There is a scene in Apocalypse Nowwhere the Martin Sheen character shows up at an outpost base that is under fire by enemy forces and has been every night for months. He walks through the chaos looking for someone to report to. He asks a soldier who’s in charge and the flustered man says, “I thought you were.” He asks the question again of another man, who just smiles, says nothing and turns away. I was in an ED the other day and I had flashbacks to this scene. Patients lined the hallways. The trauma rooms were filled, people scurried in and out. A crazy patient shouted to Jesus. It was like bumper cars with stretchers and hospital beds going in and out. Phones ringing unanswered. People being paged on the intercom. A priest giving last rights. The sounds of ventilators. A naked man walking through the middle of it, unnoticed. A janitor moping blood. The smell of feces. Conversations in Spanish. The radio going off – a patch about an elderly man with difficulty breathing. Cops standing next to a shackled tattooed girl. A little boy on the floor playing with a truck. I found a nurse, who was mixing a drip and started giving my report. She looked up at me. “Who are you talking to?” she said. “You aren’t talking to me. Nooo, nooo. You aren’t talking to me.” I pointed to my patient. “80 year old. Rectal bleed. Going on for two days. Stable vitals.” I showed her the paperwork and set it on the counter. “I’m leaving it right here for you.” She just kept shaking her head. Down the hall came another stretcher, being pulled by a firefighter in turnout gear, a paramedic bagged a nearly blue patient with an ET tube sticking out of his mouth, while an EMT rode the rails doing CPR. My pager went off. “CAN U CLEAR FOR PRI 1?” *** The next day I worked I did one transport. The hospital was nearly empty.
