No time to stop at the sink or run through the shower to freshen up. Within seconds, I was standing at the elevator, pressing the button in rapid succession. It gave me something to do as I waited. When the door swung open, I jumped on board, rode to the ground floor, and ran toward the emergency department. Once there, I quickly put on a disposable yellow gown to cover my scrubs. This case would be bloody for sure, and I couldn’t ruin the only pair of scrubs I had with me. I made it to the ambulance bay with the rest of the trauma team to await our patient. This was my second rotation at University Hospital’s trauma center, and I was one of two visiting residents. The rest of the team included the chief trauma resident, the junior resident, and a couple of medical students.
Ron, the trauma nurse, was there, too. With two decades of experience, he was the true leader of the department and got a kick out of us bambinos learning the field. Like many of the nurses, he would make biting remarks to prove that the nurses were the true kings and queens of this jungle. You couldn’t show fear or weakness, or they would eat you alive. I’m sure they sat around most days laughing at the first-year residents (also called “interns”), wandering around the E.R., barely able to distinguish a stethoscope from a blood pressure cuff. An outsider could probably figure out our seniority just by our facial expressions and body language. The more confused and bewildered, the less experienced they were. The chief resident looked more exhausted than anything else, and the king of the jungle was looking for his prey. Ron’s shift had just begun, which meant he was fresh and ready to torment one of the residents or medical students.
In an instant, the doors flung open, and the emergency medical technicians were rushing a stretcher toward us. The team quickly lifted our patient onto the gurney, and I used a huge pair of shears to cut off his clothes. Ron swooped in and barked at the intern: “Now, you know you don’t know what you are doing, MOVE!” Within seconds, he had hooked the patient to a monitor, established a second IV, drawn blood for the lab, and placed a Foley catheter, while the rest of us assessed the damage.
Our patient, a young brother, was alive, but barely. The monitor picked up a heart rhythm, and as I placed my gloved hand into his groin region to find the femoral artery, I could feel a faint pulse. I inserted a large bore IV right next to the artery into the femoral vein, allowing us to pump in saline and blood. Blood gushed from the wounds in his chest and abdomen, toward his crotch, and my gloved hand was suddenly bright red. The junior resident moved in with a Number 11 scalpel to insert a chest tube, and the rest of the team completed our mental checklist, examining the patient for further injury. I counted three gunshot wounds, two to the abdomen and one to the chest. The X-ray technician moved in, giving us a quick look at things on the inside. The bullet appeared to have struck the spine, knocking its alignment off track, indicating a high probability of paralysis. The patient was rushed to the operating room. Finally, Ron retreated. As the stretcher disappeared around the corner toward the elevator, the intern fought back tears. Just one year removed from such status, I knew how overwhelmed she must have felt.
Moments later, I heard yelling on the other side of the department. Another young man was stumbling in, his white T-shirt drenched with blood—another shooting. He was a big guy, six feet two inches tall, roughly 250 pounds. A female companion was struggling to keep him upright; his legs were wobbling underneath his large frame. Then his feet gave way and he collapsed in the middle of the department. Ron quickly grabbed a stretcher. Newly regloved, the rest of the team rushed to the patient’s side and tossed his limp body onto it. Ron whipped out a needle from his back pocket and established almost immediate IV access. Fluids were attached to the catheter and squeezed in. Ron was back on his throne, and his target, this go-around, was the junior resident.
“What the hell are you doing?” Ron yelled. “Get this guy intubated. Come on, let’s go!”
Ron was as good as any trauma surgeon. In a pinch, he might have even been able to perform surgery—at least that’s the kind of confidence he exuded. “Listen, if you can’t do it, then move and let someone else.”
