my right hip, which had been dislocated and pushed completely through the socket, was sending shrill, unbearable waves of nauseating pain throughout my body Unable to move - in part because of being strapped securely to a gurney and more to the point, because there had been some as of yet undetermined level of injury to the spinal cord - there was no relief. As routine practice, pain medications were not issued until further testing at the hospital could confirm the severity of my injuries. It would be a long night.

Even though I couldn’t see where we were going, I knew the route. I had driven it hundreds of times. It was the same route I had often taken to the hospital when visiting hospitalized parishioners. The ambulance tore south by southeast down Valley Drive to University Boulevard. I remember feeling the wide sweeping left hand turn, just in front of the Spanish Territorial Holiday Inn with its bright white stuccoed walls and its sienna tiled roof. The ambulance swayed slightly to the right as it careened around the corner. Even though lashed to the gurney I felt I might slide off just the same. Then it was East on University Blvd., up the slight hill past New Mexico State University, and across Interstate 25 then past the NMSU Golf Course. The driver, a man who attended our church on occasion, artfully dodged through afternoon traffic, honking his horn through the numerous intersections regulated by traffic lights. Then it was left on Telshor Boulevard, the street which was home to the hospital. Up under the covered drop off in front of the Emergency Room entrance, personnel from the ER/trauma unit were there to meet us at the door. Their voices echoed vaguely in the recesses of my semi-conscious mind.

“Pedestrian MVA. Mr. Davis was allegedly run over by a school bus and was drug approximately 40 feet. Blood pressure 60 over 40, pulse 150, respirations 50 and shallow. Pupils are equal and reactive. Patient complains of pain to pelvis and right hip. No movement or sensation of the bilateral extremities. Severe abrasions and bruising to the back, face and head.”

The businesslike communication was just like something from television’s, “ER.” Interestingly enough, “ER” was Judy’s and my regular television show to watch every Thursday. It would be on TV that later that night and I wouldn’t be able to watch. Judy probably would miss it as well. But then I guess we didn’t need to watch the show. We were living it.

With Ambulance and Hospital personnel running alongside, I was wheeled into Trauma Room 1, the room reserved for the most seriously sick or injured patients. Bright overhead lights glared down on bruised and swelling eyes. The blinking and beeping of all the ominous monitors, gauges, instruments and other unidentifiable paraphernalia gave this small room the look of some mad scientist’s laboratory. I felt like Dr. Frankenstein’s monster.

I was slightly aware that all my clothing had been cut off my body including my new, peach colored Land's End shirt, a pair of Polo Khakis and my favorite tie bearing the picture of a bottle of Tobasco Hot Sauce. I was totally exposed and vulnerable. I could not have cared less.

Under the glare of the overhead lights, it was painful to open my eyes. They were swollen and bloodshot. The scratching of the eyes must have been from spraying gravel as I was drug underneath the bus. I wondered if my contact lenses had gotten folded up in the corners and were further irritating my eyes. At some point they had come out. An Opthomologist confirmed that there were no contact lenses in place.

A bevy of nurses, doctors and attendants began introducing themselves to me and asking me how I was doing and reassuring me that they were going to take good care of me. "How was I doing?" What a stupid question. But their calm, reassuring voices did have the desired effect. I felt I was in good hands. Each one in turn asked, “Where does it hurt?” Then came the poking and jabbing; testing to see if my belly was tender from any internal bleeding.

Someone said, “Dr. San Filippo should be called in.” Dr. Bruce San Filippo was Las Cruces’ only neurosurgeon; one reason why the Hospital did not have Level 1 Trauma status. In most cases, patients who incurred serious head or spine injuries had to be sent to El Paso or Albuquerque to such a Trauma Center. On this particular night he was on call. He arrived shortly - I have no idea as to how long - to consult on my case.

CT scans, MRIs, X-rays all revealed that there was a subluxation/fracture or dislocation of the spine between the C5 – 6 vertebrae. The spinal cord had been pinched. It wasn’t severed but it had been compromised. As a result I was experiencing partial quadriplegia or, as it would later be diagnosed, quadra-paresis. I had very little if any movement in any of my extremities. People began taking my arms and asking if I could push against their hands. There was very little movement; even less strength. The same routine began with legs. However first, they asked if I could wiggle my toes. Try as hard as I might, I could only slightly bend them downward. Soon I was being pricked with some little instrument and then alternately tickled with a finger. “Can you feel this Mr. Davis? Where am I touching?” I had very limited sensation.

