Dr. David Peters was on his way to work as an Orthopedic Surgeon at Jackson Orthopedics. He also did some surgery for the hospital next door since they were frequently short on emergency situation doctors. His schedule for the day was clear so he had taken an extended lunch with his beautiful wife Molly. He was headed back to the office to finish up some paperwork until the clinic closed at five. Classical music echoed off the nearby buildings as his silver Porsche sped along the boulevard.
The distant sound of an ambulance siren brought his attention back to the road, up ahead he could see that the traffic was backed up in all directions at an intersection. He slowed down and tried to see what was going on, hoping that it was just a spilled load of lumber or something. From what he could see, there was a car laying on it's side against a thick oak tree, the door was smashed in like it had been hit by a truck but there was no sign of another car. There were no emergency vehicles on the scene yet, so it must have just happened, he reasoned. Weaving his Porsche through the haphazard traffic at the intersection he pulled up near the crumpled Miata.
"Listen up everyone, I'm a doctor, please move back. You, in the red, go call am ambulance right now." Dave said to the small crowd of people who had stopped, intending to help but frozen in fear and indecision. He looked at the car and shook his head, thinking 'another damn drunk.' to himself. The once-flawless car had been smashed on the driver's side, then it must have rolled through the intersection to come to rest against the tree, driveline skyward. He stooped down into the shade to look under the car and to try to help anyone who might have survived.
The first thing he noticed was a strong odor of motor oil mixed with a stomach turning smell of spilled blood. There was a teenage girl swaying slightly above the ground, held up by the seatbelt still wrapped around her waist. Blood dripped freely from a long gash in her forehead and puddled in the flower bed under the car. He could see where the windshield had spiderwebbed from the girl's impact with the glass. The driver, another girl probably about the same age, had been crushed against the center divider of the car when the drivers door had buckled and looked to have severe crush injuries to her legs and arms. He opened his black medical bag and took out some sterile gloves, gauze, and tape and very gently tried to staunch the blood oozing out of the cut in the passenger's forehead without moving her neck which could easily be broken. Then, with the wail of approaching sirens stopping, he decided that there was nothing more he could do that would not worsen the situation. The paramedics rushed over to the car and began their work. Dr. Peters gave the police officer on the scene his card and said that he needed to get back to the hospital to prepare to recieve these patients. The officer thanked him and said they would be in touch. John walked back to his car and continued his drive to work, without the music this time, his mood was somber.
Dr. Peters arrived at the hospital, a few minutes ahead of the first ambulance with the passenger of the car accident he had just left. He decided to check in on his friend Dr. Arthur ClearWater, the on-call doctor that afternoon, to see if he needed any help. The ER receptionist told him that Dr. ClearWater was in the OR repairing the spinal injury of a teenage car accident victim.
"There's another case coming in that we could use your expertise on, though." said the nurse.
Since he didn't have any pressing business, Dr. Peters said he would do whatever he could to help a patient.
"Patient is approximately an eighteen year old female, 5'10, 110 pounds. EMT's predict severe fracture-dislocation of humerus and femur. Patient is unconscious but there is no obvious spinal trauma. If you want to take the case, the ambulance just arrived, otherwise we'll have to wait for another on-call to get here."
The glass automatic doors opened with a swoosh and the Emergency Medical Technicians wheeled in a shapeless bundle on a stretcher. Dr. Peters knew that it was a special backboard that had foam attachments that could hold every part of the body very still for safe transport. It was usually only used for helicopter rescues or for extreme skeletal trauma cases. The girl was wheeled past him and into the operating room. He made the decision right away, he needed to help this girl immediatly. He had the responsibility of being a doctor to live up to, this was why hed had become a doctor afterall. He was ushered into the clean room to prep for surgery. As he was dressing and washing a nurse read off the girl's history and current status that was being determined by the nursing team already in the operating room. The preliminary physical exams had suggested at least a fracture of the femur and the humerus, with probably a lot more. There did not, miraculously, appear to be any internal injuries or brain or spinal injuries. X-ray's and a CAT scan would confirm that supposition. He would know more when he examined her himself.
A nurse put his soapy hands directly into a pair of sterile gloves when he was ready. He walked into the Operating Room that was covered with green surgical drapes. The girl was laying on the table, completely naked and stirring unconsciously. Peter's walked up to the head of the bed and spoke to her.
"Beth, Beth, please open your eyes. We need your permission before we can help you."
Beth's eyes fluttered open, the pupils dialated and staring off into the distance.
"Beth, please, can we help you?"
Beth's lips moved slightly, her words nearly uninteligible, "Yes."
"You've been in a very serious car accident Beth, we may need to operate and put you into a cast. We cannot do this until we have your permission. Do you understand?"
Beth's eyes focused on the doctor and her eyebrows furrowed slightly. "I understand." she managed to say.
"Thank you, let's begin."
The portable x-ray machine was ready to go and that was what he started with. The machine was just a small rectangular box attached to a balanced arm that could reach every part of the body and take pictures from any angle. The first thing to check was for internal bleeding, which miraculously there was none.
Since she was stable, he started by taking an x-ray of the upper femur of the girl's right leg, which was obviously broken and dislocated since the leg was still at an odd angle. The x-ray clearly showed a distal radial fracture with an overriding posterior displacement of the distal fragment. The hip part of the femur was sliding over the bottom part, and would either have to have a plate put on it, or have a couple weeks of traction. Dr. Peters told the nurse to get the tools needed for the insertion of femoral traction pins. The head nurse quickly started ordering her underlings to get the desired equipment. The next part of the body to be x-rayed was the left lower leg, which he could tell from feeling the leg that both of the bones had been broken clean through. The x-ray's confirmed this and showed that they were sharp fractures that could be treated non-invasively
After taking radiographs of the rest of her legs, to be sure there weren't any other hairline fractures, he moved onto the pelvic region. The digital x-rays, which were being displayed real time on the video monitor, showed faintly a hairline fracture on the left side of the pelvis. There were no rib or spinal fractures.
He moved on up to her arms and found that she had a fractured scaphoid in her right hand and a spiral fracture of the humerus with displaced and overriding fragments, and the shoulder had been dislocated. The left arm also had a hairline fracture of the fifth phelangeal. He also decided, based on experience, to permanently immobilize her head, just in case there was any cervical trauma.
He heard a groan come from the table as he told the nurse what types of casting materials and other operating equipment to have ready. The girl was looking around wildly, trying to understand the situation. She tried to say something, even though she had a breathing tube down her nose and into her lungs. Dr. Peters walked over to her and told her that she was in the hospital, and to try not to talk because of the tube. Her eyes sort of glazed over and she passed out again.
"We need to get this done quick, to avoid complications." he said to his team. "Is everything ready?"
"Yes Doctor." said the head nurse.
They began the casting process.