"We Can't Kill Your Mother" and Other Stories of Intensive Care
by Lawrence Martin, M.D.
Table of Contents

NOTE: "We Can't Kill Your Mother" and Other Stories of Intensive Care can be downloaded in its entirety as an e-book from 1st Books Library ($4.95). The book can also be ordered in trade paperback format for $13.50. For purchasing the e-book or print versions, please go to 1st Books Library and enter part of the book's title or the author in their search engine. Below are the first few paragraphs of THE WILD MAN.

Joe Cartney was one of our most difficult patients, and we almost lost him. He showed up in our emergency department -- dumped there is more accurate -- one cold Saturday morning. It seems his brother or brother-in-law brought him in because he, Joe, was "taken real sick all of a sudden." After imparting this message to one of the secretaries, Joe's relative sat him on a waiting room chair and went to "park the car." He did not return.

Left behind was a young man too sick to stay in any chair. He fell to the hard linoleum floor and proceeded to moan and wail. The ED nursing staff responded with a quick check of his vital signs, and lots of questions: "Who is this? Where'd he come from? What's his name?" Only the hapless secretary had any information: "Mr. Joe Cartney...brother [?brother-in-law] brought him in...said he's real sick, then left...said he'll be right back...didn't leave any phone number...didn't sign any forms."

As for the patient, all he could do was scream and flail his arms. Four of the staff lifted Mr. Cartney to a stretcher and brought him to the treatment area, then placed him in a bed. If acutely ill, at least he was in the right place.

He could give no history worth a penny. He just moaned and screamed at the slightest provocation, calling for "Emma," presumably his wife or girlfriend, and various other people who he could/would not identify. He knew his name but not the day, year, where he was or how he got there. He could not answer any question coherently. He frequently resorted to scatological phrases like "you mother f-----." Joe Cartney was, in a word, delirious; though acutely ill, he was simply unable to communicate his problem. The ED staff had no more history than a veterinarian presented a sick dog found on the street. Methodically, the ED physician and nurse documented what they could:

Vital signs. Blood pressure stable at 130/70; pulse irregular at 150 to 170 beats/minute (normal is less than 100/minute). Temperature 101 degrees.

Physical exam. Young male, ?age. Medium build. Appears disheveled, unshaven, dirty. Skin moist and sweaty. No obvious signs of trauma or recent injury. Three tatoos noted: "Emma" over left arm, skull and cross bones over right arm, and "Born to die" over chest. Scars over abdomen, right thigh (?knife wound). No neurologic defects, nothing to suggest he had suffered a stroke. Able to move all his extremities.

Cardiac rhythm. Irregular, with many extra heart beats. Technically, "supraventricular tachycardia with numerous multifocal beats."

Arterial blood gas test. Adequate oxygenation and ventilation, (i.e., his lungs were working normally).

Other blood tests. Results pending, including a "toxic screen" of his blood and urine for drugs commonly used to overdose.

Chest x-ray. Clear; no evidence for pneumonia.