Emergency Thoracotomy

On Thanksgiving night 1988, my wife and I had just gone to bed after a Thanksgiving dinner with friends and family. My wife and 2 daughters were sound asleep, as was I. It must been about 11 PM when I heard a scream from across the street where I lived on Betz Avenue. We lived one half block on the other side of Jefferson Highway from Ochsner hospital. I recognized the scream as coming from Jane across the street. She had a daughter 3 years old, the same age as my daughter. They frequently played together. Since I sleep in the nude, I quickly put on a pair of scrubs, and before I knew it, I leapt off our front porch heading across the street. I was right in discerning where the scream had come from. Since the door was wide open at Jane’s house and there was Jerry, lying stretched out with agonal respirations. I recognized him as the boyfriend of Jane. Immediately, I made an assessment locating a bullet hole in the left upper chest. There was a faint pulse and he was unresponsive. I don’t know who the first shadow belonged to that appeared over my shoulder, but the second was my wife coming to investigate. I told her to call 911 and to get my stethoscope. Before the ambulance arrived, I had started CPR. Still barefoot, I climbed into the ambulance with my Jane’s boyfriend and was able to intubate him easily. Once inside the emergency room at Ochsner hospital, I requested a knife, rib spreader, and Kelly clamp. With only one or 2 passes with the knife, a large amount of blood escaped from his left chest. With a little bit of suctioning, I was able to see the bullet hole through the pulmonary artery. At about that time, the room was filled with numerous nurses, techs and inquisitive people wanting to know what was going on. It was either the vascular fellow, or cardiothoracic fellow who asked if I needed any help. I relayed that it was over; he had bled out through his pulmonary artery. A nurse then asked, “Who are you.” amongst all the blood on the floor, and a knife in my hand. I replied “I’m his neighbor” she then asked if I could tell his family since they didn’t know what the hell was going on. To which I told her “I would be glad to.” I was able to get the blood off my bare feet while walking on the grass in front of Ochsner hospital back to my house. My daughters amazingly were able to sleep through it all, including the hour spent with the policemen in our kitchen taking my statement and writing up their report. It turned out that “Jerry” had a rap sheet a mile long.
I was able to get the story at that point in retrospect. Jane and her cousin, who is a security guard, had gone downtown all day for Thanksgiving. When Jerry arrived at Jane’s house drunk and pissed off, Jane’s cousin told him he needed to leave. When Jerry picked up a tire iron, Jane’s cousin went back to his truck and retrieved his 357 magnum revolver. That didn’t stop Jerry from coming at Jane’s cousin anyway until he was dropped with 1 shot. It was then that I heard Jane’s scream. The police were all convinced it was a justifiable homicide and Jerry needed killing. They left after coffee and dessert at my house.
The next day, I asked Dr. William Browder if I could get credit for an emergency thoracotomy I’d performed the night before. He said, “Sure, why not.” Since there’s usually at least 1 emergency thoracotomy per night at Charity hospital, he didn’t see why not, until I told him I did it at Ochsner hospital. Needless to say, I had to tell the whole story from top to bottom.
Interestingly, after 10 years in private practice in Mobile, Alabama, I had an occasion to be at a party with several other physicians. We were exchanging stories from residencies when a radiologist told us about the time that someone barefoot and in scrubs came into Ochsner hospital’s emergency room and open someone’s chest and made a mess. Apparently everyone in the hospital on the late shift had to go down to the ER to see what was going on, since they had never seen an emergency thoracotomy done. I did put the emergency thoracotomy down as a case. It’s the only surgery I’ve done at a hospital where I had no privileges at.

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