Sweat formed on the junior resident’s forehead as he pushed the tube into the patient’s trachea. I checked for sounds of breathing and gave a thumbs-up, signaling that the tube was in the proper place. I believe the poor resident feared Ron more than missing the intubation. The medical student took my shears and removed the patient’s jeans and bloody T-shirt. I inspected his body and found one gunshot wound in his abdomen. There were no bowel sounds, and his stomach was swollen to the size of a full-term pregnancy. He was surely bleeding inside. The chief resident placed a central line catheter into his neck. Ron hooked him up to the monitor, and we rolled him over for the standard back and rectal exam. The white sheet covering the black foam mattress was now a bright maroon. The patient’s blood pressure was low, and his heart rate was fast. He was barely hanging on. I could see the attending trauma surgeon making his way through the department, and, like the parting of the Red Sea, everyone moved. This was the only time I saw Ron back down. It wasn’t as much a retreat as a show of respect for a fellow king of the jungle. If challenged, though, Ron would rise up, and he and Dr. Langston would battle, right there in front of everyone. Dr. Langston looked at the chief resident and quickly uttered two words: “Let’s go.”
Eight more traumas came in that night—a total of twenty during my thirty-hour shift, not reaching my personal record of thirty-five. I was so drained that I welcomed the morning report, when all of the trauma docs, radiologists, nurses, and other staff gathered in a room to sign out the cases from the night before and hand over operations to the next team. This was the attending trauma surgeon’s stage, as he drilled us, pointing out every mistake. The chief resident usually got it the worst, but no one was exempt. It was like a fraternity den, and hazing was allowed.
“You radiologists are fancy art critics,” Dr. Langston joked while making his assessment of our performance the night before. “All you do is read pictures and offer your impressions.”
I sat back in my seat, coffee in hand. Medical school had introduced me to the world of coffee, and I’d since become somewhat of a connoisseur. Even with the caffeine, I was struggling to keep my eyes open. The initials of all the patients from the night before were marked on the green board. The gunshot victim who had walked in with his female companion had made it out of the operating room—critical but alive. He needed more surgery. “Severe internal damage occurred, and he was unable to be closed up,” the chief resident said. A plastic covering from a saline bag had been placed over his exposed abdomen to prevent bacteria from entering the body cavity.
Five patients, highlighted on the board by their initials, had one final update: DECEASED. My patient who’d come in with the three gunshot wounds was still alive but quite truculent. When he woke up from the anesthesia, he started yelling profanities, asking the nurses about the shooter and saying what he would do if the police didn’t capture him. He was Mr. Tough Guy, a common attitude around Newark blocks that seemed to require that those who live there have an edge to survive. No sign of weakness was allowed. Healthwise, though, he appeared better off than the one who’d been shot just once. The number of times a person has been shot is always less important than the trajectory of the bullet.
It was about noon when we closed out the morning report and handed over the next thirty hours to the Trauma B team. I would report back to the hospital at 7:00 A.M. the following day with my team, Trauma A.
The sunshine outside was bright. It was going to be another warm day. I headed for my Honda Accord. That car was tough. Despite a few fender benders and even a couple of burglaries, she was still holding up, still reliable. She’d been broken in to so many times, I sometimes felt like I was borrowing her from the thieves. I’d mistakenly left the steering wheel lock off the last time she’d been stolen. The perpetrator was found two weeks later, asleep in the front seat. When the police finally contacted me, and I went to claim my car,
it appeared the thief had been living inside. Empty French fry cartons, burger wrappings, liquor bottles, and drug paraphernalia littered the floor and seats. The guy behind the counter at the car lot told me I’d have to pay $210; to take her home. When I asked about the damage, he responded: “You pay here first and then you can see for yourself. You can sign the car over to us if you don’t want to take it.” He then pointed the dirty fingernail of his stubby index finger toward a sign that said: “NO Exceptions, Money First, Then Your Car.”
The Honda was worth it. She had traveled with me from medical school to Newark, never giving up. Through it all, she had required only minimal repairs. I liked to think that the scratches, dents, and off-track front window added character to her ten-year-old body. I’d nicknamed her The Coupe. She’d gotten me not only to work, but in and out of New York regularly, never breaking down—as I feared she might—in the Holland Tunnel. Many times I’d entered the tunnel in New Jersey, fingers crossed, hoping to make it to the other side. I didn’t want to be the guy that everybody who travels that route has seen—the one with the stalled old car paralyzing traffic in the tunnel, inciting furious horns and looks that could kill. The Coupe reminded me of me. We’d both been beaten up pretty badly, but we kept on pushing.
