It was a beautiful Spring day. My wife and I were returning
from UNC-Chapel Hill after visiting our oldest son. Driving on Highway 54, I
suddenly saw a young woman on the left side of the road frantically waving her
arms and screaming. Behind her, a pickup truck had crashed into a tree. I
immediately stopped the car. That’s when I saw him. Lying, unmoving, on his
back was a young man in his 20s. I quickly ran to him. He had significant head
trauma. There was a large, gaping, right parietal skull fracture. His brain
exposed. He was bleeding from his nose, mouth, and ears. Surprisingly, he was
breathing and had a pulse. A few feet away, his girlfriend screamed hysterically
as my wife tried to calm her.
A woman appeared on
the opposite side of him, quickly saying she was a nurse. At that moment, he
stopped breathing and what was real suddenly became surreal. What do I do? Do I
start CPR knowing I would expose myself to his blood and the potential risks
that carried? Do I do nothing and let him die, his distraught girlfriend
standing over me? Memories of the scores of HIV infected soldiers I cared for
in the Army during the mid-1980s came flooding back to me. All died horrible deaths
from AIDS. I had to make a decision. Everyone was waiting - the young woman,
the unknown nurse, my wife, and now several newly arrived bystanders - all
waiting to see what I would do.
I gave him two
breaths. The nurse started chest compressions. With each breath, my blood
exposure increased, yet I continued. Why? That question came later. Later,
after the EMS arrived and took over; after a kind woman took me to her home to
clean off the blood; after I returned to the site - the man, the girlfriend,
the ambulance no longer there; after the surreal became real again. Did this
really happen? My thoughts returned to those soldiers….
From my car, I called the ED at the hospital where I worked.
I relayed what had happened to the ED physician, a good friend. He was waiting
for the patient to arrive as EMS had called with their report. He told me they
would do all they could. He quickly added he would get the necessary blood tests
and call me as soon as they returned. As I waited for his call, my thoughts
went back to my family. Any fear or anxiety for myself were replaced by fear of
what this could mean to my family should I become infected.
Did I do the right thing? Does a patients’ needs come before
our families, ourselves? My years of education, training, and practice said
yes. What would my family say? My wife was there. I did not ask her. I just did
it. I believe I did the right thing. I would not question anyone for choosing
otherwise.
The call came. He
died. His HIV was negative as were subsequently all the other tests. The next
day I bought a portable CPR mask to keep in my car.
Andy Lamb, MD
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