Naïveté

Setting the stage

I was sitting around thinking about funny things that have happened at work over my life time and this story popped up. I was working in a regional trauma center in the Midwest in the early 1970s. I had recently graduated from college with a degree in psychology when the grand idea of entering medicine came to me.

So, I decided to get a job as an orderly in a hospital. I thought it would give me a chance to see the machine from the inside. The Personnel Director told me that there was on opening in the Trauma Center (an Emergency Room Plus), AND that it paid more per hour - $2.05 instead of $1.95. For that kind of money I jumped at the opportunity! It turned out to be an experience of a life time.

This was a 900-bed teaching hospital. We had doctors, residents, and medical students all over the place. The Trauma Center served about a fifty-mile radius. I worked the 3-11 pm shift and we were swamped nearly all day every day during that time. As a Trauma Center we saw the worst stuff. Since I was a college graduate I was soon doing all of the stuff that the nurses were doing except dispensing medications. Consequently, the head nurse would schedule one less nurse on the shift when I worked.

Most of the time, from 3-11 pm, I was the only orderly in the hospital. Occasionally during the summer there would be the son of one of the doctors working with me. This person would be going to college somewhere and needed a summer job. He would end up mostly running errands while I got to do all of the cool stuff.

Oh yeah, the story

One day a young girl who had been injured in an auto accident was brought into the Trauma Center. She was unconscious. As was usual with this type of case, she was taken to one of the outpatient surgery rooms just across the hall from the rooms where the usual ER patients were seen. There were nurses, staff doctors, orthopedic residents, neurology residents, internal medicine residents etc moving around the room with this girl at the center of their attention.

The typical scenario for this type of thing is that the patient is lying on a surgery table in the center of the room. Since the patient is unconscious and unable to assist with information, all clothing is taken off so that the doctors can perform the necessary examinations and the nurses can hook up the various IVs and other equipment. After these traumas you never know what has been injured or what will need to be done, STAT! I always found it interesting that having a naked unconscious body there on the table did not have the same effect as seeing that same person asleep naked on the beach. This patient was just another object in the room; and she was the main object.

Here is the setting for all of this: we are in a surgery room with an unconscious patient (stable at this point) and all of the really immediately serious decisions have been made. Outside this room is the hurried world of all the other emergency room situations. There are adults and children wailing in the waiting room, people holding makeshift bandages over cuts on their faces while giving a staff person their insurance information, people lying on gurneys in the hallway coming from or going to the X-ray department, and much, much more including a demented old woman lying on her gurney constantly, mindlessly, and rapidly saying, "Help, help, help, help, help, help, help..."

In one of my forays back and forth, I stopped to see if I could assist this lady. I bent forward a little and asked, "Can I help you, m'am?" She stared up at me for a few moments, and as she looked right into my eyes she said, "Help, help, help, help, help, help, help..." I had never encountered dementia before. A little confused, I took off to finish my task.

So, the hustle and bustle had now cleared the surgical room where the girl from the auto accident was lying. The only people left were a surgical resident, a nurse, a new orderly (about 20-years old and very inexperienced with the world), and me. The resident had just arrived and was examining this young girl. Although still unconscious, she was considered to be outside any immediate danger. It was now very quiet in the room, with all of the calamity that I mentioned above just outside the door.

The resident asked, "How old is this girl." (By her physical development, she looked to be at least sixteen or seventeen years old.)

I answered, "The chart says that she's fourteen."

Without looking up from the patient, as an aside, he replied, "She is a very healthy looking fourteen-year-old." (Clearly his comment came from surprise at her physical development at such a young age)

The young orderly, without hesitation, said, "That's probably why she is doing as well as she is."

The resident looked at me with that inquisitive look like, "Am I in the Twilight Zone? Did he really think I was referring to her physical health?" Then he exchanged glances with the nurse, who just shrugged her shoulders as she shook her head and rolled her eyes.

Her expression said, "Yep, you're right. That's what he said."

It was such a interesting juxtaposition of potential life and death with the humor of daily life. In the quiet of that room, after the real emergency decisions had been made, this brief exchange, and this young orderly's naïveté, was recorded in my memory; and remains after 35 years.