It was 5:27 p.m. on a Friday evening when the pager went off. “Ahh,” said the intern, “Three minutes before shift change, and the ER is paging for another admission!”
I could see the dismay on his face as he dreaded the thought of staying late on yet another Friday night. I decided to take care of this patient myself and relieved the intern of his duties. As I went downstairs to the ER, I felt the restiveness in the atmosphere. Walking through the busy hallway of the ER, I saw a bunch of people rushing in and out of a room and my feet impulsively started walking towards there knowing that had to be my patient.
As I entered the room, I saw the nurse bagging the patient to deliver oxygen. Next to her was the ER resident with an endotracheal tube in his hand but was unable to intubate the patient. The ER attending attempted next but failed to intubate the patient as well. Minutes later, the anesthesiologist hastily entered the room and tried to intubate the patient but failed as well. The patient’s husband stood sobbing across the room. His fists were clenched, his skin was flushed, his eyes looked down as he slowly fidgeted holding back his tears. I gently paced walked towards him and introduced myself. His voice trembled as he said, “We were just having a nice meal when she choked on her hamburger.” His eyes showed deep agony as if life had been unfair to him. He eventually said that the patient had a history of multiple back surgeries with rods in her back which caused an inability to extend her neck leading to the multiple failed intubation attempts. We decided to scope the patient’s airway and were finally successful in intubating the patient. I stayed late that night stabilizing the patient and made sure the patient was well taken care of.
Fortunately, in one week, she was not only extubated but was ready to be downgraded from the ICU. She had done well overall but had failed her swallow test and was recommended a feeding tube. However, the patient had refused the feeding tube stating it would reduce her quality of it and insisted on eating. The patient’s husband tried to persuade her multiple times to get the feeding tube because he did not want her to have a “near-death” experience again. The argument had been ongoing, and there was some “yelling” heard from their room multiple times.
It was 7:45 a.m. the following Friday when I received sign out from the night team. I was about to start my morning rounds when I heard “code blue,” which indicated a medical emergency. As I put my computer down to run towards the code, I heard another “code blue” announced. A few seconds later, I heard “code silver” — that was the code for a person with a weapon in the hospital. My heart started racing, and my feet started pacing. I started sprinting towards the code. As I got close by, I saw the nurses gathered outside the room. I could see they were panicking but were trying hard to keep calm. All their concerning faces simultaneously looked at me as I walked past them to enter the patient’s room.
As soon as I entered the room, I smelled gunpowder. I saw a man seated on a chair next to the patient bed — his hands were flaccid hanging off the side of the chair with a gun fallen underneath the chair. There was a bullet hole on the side of his forehead, and blood was gushing down. As I walked past him, I saw a lady with two gunshot wounds in her abdomen. The white hospital sheets turned red from the profuse bleeding. The patient’s face looked pale white, but I suddenly realized it was the same patient I downgraded from the ICU the previous day.
I had never seen a gun in my life. I felt like I was going to freeze but I knew I had to keep going. I had to save this patient, yet again, and I had to save this man. Emotions were flowing … my hands shivered and my voice quivered while the chaos in the room increased. I took a deep breath and quickly got myself together and announced: “Someone please get the code cart!” A series of events followed and, unfortunately, I was unable to save the patient. This incident left a deep impact on me. A murder-suicide incident on the grounds of a facility that imparts health is not just disturbing but is also heartbreaking.
Gun violence has been increasing in this country and is now not just a public health crisis but an epidemic. It has been inadequately researched and inadequately treated. How is it that diseases like measles, mumps, Zika, and Ebola gets all the research funding, but firearm-related death and disability doesn’t? Contrary to popular opinion, most gun violence is not caused by individuals with mental health conditions as per the American Academy of Psychiatry. As of today, there is no solid research to prove whether people are safer in a society with more or fewer firearms. As health care professionals, we all need to speak up to remove the legislative barriers and get the Center of Disease Control and Prevention to generate more evidence-based solutions to treat gun violence. It is time for a change.
The author is an anonymous physician.
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