19:20, NY-Presbyterian, Discharge…

The CT scan complete, the gurney and I headed back to the ER.

With head injuries, the Dr. will order a Computerized Tomography (CT) scan which is a test designed to detect a cracked skull or a serious brain injury; a concussion, bleeding, or aneurysm. With IV contrast, adding a special dye called contrast helps highlight areas of the patient’s body being examined as the contrast dye appears white on the images, emphasizing blood vessels or other structures.

The laceration on my forehead felt tight.  The bleeding had stopped.  They were waiting on the results of the CT before using stitches to close it.  I needed to take a “break” so I leaned over the side of the gurney and caught the attention of someone at the medical staff’s station about 18″ to my L.  I had not tried to stand or move off the gurney since I was wheeled into the ER.  She said she would get my attending.

The Dr. had given me a sedative and something for the pain I had in my back and neck when I was first admitted.

“Touch your nose with your left hand.” I did.  “Make a fist, resist as I push it to the right.  Now the left.” I did.  “Can you stand?” I moved away from the gurney just far enough that it would act as a pillow and catch my fall if I couldn’t stand.  I stood,  flat, both feet and didn’t feel I would fall.  “Can you rock toe to heel?” I laughed.  There is a reason I’m in Finance and not performing in Circ de Soleil, I nearly blurted out.  I did, with an uncoordinated balance, rock toe to heel.  He had an attendant support my left side and walk me to the lavatory.  The Dr.’s evaluation was that I seemed to be having “spasms” in my back, likely set in motion from the trauma. He instructed me to follow-up with my own Physician as since he didn’t see anything life threatening, he was not going to treat me further.

When I arrived home, my gurney, there was a Dr. waiting for me.  He had arranged what looked like a bed pan, gauze, sterile solution, and surgical gloves on a sterile pad on the top counter of the medical staff’s station.

He introduced himself and started to apologize.  He asked if I would be okay with him cleaning my forehead and laceration, suturing the incision, right there, in the middle of the ER.  “I’m sorry.  We don’t have any open rooms.  It won’t take long.  I just need you to lean to your right while I cover you with this (a sterile apron) and if you could help me position this under your chin (the bed pan), I can get started.”  I’ve been told that as you age, scars add a kind of maturity, an air of sophistication and even sex appeal. I thought, the worse case scenario is that I will get the starring role in the next local production of Frankenstein.  I wasn’t going to be America’s next top male model.  I told him yes, go ahead.

The sterile solution flowed down my cheek.  It was so cold.  I shivered.  It collected in the pan.  He used a numbing solution before he started suturing. I watched his hands gently loop the surgical strand back and forth as a “sewn seam” emerged just below my hairline. He had closed the incision.  I watched, within inches of my gurney, two more patients being rolled thru and lined up against the wall behind me.  They weren’t getting rooms either.  They had arrived at their destination.

The CT scan was clear with exceptions.  Behind my right retina, there was a small mass which after examination and further diagnosis by the Retina Surgeon and Ophthalmologist, was thought to be an imperfection on the film.  They were both very thorough and mirrored all the actions of my own Retina Surgeon.  I was comfortable with their evaluation as I was all too familiar with what too expect if there had been any damage to the retina.  The other exception was discussed with my attending Dr. and another Dr. which I hadn’t met.  There was a mass in my soft palate.  It wasn’t significant in size but it was of concern.   I would need to follow-up with an Oncologist and explore this further.

“Do you have any other questions for us?”  I did.  I had so many.  I was decorated in gauze, was tired, and although I knew an Oncologist was a physician who will diagnosis and treats cancer, wasn’t up to speed with my soft palate.   My eyes were safe.  The flow of blood had been stopped.  But, I hadn’t had anything to eat or drink since breakfast and I was tired.  Had I missed the rules of a soft palate?  Was I only concerned with learning that the face seems to always bleed the most?

The role by definition of the ER is to treat patients who are suffering from an acute serious illness or injury that would lead to severe complications if not treated quickly.  It is not designed to provide ongoing care.

“No, I do not have any more questions.  I will follow-up with my own Physician.  Thank you.”

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