Triage Two-Step

At some point on Sunday, just one day after being released from Hospital X, I returned to Hospital X's emergency room entrance. My wife quickly procured a wheelchair and either wheeled me inside or had me wheeled inside; I'm not quite sure which. In either case, my job from that point on was simply to sit in the wheelchair, hold onto my walking cane, and wait to be called back for triage.

Around 30 minutes passed, according to my wife, and I had yet to be seen by any of the ER staff. I realized at that point that I was going to have to use the restroom if the wait stretched out any longer, so my wife wheeled me over to the nearest one. The bathrooms near the ER at Hospital X are of the unisex one-person-at-a-time type, and I learned by trying to open the door that the one I wound up at was in use and its door was locked at the time.

I remember my wife saying, "It's locked," followed by the sensation that she had moved me slightly away from the door. For some reason that I do *not* remember, I felt the need to get out of the wheelchair and try the door handle again. I stood up with the help of my walking cane, determined once more that the door really was locked, and then turned away with the intent to move out of the path of the current restroom occupant once they were finished with their business.

Now, if you've ever experienced the sensation of blacking out while still being aware of things that area going on, you might partially understand how I felt in the seconds that followed. However, you'd also have to understand what a tree probably feels and hears when two of its major branches break off in order to fully comprehend how I felt. In any case, my vision suddenly went to black and I had a sensation of falling, accompanied by the *feeling* of a snapping, cracking sound moving through my body to my ears.

The next thing I remember is being on the ground and hearing my wife gasp in horror:

"Oh my god! His ankle's broken!"

Close, but not exactly right. Both of my ankles were broken.

I had apparently slumped against a wall behind me and fell, just like a tree, to my left. As I fell, both ankles snapped as if my shoes had been glued to the floor. Unfortunately, neither my wife nor anyone else saw exactly what caused me to fall, so no one really knows if I passed out and fell on my own or was knocked over by the man and his 4-year-or-so-old daughter who had exited the bathroom as I was turning away.

I passed out before I could hear my wife yell at the man to hurry and get help. I regained consciousness only long enough to hear a nurse call, "Rapid response to ER...Rapid Response to ER," over the hospital intercom, then blacked out again until someone started moving me around. I remember knowing that I was in intense pain at the time, but my mind had disconnected itself from the sensation to the point where I don't remember what the pain felt like. My wife tells me that I'm lucky on this point.

During another brief moment of consciousness, I recall being moved onto a body board. I also remember someone cutting off my pants so that they could get to my legs for an examination. I somehow gathered up enough brainpower to crack a joke about needing to go shopping for new pants again, since they were cutting off a pair I'd just purchased a few days earlier.

The last sequence of events I remember in the hallway began with a nurse telling a doctor that my blood pressure was 60 over 20. Normal blood pressure is usually near 120 over 70, so 60/20 meant I was losing blood, and losing it badly somewhere. The doctor got her to re-check, and she still came up with 60/20. He thought for a second and then flew into action, ordering up IVs of fluids and blood.  When the nurse asked what flow rate she should use, he told her to "flood" me since I was obviously running several pints low.

I have no memory of what happened from this point until I woke up in the Intensive Care Unit. Again, my wife tells me I'm lucky and that she has no intention of refreshing my memory on the matter. She *did* take a photo of my badly broken ankles while in the ER, though. When a nurse asked her why she did that, she said that I would want to see what they looked like.

Damned right. Anything that would cause as much trouble as they would absolutely required documentation.