It was January 1, 2000, and I was an intern in emergency medicine at the University of Arkansas for Medical Sciences.

I had gone to sleep the night before listening to celebratory fireworks and congratulating myself for surviving Y2K.  Now I was walking into the emergency department of our large, level 1 trauma center where I was furthering my medical training.  Like most urban ERs, this one was a busy place filled with the sights and sounds of the organized medical chaos that occurs in these locations, and I was a young trainee, six months out of medical school and reveling in the opportunity I had to learn the skills of my trade.

As soon as I walked through the door I was assigned my first patient.

“Hey, Bledsoe,” said my chief, “go into room one and sew up that patient’s thumb.”

I made my way into the room and found a middle-aged woman sitting on the stretcher.  She had a large laceration to one of her thumbs.  She was quiet, and sniffling a bit, an emotive state that I assumed was from the pain and shock of receiving a significant cut.  We exchanged pleasantries and I began to close the wound.

During the course of the procedure I made small talk with her.

“How’d you get cut?” I asked.

“My husband,” she replied in a very matter-of-fact manner.  She didn’t seem too eager to discuss the situation so I avoided it and talked about other things.

When I was finished she thanked me, and I said something about hoping the rest of her year turned out better than her first day.

She didn’t reply.

I left her room and made my way back to where my chief was working on some charts.  En route I happened to pass by the large trauma rooms in our ER where we resuscitated our most ill and critical patients.  From the doorway I could see a body lying on the resuscitation table covered by a sheet.

“Did you get the thumb closed?,” my chief asked me.

“Yeah, I did,” I replied.

Curious about the body in the trauma room I couldn’t help asking, “Who’s the guy in there?”

“Oh, him?  That’s her husband.  He came at her with a clever but she got him with an icepick right to the heart. He was dead when he got here,” he said.

If I ever had doubts about the depths of the problems in our society, they ended that morning.  My first patient of the new century was a woman who killed her own husband with an icepick to the heart.  By all accounts it was an act of self-defense — so I wasn’t blaming my patient for doing what she had to do to protect herself — but it did serve as a memorable testimony to this young physician of the level of dysfunction we had in our society.

Gregory Bledsoe is an emergency physician who blogs at GH Bledsoe.