No Place to Hide by W. Lee Warren

Author:W. Lee Warren
Language: eng
Format: epub
Tags: ebook
Publisher: Zondervan
Published: 2014-04-01T00:00:00+00:00

“By published criteria, he’s unsalvageable,” I said, looking at 2185’s brain scan with Tim. We’d been working nonstop for three days, since the enemy was doing everything he could to discourage the citizens of Iraq from getting out the vote for their first democratic elections, scheduled for tomorrow. Now Tim and I were faced with a fresh batch of IED victims, and we had some tough choices to make.

We were almost out of ICU beds, and we had several Iraqi patients on ventilators who had such terrible brain injuries that we knew they weren’t going anywhere soon. The enemy didn’t seem to care that the hospital was full — he just kept blowing things up every day. In America, we would have simply let the trauma system know that we had no beds available, and they would have notified all the ambulance crews in the city to divert patients to another trauma center. That wasn’t possible in Iraq, since we were the only hospital other than Ibn Sina in Baghdad, and Ibn Sina was full too.

So here we stood, looking at the scan of yet another numbered Iraqi, trying to decide what to do with him. We didn’t have his story, didn’t know whether he was a terrorist, a merchant, or an Iraqi National Guardsman. We did know he was dying.

“We can keep him alive with a big decompressive craniectomy,” Tim said.

“Yeah, but he’s not going to wake up. Both frontal and both temporal lobes are hit. At best, he’s going to be vent-dependent, comatose, and he’ll be here forever.”

Tim shook his head and dropped into a chair by the CT desk. “I hate this part. Your call, though. I’ve got to do the American in a minute, if he survives his open heart surgery.”

Tim’s patient had an open skull fracture, and part of his frontal lobe was exposed. The Army lieutenant had been ambushed with his unit and had taken a bullet to the forehead, along with two that had hit him in the seam of his body armor, both of which had gone through his heart. Todd and Mike were working on him, and if he made it through that, Tim would clean up his brain. The bullet must have hit the lieutenant’s helmet first and lost some of its energy, because his brain injury was really pretty minor. My patient’s was not.

“I hate it too,” I said, while the last few images scrolled across the screen. A sour taste rose in my mouth — the foul taste of chewing on two equally unpleasant choices.

Back home, when I had a patient whose injuries were neurologically devastating, I would leave the choice to the family. We’re very good at keeping people alive, I would tell them, but the brain injury itself determines how much of a person we can actually deliver back to them. With aggressive surgery, I can often save someone’s life despite the severity of the injury, only to commit the family to many years of breathing machines, feeding tubes, and long-term-care facilities.

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