I work as an emergency physician in the emergency department at a Level 1 trauma center. Because time is of the essence, when we get a trauma into the ED, they are automatically deemed a Doe – John or Jane. Due to the number of traumas we see at our trauma center in a given year, another word gets added to the Doe to make them easier to identify. It can be a random word, or a color, or call signs, or animals. We’ll then add on a sequential number because the words get reused over time. So their final identifier name will be something like John DoeChameleon231, and that’s their only identifier during their hospital course until they’re discharged. Their real name gets linked somewhere in the medical record so that later on, when (if) they get discharged, we can write prescriptions, put in their follow-ups, etc. They also all get the same birthday 01/01/1880. Why it’s set in 1880 I couldn’t tell you because even our oldest patients (aged 101 is the highest I’ve seen) couldn’t have been born any earlier than 1924.
Still.
Today I worked on a Doe. I can’t tell you anything about them except for the fact that they were broken (like, all over broken): broken head, broken face, broken neck, broken leg, broken on the outside and broken on the inside. EMS found them on the side of the road, so no one could even tell me how they got so broken. Other than how they were at the moment, I didn’t know anything about them.
What I did know was that they needed emergency surgery to fix the bleeding going on inside of their belly. But no surgery would fix the bleeding in their brain which was already causing cells to die. Surgery probably wouldn’t fix the problem with their neck, although I’m sure there will be some kind of procedure to stabilize it, if they survive. For now, the C-collar would have to do. And, sure, their leg could be fixed with pins and rods, but even so, I’m not sure they’re going to be able to ever walk again to get the true benefit of the repair. That neck injury was pretty severe.
All I know about them is what I have in front of me, and I try to figure out what I can fix, help fix, or help my colleagues figure out what needs to be fixed. As I look down on this person who had woken up that morning and got on with their day, until they somehow ended up here, I despair. It’s these shifts that make me sad because there are some things that just can’t be fixed despite our best efforts. Those are the Does that I carry home with me to dwell on. Some of these Does, like the one from today, are added to my personal cemetery. Not because of something I did, but to learn from. And there they remain. Anonymous. DOB: 01/01/1880. Maybe older there than they’ll ever get to be here.
Veronica Bonales is an emergency physician.
