Sympathy for the Devil

The other day, an EMS crew dumped a guy on one of our trauma stretchers. He was on a backboard, so we did the usual stuff as far as stripping him down, looking for injuries and asking him a whole bunch of questions. I can always get a bit of a hint from EMS about the patient. If the patient's been difficult, they pretty much transfer them over and take off before you can get any questions in. If the patient's injuries are interesting, or if they like the patient, they tend to stick around through our initial assessment and x-rays. This was clearly a case of dump-and-run.

This guy was a motorcyclist that rear-ended a stopped vehicle and went flying over the handlebars. He was wearing a helmet, and supposedly stood up and was walking around on scene, but now was complaining of some rib pain and difficulty breathing. As we were checking him out, his main concern was that we didn't cut up his black leather vest. Fine.

So, I continued looking for injuries. There wasn't a mark on him, but he had an interesting collection of tattoos. On one arm was an Irish flag with swastikas, on the other side big letters (in Old English script) that said, "Death to the Queen!" I felt the need to ask him which queen was out of his favor... apparently it's the one in England. He countered with a series of questions about my heritage, and I would have loved to tell him I was English, but my last name kind of gives away my background.

We continue on with the questioning, and there's not any telling marks on his body for injury. His chest x-ray in the trauma bay is negative, but he's complaining of a lot of pain, so we get him ready for a catscan. At this point, he tells me that he doesn't want to be given any blood because "It's against my religion." His vitals are stable, so I tell him that I don't think that's going to be an issue.

One of the nurses asks him if he's a Jehovah's Witness, and he says, "No, I'm a devil worshipper." This causes one of our nurses to cock an eyebrow and reflexively make the sign of the cross across his chest. "And I don't want any salt, either," snarls the patient.

Drip.... drip... drip..

"I don't plan on giving you any salt." I tell him.

Drip.... drip... drip..

"Saline, I mean, I don't want anything with salt in it," he adds.

Drip.... drip... drip..

"What's wrong with a little salt? The only reason it's in the saline is to make it more balanced with the electrolytes in your blood. If I put water into your veins, it would leach out all of your electrolytes and make you very sick," I try to rationalize.

Drip.... drip... drip..

"I don't care. Salt is used in Christian ceremonies like baptisms and weddings, and I can't have any of it in my body. I don't ever eat it, and I don't want any saline!" he protests.

Drip.... drip... drip..

"Ok sir, if you don't want the saline, I can stop it, but I should probably let you know that it's been running since the medic put that IV in your arm, and you've gotten almost a full liter of the stuff."

"WAAAAAAAHHHHHH!!!! TURN! IT! OFF!!!! WAAAAAAAAAAAAHHHHHHH!!!!!!!!!!!" he screamed, and started thrashing around.

So the fluids got turned off. The rest of his time was pretty uneventful. CT scans were negative for any fractures or pnemothoraces and he went home. His blood pressure and heart rate stayed within normal range, so he didn't need any more fluid or blood products and he went home. One of his matching vest-wearing buddies showed up for moral support, and before he went home, a Hispanic woman showed up with his 6 year-old son. With all the swastikas, I was kind of surprised that the guy spoke a little Spanish and would have a minority taking care of his child. I always find it odd that people that are obviously born and raised in this country still carry around predjudices from generations ago (Ireland vs England). Then again, since I don't have any tattoos, I always have the expectation that if you are willing to have something permanently scored onto your flesh, that it has some meaning for you, and I suppose that is not necessarily true, either.