She was waiting for me in the parking lot after the morning report. As I drove home, I couldn’t wait to get into bed. I lived less than fifteen minutes from the hospital, in a working-class neighborhood, where I rented a room in a three-story home owned by Carole Jackson. Her daughter, Mary Ann, who had been friends with George, Rameck, and me in high school, lived in a first-floor apartment connected to the house. Mary Ann had stayed in touch with George throughout college and dental school, and he’d told her that I was moving back to Newark for my residency and was looking for an affordable place to stay. She’d asked her mother if she’d be willing to rent me the vacant third-floor bedroom. The setup was perfect. I had no savings and no intention of moving back home with my mother, which would have meant sharing a room with my younger brother. A place of my own would symbolize my fresh start, and a room was about all I could afford.
When we’d been in high school, Mrs. Jackson had been the active PTA mom that all the kids knew and loved. She remembered me and welcomed me into her home. She was like my mom in that way: She always had a house full of relatives and friends, some of whom stayed with her from time to time and others who just popped in occasionally for one of her delicious home-cooked meals. That, of course, made me feel right at home. My room was nothing fancy, but just right for me: a double bed, a dresser, and a desk. There was also a window, which I covered with black curtains to block the sunlight on days like this, when my shift ended in the middle of the day and I needed to hibernate until it was time to rise and do it all again.
That day, I headed straight to my room and slept for six straight hours. When the aroma from the kitchen told me it was dinnertime, I stumbled down to the kitchen. Mrs. Jackson was standing there, smiling.
“I was just about to tell Frankie to wake you,” she said, referring to her middle-aged niece, who lived in another room on the third floor. “Another long night, huh?”
“Yeah, they kept coming, all night long,” I said.
She pointed to a pan of freshly grilled salmon on the stove. “Well, have some of this,” she said. “I brought it today from the market.”
I inhaled my meal of fish, mashed potatoes, and string beans, then retired back to my dungeon and slept through the night. At 6:00 A.M. Sunday, my alarm blared. I dragged myself out of my squeaky bed and headed to the bathroom down the hall. The forty-five-watt lightbulb gave the hallway a tunnel-like feel, and the pipes growled in the bathroom as I turned on the hot water. I showered quickly, changed into a new pair of scrubs, and threw an extra pair in my bag so I wouldn’t get caught off guard again with back-to-back bloody traumas and no change of clothes.
I had to hurry if I wanted a cup of coffee before the morning report. I rushed to the cafeteria, and the first person I saw was Ron. We greeted each other cheerfully. Ron liked me, I think because we were both from Newark and shared both love and concern for our city. He talked to me often about his son and how proud he was of him. I’m sure it must have bothered him, too, to see so many young men who looked like us passing through the E.R.
I glanced up and saw the chief resident at the oatmeal stand. She still looked exhausted. I wondered if she had been able to rest on her day off. She was in her last year of residency, married, with a son and daughter. I couldn’t imagine raising a family during this time. She and I met up at the cash register.
“Good morning, young doctors,” said Mrs. Wallace, the cashier and matriarch at University. She’d been working there for thirty-five years. Even the senior docs greeted her with warmth. She was one of the few constants at the hospital, having known many of the doctors now inching toward retirement since they were residents. We made our way to morning report. The room was crowded; some staffers were standing, as there were never enough seats. The senior doctors occupied the front of the room; the chief resident from Trauma B stood at the podium. He was shifting nervously from side to side. Glancing up at the board, I noted twenty more trauma cases from the night before, and seven deaths. The two patients I’d treated in my previous shift were still alive. The condition of the first one, the guy brought in by ambulance with multiple gunshot wounds, had been upgraded, and he was now in a regular room, out of the Surgical Intensive Care Unit. The second one, who’d walked in with the young woman, had taken a turn for the worse, though. He was scheduled for additional surgery later in the day to remove more of his intestines.
