1.) BACKSEAT SAFETY BELT

A Brave Little Girl

I think she was 11 or 12 years old...

She was sitting in the back of her dad’s car on their way back from a family holiday at the coast. Her dad always insisted that his kids wear their safety belts even in the back. This is commendable in a country that is very ignorant to the importance of safety belts. But his daughter had pulled the shoulder harness under her arm so that the safety belt, that was supposed to be over her collar bone, was instead spread out over her stomach. Many kids do this—it’s more comfortable.

The force of the accident was supposed to be distributed evenly over the strong bony parts of her body. It would still hurt like hell but safety belts are designed to save lives and they do if used properly. This simple act for the sake of comfort decreased the surface area of where the force could be distributed.

After what seemed to be a low impact “T-Bone” accident (when a car’s front crashes into the side of another car usually at intersections) she complained of severe abdominal pain. The force of the accident transferred into her soft stomach and crushed her abdominal organs. She did not have any obvious injuries yet her father wisely took her to the nearest local clinic.

The doctor at the small clinic performed an examination and X-rays and realised that his patient was in a critical condition. To the untrained eye she would seem fine; no bleeding, no fractures, just pain and her skin getting paler and the light in her blue eyes fading. But she had severe internal bleeding that only a well equipped theatre could deal with.

The doctor contacted our emergency control room and the best plan of action was discussed with him. The clinic was too close to fly to and too far for them just to wait for the relatively slower ambulance to arrive. Her spinal cord was cleared of any injuries so the doctor decided to load her into the back of his Mercedes and we would meet him and his patient half way.

After about 20 minutes of responding (driving with lights and sirens) out of the city, we finally saw the Mercedes approaching, frantically flashing headlights at us. They pulled over to the side of the road and we did a u-turn anticipating heading back to the city.

The little girl was lying in the back seat of the car with her mother. I switched into paramedic mode when I realised the severity of the patient that was now handed over to my care.

I asked the worried mother to sit in the front passenger seat of the ambulance next to the driver and the father sat in the back with me. The little girl was still conscious but showing signs of fatigue. She was surprisingly calm. Her lips were mottled grey and her blood pressure was too low for her age, signs that she was in hypovolaemic shock (loss of blood). I needed to put a second drip up to replace the lost fluids. I don’t have all the medical reports with me and they aren’t in my head. I do remember weird things though, like her long blonde hair that was much like my little sister’s hair when she was that age.

She was so brave. I kept on telling her, “You are such a brave girl, I’m so proud of you.” She barely winced when I put up the second drip. This was yet another ominous sign. The ECG blipped, the O2 saturations were good, the drips were up, and the blood pressures were being automatically taken. There was little else I could do so I just held her hand in mine and asked her about her school and she told me about her younger sister. I remember how the father was sitting uncomfortably on a blue box used for storing oxygen devices near the head of the stretcher. With his one hand he tried to console his daughter in front of him and the other hand was holding his wife’s hand behind him.

Despite the fact that she had needles in both her arms and that her stomach was painfully hard from the swelling the only thing that made my patient uncomfortable was the oxygen mask and she repeatedly told me. I landed up getting the dad to hold the mask to his daughter’s face so that the elastic band wouldn’t have to go around her head. She was never comfortable with that mask in front of her face but I needed to get as much oxygen as possible to her desperate body.

The driver got us to the hospital quickly but safely with minimal stress, the way I like it. It’s no use getting into yet another accident.

The surgeon on duty was one I had respect for. We had never chatted much but I had heard a lot about him and I got the feeling that he was confident about his abilities but at the same time realistic about the limitations in medicine – a rare find in doctors. Over the years I had become quite cynical but this doctor was gentle and humble.

My young patient died on the operating table a few hours later.

I went to her funeral the following week. It was the first funeral of a patient I had ever been to. I haven’t been to another one since…

The pain in me right now is very real. I’m at work blinking away my tears. I don’t want the guys here to see me now.