Tuesday, March 31, 2015

Corpsman Chronicles IV: Major Major Trauma

I stopped by the local junior wallyworld yesterday to see if they'd kept their promise to restock the La Croix lime flavored sparkling water. They hadn't.

Walking back toward the front of the store I passed along the donut/cookie aisle and was surprised to see a rack of Hostess fruit pies. For some reason the thought of Hostess pies snapped me back to 1969.
1969 magazine ad

There was a little Ma & Pa grocery store just a block north of the school. Emerson Grocery. It was more of a shack than a store really; it had been converted from a granary, probably sometime between The War to End All Wars and The Sequel. Now before you guffaw too much, there are a good 60 homes in Kimball that began life as granaries. Back in the 20's and 30's becoming a home was not out of the reach of a hard working, savvy granary. Some granaries even hit the big time and became proto-convenience stores.

Anyway, back in 1969, whenever I managed to scrape up a dime, I'd head over to Emerson Grocery and get me a pie. Chocolate was my fave (and not exactly a fruit pie, eh?) but sold out the fastest. I usually had to settle for apple. Which was fine. With nine cents expended on the pie, I had a penny to whack in the gumball machine on the way out the door. Big red and purple gumballs. Cinnamon and grape. I loved the grape. Usually got cinnamon. Which actually paired better with apple and even chocolate Hostess pie. Life was good in 1969. A dime was worth 70 cents in 2015 bucks.

1969. Remember it well.

Well, not Woodstock exactly. I do, however, remember July 20.

We watched the coverage on the neighbor's color television; black and white moon video on a color tee-vee. A bit of a giggle, perhaps, for 2015 hipsters. But. It. Was. The. Moon. Landing. Let's see the 2015 worldwyde interwebs top that.

I remember the six weeks leading up to the moon landing also. I'd managed to catch a batch of impetigo, probably from, as the local Marcus Welby put it, "playing with those filthy Mexican kids."

Wasn't very PC of ol' Marc, now was it? He was right on the diagnosis, though, and right about the Mexican kids. They were filthy. Taught me to cuss right proper, a skill I rely on to this very day. They also gave me, indirectly via the S. Aureus  infection, an opportunity to grow a pair and man up about getting injections.

Because that was the cure for impetigo. Penicillin in the butt, once a week, for six weeks. The first go was a train wreck. I howled and fought and wasn't too proud to scream. The nurses ran off to "fetch Doctor," and Doctor was pissed.

But ol' Marc (no, he wasn't really Marcus Welby) pulled a neat trick on me. He treated me like a person rather than an object. Laid the cards on the table and let me work through the options. I didn't want to get the shots, but agreed that it was the proper course to take. Probably the first grown up decision I ever made. The genesis of "suck it up and drive on."

And now we flash forward to Major Major and his major trauma. In my usual disjointed and highly unreadable style, I'm gonna flash forward a bit too far to get the Major's unofficial call sign out of the way.

The Major, who will remain nameless and who will certainly have a different recollection of some of these events, was an Air Force F-15 driver. He came to the squadron as a Captain on an exchange tour. He was a great guy in my book and spent some time as my division officer. He also ran the squadron fat boy program for six months, and like every other fat boy officer, wanted to sign me up when her reviewed my record and saw five-eleven and 210 lbs. The book, you see, said five-eleven was s'posed to equal 180 lbs. and not a single pound more.

I was genetically blessed with massive, tree-trunk legs and rather more muscle mass than average. Low center of gravity. Wide track. Can't knock me down, even today in my advancing years. Which is not to say that I'm unfamiliar with the ground. I just get there on my own. But I digress.

The Major (then Captain) told me I was overweight, and I sucked him into my usual trap. "0500, Sir. SAR Hangar, wear your running shoes." If I could run the fat boy officer into the ground the squadron could waive me. I never spent more than 12 hours on the fat boy program, and this was no exception.

