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Late on April 21, 2006 I received a call from my son’s cell phone; it was not him, it was a social worker at the University of Michigan’s ED who picked up Alex’s phone and hit redial. “Do you have a son named Alex? He’s been in a bad car accident, can you come right down?” Countless times I have been on the other side of that phone call. I always imagined what it must be like to receive it; now I know. As emergency physicians we try to never tell someone over the phone that their loved one has died. Get the family to the ED first. This knowledge served to increase the fear and anxiety that Marion and I felt rushing to get up, rushing to the hospital and brings tears to my eyes just in the recollection. When we got to the ED a number of the attendings and students recognized me and their discomfort was palpable as they themselves seemed to vicariously feel what it was like to be on the other side. We found Alex intubated and on a ventilator. By then his injuries had started to be catalogued: Intracranial bleed, diffuse axonal shearing, fractured C3, sinus and orbital floor fractures, blood loss from major scalp and facial lacerations. Alex was having decerebrate posturing which seemed to increase as time went by.
Talk with the neurosurgery resident of a ventriculostomy was put on hold when Alex seemed to show some subtle improvements but I could not stop myself from thinking about how I could possibly cope when they ask me for organ donation signatures. Twenty years of hopes and dreams seemed to be shattered. During the next two days in the trauma ICU we dealt with a steady stream of grieving friends and an uninjured, responsible, teenage driver who sobbed and cried by Alex’s bedside for almost 24 hours before we insisted he leave to get rest. The second night Alex showed some purposeful movement and then the next morning, he woke up. Completely. He was extubated, pulled his own feeding tube, sat up, and demanded to go home. The following morning he was indeed discharged, not from the ICU, but from the hospital. He walked the two blocks to the car himself. Decerebrate to walking home in less than three days! Now at home, I cannot minimize his discomfort as he contends with bruises and broken bones and the inevitable feeling of self sorrow, but…my God…he can feel!
My family and my son were astoundingly lucky, to the point of giving meaning to the word “miracle.” I was able to see and feel what we as providers do from the perspective of our patients and their families.
Used with permission by EPMB.
Charles Grassie, MD