The chief resident filled us in on what he’d learned about our gunshot patients from the police, who had been notified by the hospital as usual after a shooting. I initially suspected that there had been a gun battle between Patient One and Patient Two, but I couldn’t have been more wrong. The two were actually brothers who had been out at a local nightclub. The guy who’d been shot three times was the younger of the two. His name was Reggie, and according to the police, he’d been dancing with a girl who may or may not have been romantically involved with the shooter. When the shooter asked the younger brother to step aside, words were exchanged, the older brother, Greg, jumped in, and a fight broke out. Then the shooter disappeared, only to return just before the club closed. Reggie was still dancing with the shooter’s girlfriend—or the woman he wanted to be his girlfriend—and the shooter approached them, got in Reggie’s face, pulled out a gun, and fired. Greg had evidently seen the situation unfolding and jumped in front of the gun. He caught the first bullet in his abdomen, and the shooter kept firing, striking Reggie three times. Everyone in the club ran for cover, and the shooter fled. He was still on the run, but the police seemed confident they would find him, the chief resident said.
The details of the story jolted my memory. I suddenly recalled what the young woman had said as she helped Greg into the hospital: “He tried to save his life.” Her words, lost in the pandemonium, now made sense. I imagined the chaos in the club: patrons screaming, ducking under tables, trampling one another in their scramble to get away.
I was reminded of a night during medical school when I got jumped by a group of New Brunswick dudes at a popular off-campus club, the Down Under.
“Where you been?” someone had shouted as I arrived, late, with three of my college friends. “This party is blazing!”
I started dancing without a partner, then spotted one of my homegirls dancing with a guy I didn’t know. For some reason (probably the beer), I moved onto the dance floor with her. Mistake number one. That’s a huge no-no in club etiquette, a show of disrespect to her partner. The dude glared at me, letting me know this wasn’t over. I ignored him as he walked off the dance floor and disappeared. I was still dancing with her when I saw him return with a few guys and point in my direction. I played it cool, finished the song, gave my friend a hug, and moved around the club, letting my boys know something was abo
ut to go down.
How ridiculous it all seems to me now.
Sure enough, when the party ended and I stepped out of the club, eight or nine dudes swooped in, punching and kicking me. The New Brunswick locals didn’t care too much for Rutgers college boys invading their space. Somehow I was able to look up, and there was Rameck rushing into the fray, throwing punches, pulling guys off me. Then came our friend Sean, wielding a huge board that he’d picked up somewhere, charging into the ruckus, plucking off the locals. I was in an armlock, tussling with another guy when we spun into a huge storefront window, which shattered. The two of us fell through it and landed, still throwing punches, on the bed of broken glass. Seconds later, the New Brunswick police were on the scene, and the crowd scattered. The local boys got away. I was thrown against the police car and frisked, while trying to explain that I’d been jumped. Fortunately, a few people from the crowd corroborated my story, and the officers let Rameck and me go. They handcuffed Sean and arrested him for using the board as a weapon. We were able to scrape together enough money to bail him out. Many years later, a routine dental exam revealed that Rameck had suffered a fractured jaw, which he presumed had happened during the brawl and which somehow managed to heal on its own without displacement.
All three of us were fortunate to walk away that night with just one cracked jaw and a few cuts and bruises among us. I couldn’t imagine the guilt I would have carried if one of my boys had lost his life over something so trivial. Yet this scenario plays out far too often in nightclubs throughout the country. Tempers, fueled by alcohol, explode over the smallest perceived insult—a wrong look, a stepped-on shoe, rejection from a beautiful woman—suddenly throwing everything into chaos. Add guns to the mix, and many times someone winds up dead. This kind of incident actually appears to be growing more common, particularly in urban centers, according to some experts who have studied the issue.
Living and Dying in Brick City Page 12