As you might imagine, the Major, as a Captain, was subjected to a good deal of ribbing from his steely-eyed Navy fighter pilot brothers. They hung the call sign "Tweet" on him. He was fine with the moniker, which stung his bros almost as much as his perennial position as near-top performer on the greenie board.

But again I digress. The Captain was promoted to Major in due course, right in the middle of his second cruise. One day the snooty squadron PN1 (E-6 Personnelman) was sucking up to him in the ready room and tried to address him by rank and name. Should have come out as "Major Smith" (nope, that's an alias) but came out "Major...Major."

Well, the ready room erupted in glee, and from then on, he was Major Major to the crowd who'd mostly never heard of Joseph Heller and had no idea that Catch-22 was a movie, let alone a novel. Being the most un-Major Major-like Major Major of all time made the whole thing a delight. It was really kinda neat. Good memory. But another digression.

Yo-yo back to Major Major as Captain Tweet. Easter Sunday. 1983. We'd only been back from deployment for a couple of weeks and I'd taken up my usual job in the NAS Oceana Branch Medical Clinic Emergency Room.

I had the duty that day as I'd traded with a married fellow so he could drink beer and grill steaks go to church

At about 0830 the ER doors whisked open and Captain Tweet dashed in, blanket-wrapped bundle of bloody little girl in his arms, distraught wife in tow. He was beside himself and deep in the throes of panic. He retained an edge of sanity and reason, but was clearly very close to losing it completely.

After you've worked in trauma for a while, you get a sense of the difference between "emergency" and "urgency." A key indicator can be stress and panic. I knew Captain Tweet as a pretty darned unflappable fellow, so his panic put me immediately in emergency mode.

As I grabbed the five year-old child and hustled her into the treatment room, the Captain filled me in with one of the most remarkable sentences I've ever heard, which went something like this:

"We were ready for church but Cynthia went back in the house for a different purse and Abby and I were pushing the swing back and forth and I swung it too hard and she missed and hit her in the head and cracked her head open and I can see her brain in there oh please Doc is she gonna make it can we medevac her or something she was fine one second and now just look at her oh my god..."

I guess you kinda had to be there, but replaying that scene in my mind 32 years later brings a lump to my throat and a sting to my eyes. Daddy Tweet loved his little girl more than anything else in the world.

While the Captain vented I went into automatic assessment mode. The little girl was conscious and alert, very quiet, and obviously very frightened. She looked at me from big blue eyes which featured a neat round hole right between them, just at the top of her nose. About the diameter of a nickel, it was gaping open and appeared to be very deep. With the illumination of the overhead light I could see glistening connective tissue at the bottom of the hole, about a centimeter down. The wound had already stopped bleeding.

I breathed a sigh of relief and offered up a quick prayer of thanks. The little girl's injury looked horrific but was really superficial. The skin and muscles are in tension on that part of the face and even the most minor laceration there will often gape and look awful. Bleed a lot, too. But looking awful is not the same as being awful. I could fix the gaping wound with a half-dozen stitches and in two weeks time she wouldn't even have a scar. It would be easy and nearly painless. The real trick would be to keep Captain and Mrs. Tweet from going into shock and Abby from giving into the fear her Daddy's panic was causing.

I turned to the cute little HN (E-3 Hospitalman) who'd assigned herself to be my assistant for the day, and said, "Get Benny, please."

Benny was the ER Physician, a Lieutenant Commander, Flight Surgeon, and trauma specialist. As the cute HN hustled off, I winked at the little girl and got just the ghost of a grin in response. We were gonna be okay. I was already more worried about Mom and Dad.

Benny arrived, speed-read the chart, took in the scene with a longish glance, noted my slight head bob and eyebrow lift toward the parents, and took them in tow.

I turned to the little girl and said, "You didn't want to go to Sunday school anyway, did you?" I got a more confident grin in return. Over the next five minutes Abby and I negotiated a contract. She had a boo-boo that needed to be fixed, and it was going to hurt a little bit at the beginning, but I'd keep the pain to a minimum. She would be in control of the process and I would stop whenever she wanted. We agreed that Mommy and Daddy were very scared for her and that she could help them by being a big girl.

