First Aid – Primum non nocere

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The first thing that alerted me that this wasn’t right was the stopping of cars, the turning on of brake lamps in through lanes cresting a small incline on a very busy street here in GDL. I was hungry and lunch was waiting at home. I cursed the traffic at a time when all should be smooth-sailing. As I got closer, I realized there was at least a body for sure on the road ahead of me, not more than three cars in front; I had just missed this accident by seconds. People were getting out of their vehicles, and I joined them.

The scene was a motorcyclist who was partially lying on his own bike, a small 200cc or so engine probably used for courier services, helmet on (thank God), howling in pain. A few people getting there seconds before I did asked, “What happened?” “Dude, are you alright?” “Are you OK?” Um, the repetitive painful screams and moans should say he’s had better days, but I guess people just go with their gut instinct, not knowing what else to do. I was told he simply lost control of the bike and they didn’t know what caused it. To be honest, I wasn’t sure what I could offer either, since there were already 3-4 cell phones out calling the appropriate help. At that moment I realized how totally, completely, absolutely lost I’d be if I actually had to help this man in a real medical way. I’m a medical student who almost certainly knew far more than anyone else there about anatomy, physiology, etc. (assuming nobody there was a medical professional) but was equally helpless. Thankfully I wasn’t in my “whites” since I didn’t have clinical medicine today, so there was no visual expectation–I was just another guy on the road wanting to help. This wasn’t a patient in one of our clinics having come in of their own accord or a patient in a hospital bed in a controlled, teaching environment — this was a stranger on burning hot pavement in the middle of the day on a now-closed highway with who-knows-what broken or bleeding inside.

Putting self-consciousness aside, I knelt down beside him and reassured him that help was on the way. He was obviously in pain, but there was no evidence of any airway difficulty. He was breathing rapidly but fully, and the few words he got in here and there showed he was alert and oriented enough to know what was going on. There were no external signs of bleeding. Not really knowing what to do (I knew I shouldn’t have stopped watching ER six years ago!), I put my index finger in his left hand and asked if he could squeeze my finger. Not stopping his painful utterances, he lightly but definitely squeezed my finger. I repeated for the right side. His left leg was partially draped over the seat of his motorcycle, and he was wearing regular shoes. I gently put my hand on his left ankle and when there was no painful reaction, I asked if he could feel my hand as I gently squeezed. He continued expressing his pain, but through it he said “yes.” I was going to check his right leg, when I saw a puddle of gasoline slowly making its way to his leg. The motorcycle was on its side and leaking gas from the tank’s cap. No one had noticed this!

“Help me get this thing up, it’s leaking gas!” I said, pointing. Two guys came to help, and taking care to support the guy’s leg, we got it up, putting it on its kickstand. At that point an astute cabbie who parked behind me said, “Hey, now that it’s up, let’s get the bike to the right lane so we can let traffic through.” I was already next to the bike, so I kicked it off the stand, but it was in gear and didn’t budge. I had no idea where the keys were, if it could go into neutral w/o turning it on, so I just pivoted the bike’s front, moving it little by little. One guy halfway helped, but it wasn’t much. Needing a bit more leverage, I reached a little too far to the other side and felt/heard a quick sizzle on my hand as I blindly touched fresh, hot exhaust piping.

“#$@&!” I screamed. I pulled my hand back to realize even more startlingly that the “sizzle” I heard was gasoline on my hand being vaporized. In actuality, the gasoline saved me from an almost certain nasty 2nd degree burn. As I type this, I have a mild 1st degree burn over parts of my left hand, but I was lucky. We got the bike moved, and in those 60 seconds or so, police had come in from the opposite side of the highway divider, so I knew the guy was going to be tended to by proper authorities. I wanted to stay and make sure all was well, but the rapid return of drivers to their cars (and the peek of an endless line behind me) meant I had to hurry back to my parked truck.

As I started to drive past, I saw the cyclist talking on a borrowed cell phone, still on the pavement. I thought of who he was talking to–his wife, mother, whomever–and the worry they’d have. If there’s a higher point at all to this post it’s that I look forward to the day where I finally know enough to make a difference when a similar situation presents itself again.