Unbelievable Survivals: 70 Patients Defied All Odds Against Grim Medical Diagnoses
Then he died of a Fentanyl o******e.
I’m an ER doc and went to see a hall patient with a complaint of “toe pain”. Sat down to really talk with the guy since it was a lull in my shift. Said his toe hurt because he dropped a knife on it. Asked him, “were you cooking, or what?” He looks up from his foot and I notice a thin red line on his neck, below his Thyroid cartilage (Adams apple). My heart sank, then started pounding. It’s *really* hard to slit your own throat without bleeding to death, but not impossible if you hit the trachea just right and it lines back up when you look down…which is what this guy had done. He had cut nearly all the way through his trachea (windpipe), and just the muscle in the back was preventing it from falling into his chest causing him to die by suffocation. Once that happened, I wouldn’t be able to help him, not with intubation (breathing tube) or cricothyroidotomy (cutting into neck) since his trachea would be retracted into his chest.
VERY CALMY I call cadiothoracic surgery and ENT and got the guy to the OR (still looking at his toe to maintain the seal) for a tracheal repair. He was discharged to the psych floor 3 days later, since this was a s*****e attempt, but did well. I knew he had already decided to live, since we had about a half hour to calmly talk to each other waiting for the OR to be ready. If he wanted to finish himself off, he would have just need to look at the ceiling!
Like many patients in the ER, his story was poignant, his acuity wasn’t immediately obvious, and there is morbid humor associated with the case. When we tell our trainees about this case we refer to him as “the Canadian”.
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