Front Row

In one of the emergency departments I work in, the clerk's desk is located near the exit and, shall we say, safely the front-lines of patient care. I sometimes remark to the clerks when they missed a really good case or interesting trauma, but they seem to be happy with their location.

Late one night, I was finishing some charting near the clerk's desk when a family of three came up to say goodbye. Their son had been in a car accident, in which he had lost consciousness. After a negative head CT, a benign exam and some pain medication, he was feeling fine and good to go.

As I wished them a farewell, I remembered an abrasion on the young man's left hand.

"Wait -- I've got just the thing for that," I said, reaching for my bacitracin, gauze and tape (the interns have well-stocked cargo pants).

I put the patient's hand on the clerk's desk and squirted some bacitracin onto the gauze. "Now you're finally getting a front-row seat" I told the clerk.

As I applied the dressing, the patient wobbled a little, and I noticed he seemed a little pale. "Everything ok?"


"Hey, ah, are you alright?"

The patient was staring off beyond my shoulder, with wide, wide pupils. He replied, in a monotone: "I can't see."

He stumbled a little bit and I caught him. "Why don't we get you back to your stretcher," I offered, with a cheeriness that rang utterly false. My mind was racing -- I haven't seen a fainting spell like this, could we have missed an epidural?

At that point, the father slumped to the floor. "My son... My son is blind."

Oh my God, they're dropping like flies.

My attending rushed over to catch him. The man was cold and clammy, similarly pale.

"No, sir, he's ok!" I was insistent. "We scanned his head. He's just... doing what you're doing."

We got the father-and-son team back to the stretchers, had them lie down for a bit, and gave them something to drink. They perked up in short order -- no hematomas, just... relational syncope.

When they felt ready to try again, I walked the family to the door, passing the clerk's desk. She (quietly) warned, "Dr. Genes, I've seen enough tonight."

As we passed through the waiting room, a question occurred to me: "Hey, who's driving?"

The father shot a glance at his son, who was shaking his head slowly. The mom chuckled to herself, as the family made their way out of the hospital.