DEATH BY STETSON; ATTEMPTED

Ok. Read the title, scratch your head, and let your imagination take you where I am certainly going.

A few weeks ago I was working overnight, again on a weekend. This particular Saturday night seemed a bit slow; however content made up for lack of bodies walking through those automatic doors. As a triage nurse, you are the first person to see the patient, determine the 'emergence' of the emergency and place the patient into the appropriate room. For example, a twenty-five year old rosy cheeked frat boy saunters in with alcohol on his breath and glazed over eyes, complaining of severe abdominal pain while making jokes about how nurses used to be in tight little short dress uniforms and rolled up stockings is not something one would consider emergent. Well, not unless he was doubled over and the tears were streaming mid joke. That versus a thirty year old woman accidentally hit by her husband backing out of the driveway (he was talking on the cell phone while backing the car, obviously a very important boy, errr, man) and rolling through the doors with a visible bone or two. Bones are not supposed to be visible, thus creating an 'emergent' emergency. Frat boy will just have to wait 'til the alcohol wears off.

This particular night was relatively interesting. After years of seeing just about everything, this was a first. A man in his mid forties or so was brought in by the police; always a joy. He was hyper, no, more than hyper...my initial guess was methamphetamine. Low and behold I was correct about that part, go figure. The triage process when people are brought in by ambulance or cop is different than the primary tell-me-your-problem triage process. It entails the patient being brought directly back into a room, in this case in handcuffs. From there we go to work trying to find out what happened so we can determine how to treat. Unfortunately there are some docs and nurses that use this time to determine what type of treatment would best fit the type of patient. Yes, even we objective medical professionals are subject to a bit of prejudicial thinking. It comes from day after day of watching perfectly healthy people destroy a body that was perfect upon birth, just for fun.

Methamphetamines usually make people undesirably strong. A small and frail looking 120 pound woman could fight off eight huge security guards with her pinky finger if the situation arose. So then, with the meth guy we were cautious...He didn't look to be in the best of moods anyway. He was having delusions and talking to a lady that none of us could see. It doesn't mean she wasn't there sitting next to him, it means we couldn't see her. He thought we were all out to get him, a normal paranoia with meth. But then something crazy happened. The cuffs came off and he fell silent. We all just stood there, on guard and waiting for him to start bending the side rails of the bed or threatening to snap our little legs in two. He look up at me and with tears in his eyes he said, "It was Stetson."

At first I thought, a delusion, I look like a bottle of Stetson. My thoughts vaguely wandered back to high school, I think that is what my old boyfriend used to wear a ton of. I snapped back to his mumblings and the "not right" feeling came over me. This is when things look ok, and they sound ok, but there is just that little something sitting on your shoulder that forces your senses to understand that something is not right. At this point I start digging, crossing my fingers that he would at least be able to tell me the truth about exactly what happened. Remember, my foremost fear is that someone will keel over and stop breathing, forcing us to intubate and keep them alive. The paperwork is a mess. My primary goal was to figure this out and get him up to psych, after all my 2 a.m. episode of Cops was about to come on.

The blurry eyed man just kept staring at me with his mouth cracked open. Then he slurred, "I wanted to die, then I changed my mind but I had already taken the Stetson..." And the mumbles continued without any sense to them. By this time the necessary steps had been taken to look at a urine drug screen and a blood alcohol level, both not looking very pretty. We will call him "D". "D" looked at me again and decided it was time to leave, grabbed the side rail and started proving his strength by bending it to try and get out. I suppose the thought of just jumping over the rail didn't occur to him. We medicated and in fifteen minutes he was snoring with a pile of blankets and the lights dimmed. Reminded me of a trip to the Marriott with my husband one year.

Come to find out, when all were sober this is what actually happened. "D"s girlfriend broke up with him and he decided he couldn't live without her. They had been doing meth all night and he was cranked. He drove to a part of town where there were train tracks. He had no idea that those tracks had not been used for over fifteen years. After lying on the tracks for hours waiting to die, he got impatient. He was diabetic, and went to the trunk to get his diabetes syringes and medication, with the intention of injecting all of the insulin and ending it that way. Looking through his supplies he realized he had forgotten the insulin, but still had the syringes. Go figure. Frantically searching his car for something lethal to inject, he found a bottle of Stetson in the glove compartment and took it out. (You know where this is going) At this point "D" was frantic. He quickly drew up one syringe full of Stetson and found a large vein in the anticubital space, inserted the needle and shot the cologne into his arm. Once the stinging subsided in his vein the meth took over and he got scared, decided she wasn't worth dying for and called the police threatening suicide and spouting the events of his last few hours.

This is the point when medical personnel make choices. Do we make him comfy or do we allow him to feel like he is truly dying, just for the effect. This is certainly better than my episode of Cops. Hell, it is the episode! As I was leaving to go home that morning I thought about how I would "go out" if I were in his situation and had limited resources. I think I would have not used Stetson. If I'm going I would like to go out in style; who wants to be remembered as the Stetson man? The least he could have done was steal some Armani or Dolce and Cabana and go out in style. But now as I think about it I would have had to change the title of this story and it wouldn't sound as interesting. Thanks "D", for making my a.m. ramblings something of a pleasantry.

"D" lived and vowed never to do Stetson again. The frat boy sobered up and his buddies took him home. The lady with visible bones was transferred to a "more suitable" hospital; we don't do that here.