15.11 Scene of a Medical Mistake

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11. Two Heads Are Better than One

Eddie and Danny, because their surnames are close by alphabet, pull the same duty at the same time. October finds them on ambulance. Their hospital is part of the city service and relies on interns and medical students to ride ambulance to serve need of neighborhood. It is preferred an intern ride but too few so twice a week 2 medical students go out together; this time Eddie & Danny both in white intern uniform with black emergency bag, they sit in rear hurtling toward an emergency at 2 AM in Hispanic neighborhood. All they know from the garbled call is man on street, ambulance needed.

The ambulance stops at corner of the Bronx's Fox St and East 156th and sees a small crowd gathered by the curb. Danny leads Eddie boasting, "Watch me wow these Spics !"in low voice. He stoops to examine a middle-age man fallen down on street on his back, clothing disheveled and smelling of beer; Eddie stands behind ready to hand down needed medicine or instrument. 
   "Heart Rate 96 regular," Danny says over shoulder after feeling carotid artery pulse in neck.
   A minute later. "BP 140 over 70."  
   "What respiratory rate?" Eddie asks in gentle reminder.
   "Oh yeah." Danny times the rise and fall of chest after opening the shirt. "Hey, 36 a minute!  Where'd that come from?" He shakes the man roughly by left shoulder. "Hey, fella! Wake up!" The man does not move. "The guy really is out. He musta drunk a gallon a beer. Let's start an IV with glucose and water to flush the alcohol out."
   Eddie leans down over Danny's shoulder and low, "Hey, Danny, not so fast! That rapid respiratory rate ain't from alcohol. The guy has got to be in diabetic coma with acidosis. Better draw a blood and start IV bicarbonate and I'll do a quick blood glucose check."
   "Uh, OK, boss," Danny says, realizing Eddie has taken control and thankful for being prevented from making the mistake of giving a diabetic a glucose infusion.
   The blood sample from hand vein is handed back to Eddie, and in the same vein an IV started with sodium bicarbonate dripping in fast. Eddie does a test-paper check.
   "Glucose more than 900 milligram percent."
   "Wow! Gimmee the insulin! Danny almost shouts and Eddie hands him the pre-loaded syringe which Danny injects while Eddie is adding more insulin to the dripping-in IV bottle.

Later, in ambulance on the trip back to hospital. "You saved my life, buddy!  I coulda killed that guy with the glucose. Boy, you are a friend!"
   Eddie says "Nada, pal", mimicking Hispanics. "You'll do the same for me another day."
   Later, Eddie thinks, "Two heads are better than one."
   For next, click 15.12 Psychoanalysis of Nymphomania