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The hospital is practically empty today, the start of a four-day weekend occasioned by Columbus Day falling on Monday. Empty of ancillary staff and non-essential personnel, that is, but certainly not of patients. I started the day with only one patient in-house, a man whose kidney I removed on Monday last, and made arrangements for him to be flown to San Antonio, Texas, to be closer to family. But I knew my case load would grow when I heard the overhead page call for "All available manpower" to report to the Emergency Room. While not code, it is a verbal signal that another planeload of patients has just landed at nearby Ramstein Airbase, and we could expect their arrival here at Landstuhl in an hour or less. A plane arrives from Baghdad or Balad or Kosovo or Kandahar every day, if not more frequently, and it takes all available manpower to lift the stretchers off the buses and load them onto hospital guerneys. Sure enough, two of the patients were mine. One had sustained a spider bite to his privates that festered into a raging abscess which then required incision and drainage and further intravenous antibiotics. The other was a young soldier who couldn't urinate, even though he had no history of infections or trauma. In between admissions, I saw an inpatient on the psych ward -- a very manic man who spoke so tangentially that I gave up on the idea of traditional history-taking in favor of the "gestalt." The most memorable patient of the day was a 21 year-old lieutenant shot by a sniper as he tried to help two other wounded soldiers in his unit. The bullet had penetrated his buttocks, missing all vital structures, and after exiting his thigh it went through his non-dominant left hand. This morning he was up at his sink, trying to shave, but with the bulky bandage on his hand he couldn't open the shaving cream can or remove the cover on the razor blade, so I lent a hand. He told me the story of the ambush, and how ironic it was that the village they were patrolling was called Hit. He left this morning for the long flight to Walter Reed Hospital in Washington, where a hand surgeon awaits him. Gotta go. |