A Reply to Hate: Forgiving My Attacker. David TuckerЧитать онлайн книгу.
in need of emergency assessment and care. Despite their initial resistance, colleagues were formally asked to vacate the resuscitation area while the accident and emergency team took over in order to begin their standard ‘resus’ protocol. They were very professional and equally courteous. For a victim with a penetrating injury, the immediate imperative is to make sure that there is no imminent threat to life. This may sound gruesome, but it is essentially making sure that a) the victim is breathing soundly and b) not bleeding to death. Once these are checked, the examination then follows a well-defined structured and systematic sequence to determine the nature and extent of the ‘primary’ damage. In essence, this involves looking for the immediate damage caused by the knife penetrating my neck. The young A&E doctor proceeded to examine me, much as I did in my own assessment earlier. Of course, he had to get it right and to his credit he did not seem to be phased by the fact that he was examining a senior colleague, knowing full well that his own competence was also being assessed! By the end of his examination, it was reassuring to learn that I had not missed anything earlier! The nurse took my vital signs again—pulse, blood pressure and oxygen saturation—before starting to prepare another intravenous drip. It was simply not my day. The A&E doctor had the last laugh. Once he finished his assessment he smiled at me and said, “I need to put another needle in your left arm.” I remembered why; for a penetrating injury, two large bore cannulas, one in each arm, is the standard Advanced Trauma Life Support (ATLS) protocol. After all, I was an ATLS instructor, and I should have seen it coming. For the second time that day I opened my arm and held my breath.
It was a very unusual experience for me to be on the receiving end of an examination that I had so often carried out and to see how this young A&E doctor was trying to reassure me and keep me calm about what he was doing and why. Once he cleared my arms and legs, he asked me to lean forward so he could examine the back of my neck. He told me the wound did not look dirty and was not bleeding much, nonetheless I still needed to have a tetanus jab, so that meant, yes, another needle. With my surgical background, I knew very early that the penetrating knife has missed all the vital structures in my neck, but I also knew that I had to go through a rigorous examination just the same. I wasn’t frightened or distressed, and I found myself reassuring others that apart from the pain, I was feeling fine and calm. Perhaps if I was not a doctor, I would have felt very different. But there I was, in very familiar surroundings and with people that I knew, going through their usual business, all of which was very comforting for me. Even though I was aware that so far I was ‘clinically stable’, I knew that the A&E doctor would still consider me to be in a potentially critical condition. The potential for secondary life-threatening internal damage needed to be excluded before I would be off the critical list.
Once he finished his initial assessment, the young doctor informed me that I would soon be going for a CT scan of my neck, and he left the bay. As he left, a young, awkward-looking police officer entered and requested a statement. I had been expecting to see the police at some stage, but I wasn’t sure why this particular officer looked out of sorts, uncomfortable and anxious. It was the first inkling I had that there were perhaps wider implications of the attack. I cannot recall exactly how the conversation went, but I remember he wanted me to go through the incident in as much detail as I could recall. Unfortunately, his awkwardness only increased during this questioning when Syrsa walked in. The questions just stopped, or probably I just stopped listening to them. I looked at Syrsa’s face and I could see she was calm. She wasn’t pale, she wasn’t hyperventilating, she wasn’t anxious, she just walked towards me and held my hand. I told her I was okay and she nodded to say “I know you are”. Her immediate words were “I’m so grateful to God”. I think when she first saw me, she could immediately tell there was nothing horribly wrong as I was sat up talking to the officer. It was probably that first eye contact as she entered. Perhaps I smiled and shook my head. She is a doctor herself, and when she saw me sat up on the trolley, she saw for herself that I was OK. We did not say much to each other; I was alright, and probably that was all that mattered.
The officer just stood there waiting for his moment to barge in, which he eventually did. But then it came to that critical question, “Do you remember what he said to you?” Up to that point, I never really thought about what my attacker said to me. It was then that I had to start remembering what was shouted at me as it might give a clue to why I was attacked. I clearly remembered walking onto the grounds of the mosque, I clearly recalled the moment of sudden pain and I clearly recalled the look on his face, but for the life of me, at that moment, I could not recall exactly what he said. As I struggled to remember, I think I mentioned to the officer that I recall he swore at me. Then I think I said that he had uttered one sentence, just one sentence, and that was all that I could come up with. Somehow, I found it difficult to recall his exact words and I wasn’t sure why. I told the officer that I needed some time to remember. To be honest, I was somewhat disappointed with myself that I could not recall what had been said. But even then, I was conscious of the fact that I should not put words into someone else’s mouth, and I needed to be careful as to what I might say. I may have told the officer that I would need to think this through more carefully and it would probably be the following day before I could complete my statement. But then came yet another embarrassing moment for a victim. The police officer asked me to get undressed and to give him my clothing as it was now ‘material evidence’. I proceeded to get undressed and gave him my shirt, my trousers, my belt and my socks. Fortunately, my underpants did not qualify as material evidence. Syrsa was not happy at all; the shirt and the belt were new, and they suited me! In any case, I thought what the heck, I am going to stay the night at the hospital as they would most likely need to observe me overnight. As for my shoes, I was somewhat lucky as they were still on the shelf at the mosque and thankfully they were not seized. I was now down to my underpants! I looked at Syrsa and we both laughed at the silliness of the situation as I tried to cover myself as much as I could with the flimsy trolly sheet. Syrsa then told me that around thirty people were waiting outside to make sure I was OK, and we agreed that she should go out and let everyone know that I was fine and to get the word around that the immediate worry is over. As she left, I closed my eyes and started to replay the earlier events to help me remember what the hell this young man had said to me.
Soon enough, the nurse returned to recheck my vital signs. At some stage I was given a strong analgesic for my pain, I think morphine, and it was ‘titrated’ in. As I saw the injection going into the cannula, I waited for that extraordinary experience of having morphine in my veins for the first time in my life. I waited in anticipation for this so called ‘trip’. This would probably be the only time I could legally experience such a trip, but sadly nothing happened, one of the more disappointing aspects to that situation. Anyhow, the nurse ran some more fluid through the cannula and everyone was ready for me to go to the CT scanner. This was the only trip I had that evening!
A CT scan is standard protocol for a penetrating injury. The scan is necessary to identify the depth of the injury and to check for internal bleeding, which is bleeding that does not gush out through the wound but stays inside the body and can put pressure on, and so cause damage to, vital structures. A few minutes later I was wheeled into the scanner room and was asked to slide myself from the trolly onto the narrow scanner bed. With a cannula in each arm, a drip line on the left and a painful neck, I was trying desperately to keep my dignity with this flimsy trolley sheet. But then I thought, at least for this night, I should just be a patient and give up on being ‘dignified’; it can’t get any worse. As part of the scan routine, a contrast dye needs to be administered through one of the cannulas. This contrast flows through the blood stream and has the ability to highlight blood vessels and so, most crucially, it can highlight internal bleeding. The protocol is for a scan sequence to be done before and after the contrast dye is injected. If there is an area of bleeding, the contrast will seep out where the bleeding is, and this can be picked up as a difference between the two scan sequences. I remember a warm feeling up my arm when the contrast went through me and I think I also felt a strange taste in my mouth, but nothing unduly unpleasant. A quick glance at my scans showed that the bleeding was very minimal and fortunately there was no major, or even minor, vessel damage. This was a big relief to everyone as the carotid and jugular vessels were very near to where I was stabbed. The smaller vertebral arteries were also missed and even the little veins that lit up on the scan were cleared by no more than a millimetre. None, absolutely none, of the important structures in