Judy was finally allowed to come back to this small room bustling with busy professionals to be with me. I don’t remember if we talked or if she simply observed what they were doing. I could see she had been crying. She told me later she had to sit down with her head down, lowered between her legs to prevent her from fainting. I didn't know that but I was extremely glad she was there by my side right then.

In a little over one month, June 17th, we were to celebrate our 25th wedding anniversary. We dated for four years before we were married. We had been through a great deal together over the previous 29 years including career changes, cross-country moves, the birth of our children, and graduate school for each of us, the death of two parents. We were close and she was my best friend. Would we make it to our anniversary? I wasn’t sure. But I knew these moments were important and I don’t think I could have endured them without her.

She told me that people from the church had already gathered at the hospital. They were taking turns, going in small groups to the small hospital chapel to pray. There seemed to be about 60 or more she said.

There were more tests. An MRI, more CT scans, Xrays, EKGs and more. I was placed in a Stryker frame to keep me immobile. The Stryker frame looks somewhat like a thrill ride from an amusement park. It is no thrill; especially if you are the one strapped in and completely immobile. It is a frame in which the patient is sandwiched between two firm sides and strapped down. These hard surfaces are mounted to large wheels at either end which allow the patient to be rotated alternately between resting on the back and laying face down; suspended in mid-air, yet without the freedom of movement or weightlesness. Neither view - staring at the ceiling and the overhead lights or the floor, littered with discarded medical supplies - had much to offer. Each was excruciating and fearsome. The specter of paralysis was real. Judy and I were both scared.

It was explained that the C-5 vertebrae was dislocated a measure of 3/4 in. Fortunately, though termed a fracture, the vertabrae was in tact and no chips had broken free to sever the cord. However, in order to reduce the degree of dislocation in the spine, Gardner-Wells tongs were attached to my skull allowing traction weights to be hung off the end of the bed. This allowed for the stretching of the spine back into its original alignment. Local anesthetic was used for this procedure but nothing could dull the sensation of the attaching screws being bolted into my head. I remember telling someone, I am not sure who, “This all hurts too much, why not just let me die right now.”

By the time the night was over, all the tests had revealed that, in addition to the dislocation and subsequent damage to my spinal cord, I had sustained numerous broken ribs (7 I think), my pelvis was fractured in 9 places and my right hip had been severely damaged. There were also abrasions, bruises, exhaust burns and cuts on my head, back, arms and legs. Thankfully, even though they had been “insulted” by the severe jostling, Drs. could not detect any obvious bleeding from my internal organs. And, even though I had suffered multiple abrasions and contusions on my face and scalp, no major blow to the head had occurred and they felt there had been no brain damage.

Dr. Tafoya, the attending physician in the ER that night told us later that mine was one of the most difficult cases they had seen in their hospital. Usually such serious injuries are medi-vaced by helicopter to facilities better suited to such trauma. He said that with each test further, more serious injuries became apparent.

The biggest concerns however, Doctors had told Judy, were the threat of infection from the many deep lacerations on my back and legs; the likelihood of pneumonia from being immobilized for what might be a very long time; and finally the real possibility of a pulmonary embolism. The pelvis is a very vascular part of the human anatomy. Even though I was not bleeding internally from ruptured or lacerated organs, the severe damage to the pelvis was an immanent threat to any recovery.

All the while this was taking place behind the closed doors of the ER, outside, in the waiting room and in the chapel, a cadre of Christians had gathered to surround Judy and Melissa with love and reassurance and to pray for me. Many of those gathered were from our church. But others had gathered as well. The host of a local radio talk show had gotten news of the accident and had broadcast the general details and had asked for people to be in prayer. A number of my colleagues in the Evangelical Minister's Fellowship and the Las Cruces Ministerial Association had also come to stand in prayer.

I, of course, was essentially unaware of what was going on out there. Yet I continued to feel a strange peace. There is great power and peace in the united prayers of God’s people. By later that night, Christians from many different churches in Las Cruces and around the country had begun praying concertedly for us. That knowledge has always been a humbling and powerful thing. It gave us all courage to keep going.

Having experienced few such trials myself, I had always asked how people faced such terrible crises. The answer I found was that God carried me – carried us – through, moment by moment; need by need; supplying just enough strength and grace to face each new stage in our crisis.

We didn’t know what the next day would bring. And to be real honest, the prognosis was not favorable that there would be many tomorrows. But somehow we knew that God held that future and we could rest in him.

Around one a.m., I was moved from the Emergency Room to the Intensive Care Unit. Judy and Melissa went home to rest. David Sallee, my friend and the local Presbyterian Campus Pastor stayed the rest of the night with me. Finally, pain medication was administered and it began to subtly dull the worst of the pain. Finally, a few moments of fitful but welcome rest.