The cute little HN came back to help, and we were soon ready to proceed. I spent a lot of time explaining everything to Abby and getting her in a comfortable position. I cleaned up the wound site and carefully painted it with betadine, taking care to keep the bacteriostat out of her eyes. I swabbed the wound edges with a sterile topical anesthetic solution to keep the pinch of the needle minimized, then carefully infiltrated the tissue with two percent lidocaine, I used a dental syringe and a very fine 27 gauge needle. Abby tensed up just a tad at the sting of the lidocaine but quickly relaxed as the pinch abated.

I scrubbed and gloved while the cute little HN set up my suture tray. Abby and I talked about five year-old stuff. I learned that Abby was short for Abigail, that she didn't like to wear a dress, that the Easter bunny isn't "real like Santa," that the swings get bird poop on the seats, and that she was learning to read and could count "to a hunnerd frontwards." She thought my clinic nickname, Mikey, was "kinda silly." She'd seen the commercial, and it was about a little kid.

As we chatted away I tucked an eye drape in place and charged my needle holder with 5-0 chromic. I kept up a running explanation of what I was doing as I pulled the subcutaneous tissue together with three quick interrupted sutures, then switched to 7-0 nylon and closed the skin with three more simple sutures. Took about 10 minutes.

Off came the eye drape, followed by a careful cleanup and a dab of bacitracin ointment.

"So what do you think," I asked, "was that as bad as you thought it would be?"

Abby's eyes got big. "It's done? Can I see?"

I walked her over to the little treatment room head and lifted her up so she could inspect my work in the mirror. The laceration was now just a thin line on the bridge of her nose interrupted by three tiny black knots trailing six tiny black whiskers.

"You can come back on Wednesday and I'll take the stitches out."

"Will it hurt?"

"It'll tickle," I said.

"Okay, I gotta go potty now."

A flush and a hand  wash later and I pointed Abby toward Benny's office. She skipped (literally skipped) off to show Mom and Dad her stitches. It was a good thing she'd hit the head first, because she got hugged pretty thoroughly.

I got to do a lot of enjoyable and satisfying stuff as a navy corpsman. It would be silly to rank those things on a list, because my experiences were so varied. But some of my most cherished memories are of fixing boo-boos in the ER. For whatever reason, I seemed to have a natural talent for connecting with kids, and when I was on the beach I was always more or less the go-to guy when a youngster needed a shot or an IV or stitches or some other scary and potentially painful procedure. Maybe I got it from my experience with Marcus Welby. All I ever did was be honest and up front with the kids and I always dealt with them as people rather than as squirmy, bawling abstractions. Seemed to work.

By the time Tweet and Cynthia and Abby headed out the door, the cute little HN was fixin' to whip a move on me.

"I can't believe that little girl let you sew her up with no fuss at all," she enthused.

"Guess I've just got a way with the ladies," I said.

Which the cute little HN was willing to believe.

And which elicited a deep belly laugh from behind the almost closed door of Benny's office.

Life was good in 1983, too.


  1. Man, can you tell a story!

    I will read one of your posts and ask myself "How's Shaun gonna top that?" Then I read your next post and there ya go, each better than the last, all just really good stuff.

    You have the knack my friend, you have the knack.

    (Isn't it amazing how easy it is to get along with kids when you treat them like humans? I like to think I have that gift as well. Or maybe it's because I never really grew past twelve? Kid at heart, that's me.)

    1. Thanks Sarge, very kind words. Those tend to keep me going! ;)

      Worst thing that can happen to a kid is to get too grown up. Life tends to suck for the too grown up.

  2. Believe it or not, one of the guys from my Holloman squadron was an F-15 Driver and went from Holloman to an exchange tour with the Navy. That would be WAY too cool of a coincidence. But it would have been around 85 though.

    1. Tweet was there from mid-'82 through mid-'84. Super guy and very well liked and respected. I'm drawing a blank on his Air Force call sign. When it comes to me I'll let you know, you probably knew the guy.