Emergency 911 – The Two Faces of Urban Medicine
“Call 911!” I shouted to my friend as I sprinted down the street. The young Caucasian male had been thrown fifteen yards from the site of impact and surprisingly was still conscious upon my arrival. “My name is Michael. Can you tell me your name?” In his late twenties, he gasped in response as his eyes searched desperately in every direction for help, for comfort, for assurance, for loved ones, for death, until his eyes met mine. “Flail chest”, I thought to myself as I unbuttoned his shirt and placed my backpack upon his right side. “Pulse 98, respiration 28 short and quick.
Help is on the way. Hang in there buddy.” I urged. After assessing the patient, the gravity of the situation struck me with sobriety. The adrenaline was no longer running through my veins – this was real. His right leg was mangled with a compound fracture, and his left leg was also obviously broken.
The tow-truck that had hit him looked as though it had run into a telephone pole. Traffic had ceased on the six-lane road, and a large crowd had gathered. However, no one was by my side to help. “Get me some blankets from that motel!” I yelled to a bystander and three people immediately fled. I was in charge. The patient was no longer conscious; his pulse was faint and respiration was low.
“Stay with me, man!” I yelled. “15 to 1, 15 to 1”, I thought as I rehearsed CPR in my mind. Suddenly he stopped breathing. Without hesitation, I removed my T-shirt and created a makeshift barrier between his mouth and mine through which I proceeded to administer two breaths. No response. And furthermore, there was no pulse.
I began CPR. I continued for approximately five minutes until the paramedics arrived, but it was too late. I had lost my first patient.
Medicine. I had always imagined it as saving lives, curing ailments, alleviating pain, overall making life better for everyone.
However, as I watched the paramedics pull the sheets over the victim’s head, I began to tremble. I had learned my first lesson of medicine: for all its power, medicine cannot always prevail. I had experienced one of the most disheartening and demoralizing aspects of medicine and faced it. I also demonstrated then that I know how to cope with a life and death emergency with confidence, a confidence instilled in me by my certification as an Emergency Medical Technician, a confidence that I had the ability to take charge of a desperate situation and help someone in critical need. This pivotal incident confirmed my decision to pursue medicine as a career.
Of course healing, curing and saving is much more rewarding than trying and failing. As an EMT I was exposed to these satisfying aspects of medicine in a setting very new to me – urban medicine. I spent most of a summer doing ride-a-longs with the Ambulance Company in Houston. Every call we received dealt with Latino patients either speaking only Spanish or very little broken English.
I suddenly realized the importance of understanding a foreign culture and language in the practice of medicine, particularly when serving an under-served majority. In transporting patients from the field to the hospitals I saw the community’s reduced access to medical care due to a lack of physicians able to communicate with and understand their patients. I decided to minor in Spanish. Having almost completed my minor, I have not only expanded my academic horizons, I have gained a cultural awareness I feel is indispensable in today’s diverse society.
Throughout my undergraduate years at Berkeley I have combined my scientific interests with my passion for the Hispanic culture and language. I have even blended the two with my interests in medicine.
During my sophomore year I volunteered at a medical clinic in the rural town of Chacala, Mexico. In Mexico for one month I shadowed a doctor in the clinic and was concurrently enrolled in classes for medical Spanish. It was in Chacala, hundreds of miles away from home, that I witnessed medicine practiced as I imagined it should be. Seeing the doctor treat his patients with skill and compassion as fellow human beings rather than simply diseases to be outsmarted, I realized he was truly helping the people of Chacala in a manner unique to medicine. Fascinated by this exposure to clinical medicine, I saw medicine’s ability to make a difference in people’s lives. For me the disciplines of Spanish and science have become inseparable, and I plan to pursue a career in urban medicine that allows me to integrate them.
Having seen medicine’s different sides, I view medicine as a multi-faceted profession. I have witnessed its power as a healing agent in rural Chacala, and I have seen its weakness when I met death face-to-face as an EMT. Inspired by the Latino community of Houston, I realize the benefits of viewing it from a holistic, culturally aware perspective. And whatever the outcome of the cry, “Call 911!” I look forward as a physician to experiencing the satisfaction of saving lives, curing ailments, alleviating pain, and overall making life better for my patients.