Darwin Award Candidate

One night when I was in residency we got a trauma patient into the main trauma bay. The paramedics called him in as an "auto-ped", automobile versus pedestrian accident. We see these all the time but this one was different.

He's drunk and complaining about being strapped on the back board. When I say drunk I mean smell it ten feet away drunk. I mean spit in your face drunk. Turns out he can only speak Spanish. Now this is a fine thing this Spanish. Who would have thought that after 8 years of post graduate medical education that no one told us to learn Spanish. Would you travel to a foreign country to live and work and not learn the language? Evidently the answer for many is yes.

And by the way, don't let anyone tell you that there are people in this country who are denied health care. Don't even let them tell you there are people in the lower socio-economic classes that get sub par health care. If there was going to be one of those people this guy was the poster child.

You see, at 27 years old he had crossed the US border, probably many times, and made his way to my city. Some years ago he lost one arm in some way that I'm sure would be a great story, but we never knew how.

So Jose, as I will call him, was out on this snowy night drinking beers and tooling around in a beater car doing reverse donuts in a parking lot. I think he was probably driving with his knees because if he wasn't he wouldn't have been able to drink his beer (or whiskey or vodka or Listerine or Rain hair spray). His circles are in the counter-clockwise direction and force him against his door, and yes, the door pops open. Out pops Jose and Jose's car comes back around and runs him over. No shit. He was the first and last patient I will probably ever see who managed to run himself over with his own car.

Jose is met in the ED by the finest team of nurses, doctors, residents, interns, and surgeons. The same team that would have met him had he been Bill Gates on a bender. Jose spits on some of them and then vomits all over himself. He's pulling at straps and trying to take his cervical collar off. He's cursing in Spanish and is soon given "chemical restraint". At this time in our practice it was droperidol intramuscularly. We called it "nice juice".

Jose went up to the operating room where he got the best care in the city. Jose had no insurance. Hell, jose wasn't even a citizen. Technically he was an illegal. The people of the city swallowed his bill for him. I have no idea how he did. I will venture a guess though. If he walked out of the hospital he walked right to the bar and here is where I would like to give you a great pearl of wisdom. Ready? Okay, the best predictor of future behavior is past behavior. May God bless you Jose. In the ED we say God protects drunks and fools and you were therefore double covered by the almighty.

Finally, another little pearl of wisdom. If you are very sick and get brought into the ED be as mean an nasty as you can. Seriously. Mean people don't die.