I assumed the traffic congestion
was due to construction. But when I got to the intersection,
I saw a tipped-over motorcycle and people directing
traffic around a man lying in the middle of the street.
I'm a doctor now, and if I don't
stop, who the heck will?
The people around the accident
were not overly concerned. "His bike looks ok," said
one fellow but shrugged when I asked how the driver
was.
There was no gushing blood, no
waywardly twisted limbs or foreign objects protruding
from the driver's body. He was lying quietly on his
side, a jacket under his head. There wasn't much drama.
Still, the mechanic beside the driver was visibly relieved
when I told him I was a doctor. "Oh good! You can take
care of him then," he said as he left to direct traffic.
I racked my brain recalling what I learned in third
year med school about trauma situations.
"Hello, sir, I'm a doctor in Edmonton.
You in any pain at all?" I asked loudly.
"Just my leg here," he said.
Airway check. Breathing check.
"Any pain in your head or neck?" Nope. "How about chest
pain?" Nope. There were no obvious sources of bleeding
and his pulse felt normal, so circulation was also a
check. ABCs done.
After finding him to be oriented
times three, I asked him what happened. He told me that
he braked too hard trying to avoid hitting a van and
ended up flipping over his bike. Finding no other injuries
after a quick pat-down, I told him to keep still. Then
I sat and waited with him until the paramedics arrived.
JACK-OF-ALL-SPECIALITIES
I was glad — and relieved — I was able to
handle the situation. It's important to me to be in
a speciality where I'm comfortable, or at least competent,
at managing any medical problem.
If someone at the accident scene
were to yell, "Call a doctor!" they wouldn't care what
kind of doctor they got. But would a radiologist or
medical microbiologist have the skills to manage the
situation?
I don't know.
As a med student, I asked a cardiology
fellow if he would know what to do if a pedestrian was
hit by a car and broke his leg. He replied, "I think
it would be a great failure of medical education if
doctors couldn't perform basic first aid."
Then again, there was that time
I slammed my finger in my car door rushing to an oncology
lecture. I happened to run into a friend who was a hematopathology
fellow. "Hey, Ian, can you take a look at my finger?
Should I bother waiting in the emerg to get it looked
at?"
He backed away nervously, not even
glancing at my bloody gash. "Ooh, I don't know. That's
not my area. You should probably ask someone else...."
Then there's the story I heard
about two doctors who identified themselves to the flight
crew on an airplane during a medical emergency. One
was a pathologist, the other a psychiatrist. They looked
at each other knowing that they were both outside of
their comfort zone.
With their combined expertise,
along with radio contact with the ground physician,
they were able to deal with the emergency. Almost as
importantly, their presence and credentials gave passengers
and crew the impression that the situation was under
control — though to what extent no one will ever
know.
We're being pushed more and more
toward specialization while at the same time the public
expects doctors to have the basic skills to deal with
any emergency. Should we maintain a set of core competencies
throughout our careers regardless of what speciality
we pursue?
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