Saturday, May 23, 2009

Couldn't Cry Till I Got Home


KHUK KHAK, Thailand - Be Prepared. Motto of the Boy Scouts. For the first time in a long time, I was prepared, carrying my kit bag beneath my seat.

Just at 5 pm, rush hour for Saturday market in Bang Niang, an ocean of Thai and farang collecting fresh meat and vegetables, the highway a converging hornets' nest of motorbikes, trucks, and speeding vans heading north, the orange cones not slowing them down.

For some reason, I went south toward Khao Lak with my goods in the basket, instead of north to Khuk Khak. A mile down the road, a cluster of people were on the edge of the road.

"Uh oh. I hope this isn't what I think it is."

Three women on a bike, patients #6, 7, and 8, this year, looked to be a grandma, her daughter probably driving, and maybe a granddaughter, about fourteen. The daughter had struck the pavement with her head and a man was holding a towel on it. She was conscious, sitting up, bleeding from her face, and dialing a number on her cell phone. The bike was laying on her legs.

The grandma was sitting up a few feet away, scrapes on her legs, a deep laceration on her heel. The young girl was bruised and scraped on her hands, arms, and legs, sitting up, nervously aware of the growing crowd, afraid to cry, but it hurt anyway. She nodded when I asked her if she was ok.

We used the all baby wipes, gauze bandages and roller gauze on the head patient, and loaded her on the first ambulance, her long black hair matted with blood. Before they closed the door, I told her she was going to be ok.

But her face will never be the same. A deep laceration to her forehead down to the skull, about five inches long. Nasty. A couple inches higher would have peeled back her scalp, but cosmetically more appealing. Relative to her head injury, a concussion probably, her other cuts and scrapes were minimal.

The grandma was okay as long as she kept direct pressure on her wound and stopped looking at it. The young girl was already in the second ambulance when we loaded the old lady. Off they went.

Just one bike. "Probably a dog," said Damon, when I told him about it later.

I never asked what happened, nor hung around the 50-strong crowd there at the scene. Got my gear, shook hands with the two guys who were part of the on-the-scene onlooker instant medical staff, and went back to my bike. I said thanks. They did, too.

With the seat up on my bike, my wallet was exposed, right there. Won't say how much was in it, but it was bigger than a breadbasket, but smaller than a plane ticket. All those folks standing around, nobobdy bothered it.

I never cried for any of my patients in Vietnam. Couldn't. Wouldn't let me. Not until I got home. Not until much, much later, like thirty-five years. After the initial suppression of shock and dismay, the rush of immediate involuntary response treatment, composing the patient, sending them off where somebody else will do the REAL work, there's a gully-wash of adrenaline that a smoke or a drink might calm, and then when you grow quiet and settle down, there's even time for a whimper and a tear.