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By Delbert Blickenstaff, M.D. 

I was an intern at Providence Hospital in Portland, OR, in 1956.  The Emergency Room, ER, was fairly active because we got most of the skiing and other accidents from Mt. Hood.  I was on duty one Saturday when some high school students came in with their injured friend.  They had been climbing on Mt. Hood, which is a relatively easy climb, when a girl fell and pulled several others down on top of her.  They had been tied together which is common for beginning climbers.  The girl complained of severe back pain and X-rays of her spine showed a compressed thoracic vertebra.  The patient was admitted and was treated with a full body plaster cast, hips to shoulders which was standard treatment. 

Some of my intern friends were invited to a duck hunting party on a farm owned by one of the Orthopedic surgeons.  I didn’t go because I was working the ER.  I was surprised to see a fellow intern walk in with an eye injury.  It was easy to see a black spot of the white part of his left eye and to surmise that it was buckshot.  He said that he couldn’t see out of his left eye.  Fortunately I remembered a lecture by an Ophthalmologist about taking X-rays of the injured eye to locate the buckshot.  The patient is asked to look up for the first X-ray and then down for the second.  Then one can determine if the pellet is in the front or the back part of the eye. 

About that time the Orthopedic surgeon who was hosting the hunting party walked in the ER.  He took one look at the intern’s eye, saw the black spot and said to the nurse, “Give me a spud and I’ll get that pellet out of there.”  I was stunned.  I thought what is an Orthopedic Surgeon doing operating on someone’s eye, but I didn’t say it.  Instead I said, “Excuse me, but I think that you should look at the X-rays first.”  He did, and when he saw that the pellet was on the back side of the eye, he didn’t touch it.  The effect of that accidental shooting was to permanently blind my intern friend. 

One day I was working on some records outside the ER when I saw a young man walk, or stumble in, white as a sheet.  I asked “What’s wrong?”  He answered “I just saw my friend decapitated.”  Wow!  How did that happen?  Here’s the story.  He was riding with his friend who was driving a low slung convertible, like a TR3, and they were going down a country road at night.  He was slumped down in his seat on the passenger side when they ran into a semi trailer that was parked across the road.  Their little car went under the trailer, taking most of the driver’s head off.  Our patient was not injured but he was really shaken.  I’m glad that I didn’t have to see the driver. 

This story did not take place at Providence Hospital, but it is a tragic story and it deserves to be told.  A college student was injured in an auto accident and was taken to the ER.  X-rays of her left leg showed a transverse fracture of her femur, the thigh bone.  The ER was very busy so she was placed in a spare room awaiting transfer to a regular room.  Her parents were called and when her mother arrived she was directed by the ER nurse to go to the fourth floor, room 410.  When the girl’s mother arrived at room 410 it was empty.  The distraught mother went to the nursing station and asked about her daughter.  She was told again go to room 410, and again the mother found it empty.  So she went back to the nursing station and asked the head nurse to come and look in room 410.  When the nurse found the room empty she said that the daughter must still be in the ER.  Finally, after two hours, the daughter was found in the spare room, unattended and unable to call for help.  That was only the beginning of the family’s trouble in that hospital.  I know because I read the patient’s hospital chart and talked to the mother. 

There are some emergencies that are so rare that we seldom ever see them.  A young man was brought into the ER at Providence in a comatose state with no history of trauma.  When I examined him I noticed a fruity aroma to his breath.  This sign immediately suggested diabetic coma, even though he was not known to have diabetes.  His blood sugar was over 500 mgm. % and the diagnosis was clear.  In my thirty years of practice I never saw another case of diabetic coma. 

I know that these stories don’t compare with the ER shows on TV now, but at the time my ER experiences seemed at times to be a bath of fire. 

Delbert Blickenstaff, M. D.