why you should wear your seat belt, never drink and drive, and avoid getting stabbed/shot/hit on the head with a hammer/canoe paddle

No one wants to be the victim of a trauma. This is obvious. However, I think that a lot of people in this country probably have a stronger and more passionate fear of terrorism or gay marriage or calories than they do of the daily dangerous things they do that are a lot more likely to make them miserable. So here's a message to everyone out there that drinks/eats/does their makeup and drives, or drives as if they're playing Crazy Taxi, one-handed, with their feet, or thinks that a good idea of a Friday night is to get really really hammered and then pick a fight with someone holding a bat: Don't assume that if by some chance that nice bystander that cares about your life finally manages to get through the overwhelmed 911 system and an ambulance comes and picks you up, that you've gotten away with it in any way. The fun is just beginning. Here's a quick reason why:

- The ambulance finally brings you in. You're bleeding out your ear, you've soiled yourself, and you're being wheeled through a hallway full of staring patients, some of whom have been waiting for 12 hours to be seen, some who are senile or crazy and wearing diapers and talking to themselves, many of whom smell like urine/old socks, and others who are in only slghtly better condition than you.

-Your body gets heaved from the paramedic board onto our stretcher. A dozen people surround you, cutting off your clothes and throwing them onto the soiled ground. We poke you everywhere, flip your body and stick a finger in your anus, with little warning. A tube as wide as large straw is placed through your penis into your bladder, IVs are pushed into each arm, and if we miss, then into your leg. We zap you with x-rays. If a nice doctor happens to be near your head, they might tell you what's going on, but you'll probably be in too much pain to hear it. No one tells you that everyone working to save your life just got out of medical school a few years ago.

- If there's any sign of blood in your lungs, a young intern will get to practice stickign a tube thicker than you thumb into your chest cavity. If they have time, they'll use Lidocaine, but usually, they don't. A 2 inch incision is made in your skin a few inches under your armpit. It's spread with scissors, and then a senior resident sticks their finger in and starts to poke around to make sure it's in the right place. You yell in pain. The intern then takes scissors with a blunt end and starts jamming that blunt end throught the muscle tissue in between your ribs. She's pushing so hard, someone has to hold your body on the other side. When she finally pops through into your lung cavity, she shoves a tube the width of your thumb in there, an experience probably more painful than the event that got you into the hospital in the first place and only slightly more painful than it will be when the tube has to be pulled out.

- If there's any sign of penetrating injury to your belly, you get to have an operation. If you are actually losing blood, we race you to the OR, knock you out with anesthesia, and make a fast and large incision in your belly from your xiphoid process down to your pubic line. Your guts are eviscerated and your abdominal cavity is stuffed with sponges as we search for the bleed. You might lose your spleen, or part of your bowels, or a chunk of your liver. You wake up hours later in horrible pain. You can't eat for days and your abdominal wound will take months to heal.

- If you don't need an operation, as soon as the x-rays are done, everyone suddenly disappears. You are lying there, naked under some blankets, your head is strapped into c-spine precautions so you can't move, and you have no idea what's going on. If another trauma comes in, we'll move you out to join the waiting masses in the hallway.

- That night or the next day, you'll eventually make it to your hospital bed. If you are lucky you might actually end up in the hospital. However, most trauma patients end up in the TNMU, the trauma nursing unit, a building so depressing and nauseating, I have strong doubts that it has anythign to do with nursing you to health. It is a trailer-type building near the back of the hospital, next to the ER. It smells of urine and bandages. It is bright and loud and cold. You share the room with 1-3 other people, at least one of them insane or in such pain that they wail all night. Your room door is never closed, you have little privacy or protection from 24 hours of flourescent light, other than the thin curtain around your bed. People wake you up and poke at your wounds at any time of day and night, and they have little patience for you if you happen to be sleepy. The nurses are young because this is where they go to start their nursing careers. Few are jaded, but most are overwhelmed and very likely to make mistakes. Your physician sees you daily at 6am, for about 1 minute. The residents/interns pop in twice a day, one of those times sometime between midnight and 5am, for about 2 minutes each time. If you have other medical conditions other than the trauma that brought you here (cancer, diabetes, schizophrenia, etc), your medical team will largely ignore them, and only bother with them if it is a case, literally, of imminent life and death.

- As soon as you can prove to us that you can walk and eat, we'll boot you out the door. If your trauam happened to leave you paralyzed/brain injured/without legs, the same rules apply, though our social workers will probably help your family find a government run nursing facility (unlikely to be any better than the TNU) to take care of you.

So, um. Don't drink and drive. Don't drive like an asshole. Don't shot/stab/hit people. And think long and hard before getting smashed and insulting some dude with an ice pick.