Now what, I thought as I strode down the hall to the swinging doors of the emergency room.  Another stat and it probably is nothing more than a sore throat or a hangnail.

            “In here, quick,” shouted Caldwell, our warhorse emergency room nurse.  She’d been an  ER nurse for ages and nothing fazed her; she’d seen it all.  But this time there was panic in her voice.

            “Doc, he’s been stabbed in the chest.  He’s going into shock.  The blood is bright red, arterial and it was spurting when he came through the door.  Now it’s only dribbling and we’re losing him.  Hurry.”

            His eyes were rolling back and he was collapsing in her arms. 

            “Get him on the gurney.  Looks like they might have got him in the heart,” I said as I gave him a quick once over.

            “Call the OR and tell them we’re coming.  Emergency thoracotomy.  Get some blood to the lab for a six unit cross match.  Come on, move girl or we’ll lose him.  Have Cynthia get the elevator for me now,” I shouted as I wheeled the gurney into the hall.

            They were finishing a belly case in the OR as I burst through the door with the stretcher.

            “Call anesthesia and break out the chest instruments in the big room,” I yelled.  “He’s been stabbed in the chest and I think they got his heart.  Get him on the table, left side up while I scrub.”

            The well oiled OR team didn’t miss a beat.  They dropped the clean up duties from the previous case, wheeled him in the trauma OR and prepped him for a left chest incision.  My “sterile” scrub was a splash of soapy water and I was back in the OR, gowning and gloving. 

            “Spray the betadine and give me an eye hole sheet.  No time for a full drape,” as I grabbed the scalpel from the back table and made a sweeping incision beneath his left fourth rib. 

 As I the chest cavity blood cascaded onto the floor.

            There.  There it is, I thought, as I exposed the heart.  Just a slight nick in the pericardium now only dribbling minute amounts of un-clotted blood.  I split the pericardial lining around the heart with the scissors and we could see a rent in the heart muscle pumping now only diminutive jets of bright  red arterial blood.  I put my index finger over the hole and the bleeding ceased.

            “Pour the blood to him John,” I said to the anesthesiologist.  “Give him all six units as fast as you can.  I know there are at least six units on the floor and in my shoes right now.”

            “OK, team, easy on now.  I’ve got the bleeding stopped.  Let’s give him a few minutes to stabilize while we get better organized.  Let’s all of us take a breather.”

            The crew visibly relaxed as the tension in the room eased.

            “Doctor M.  Can I speak to you for a minute?” whispered the circulating nurse hesitantly.

            “Sure Cindy.  Before you do see if you can clean up this bloody mess I spilled on the floor.  It’s all over me, the floor and it’s in my shoes.”

            “In a minute, doctor M.  I think this takes priority.”

            “Go ahead, now what?”

            “Your wife called when you burst through the door.  I took the call.  She said she was in labor.  I told her you couldn’t come to the phone right then.  She said her water broke and wanted you to come get her.  I explained that you were busy and told her to get a cab and come here to the hospital.  What else was there for me to do?”

            “Oh my.  Forgot all about her being so close to delivery.  Go on.”

            “Well, she did as I asked.  She’s now down on the OB floor and she’s OK.  I’m afraid she delivered in the cab.  You’re a new father.  She’s fine they tell me, and asking for you.  It was a boy and all the fingers and toes are in the right place they tell me.  I had to wait till now to tell you.  You were too busy to listen.”

            “Golly.  Thanks for grabbing the ball and running with it Cindy.  Now get me some three O cardiovascular silk so I can fix this hole in this man’s heart.”

              “Is he OK, John?”

            “His blood pressure is coming up and his pulse is coming down.  Go ahead and finish what you’re doing.  Looks like he’ll make it.  And by the way, congratulations, dad.”

            We finished the case.  The patient survived with no complications. 

            My wife did fine after her single handed taxi cab delivery. 

            And my son?  Oh yeah, he’s OK too.