Knife Attack

He's 22 years old and a new patient to the clinic. He's hispanic with a crewcut. He's wearing shorts, sandals, and an undershirt. He's here with his mother. He says he needs to have a knife wound repacked. As he takes off his undershirt his mother winces and looks away; I drop my jaw in amazement. His abdomen had been filleted open and after a long surgery is now stapled shut. The wound extends from below his breastbone to his pubic bone, about 12 inches. "Can you take out these staples?" "Oh no, you need to go back to the hospital for that", I say. I see a bandage taped on his left side and a long gash on his left arm which is closed with stitches. "What happened?" I ask as I inspect how perfectly his core had been stapled shut. "I don't know man. I don't really remember. Some guys came at me with a knife." His mother winces some more and says, "I have hard time looking." Spanish is her first language. 

He says he drove to his mother's house after he was attacked outside a Mexican restaurant and then was taken by a medic to the hospital. "You drove?!" I imagined his guts spilling out in his car. "Your car must be full of blood." "Yeah man. The cops have my car now. Do you think I'll get it back?" "So you were able to drive to your mom's house but you don't remember who attacked you?" It occurs to me I'm not the only one to ask him that. When the police questioned him in the hospital they must have said the same thing to him 15 different ways. 

He was put back together at a county hospital which is also a trauma center. This kind of attack, unfortunately, isn't new to these doctors. I imagine a young doctor, anxious for the trauma training, hurrying to be the first to scrub in. Stomach, spleen, liver all closely inspected for damage, guts put back to their proper position, then meticulously stapled shut. 

"Can you pack this wound again for me?" pointing at the bandage on his left side. "The nurse at the hospital told me it's 7 inches deep." (Wounds like this need to be repacked everyday so they can heal from the inside out). He tells me his mother feels sick when she does it so he does it himself. I pull what seems like an endless amount of gauze from his side. His wound looks good. He's done a good job these last couple days. I clean it and repack it. As I push the packing tape in, I don't feel any resistance for just about 7 inches. Then, finally, I can't put anymore tape in. I clean the gash on his arm and rebandage it. I send him home with enough supplies to pack his gaping hole by himself over the weekend, keeping in mind that most people wouldn't be able to do this on their own.

A drug deal gone bad? A gang attack gone good? A random slaughter? For a moment I put myself in his mother's place, one of my kids brutally attacked with a knife. But then as quickly as I'm in her shoes, I'm out. It's too unimaginable.