The one with the drunk driver

Unknown to the general public, the ED comes in many flavors (1).  There is of course the standard emergency room but to help with triage and whatnot there is usually a pediatric and sometimes a geriatric ED in most hospitals.  Furthermore, most hospitals also have a "crisis" ED which deals with people who come in with acute psychiatric illnesses (2).  This includes acute psychotic breakdowns, exacerbation's of existing mental illnesses, and even really really drunk people who start flailing around at cops with their penis' (3).   The crisis ED is also home to some of the most depressing cases in the hospital because unfortunately this is where the people who attempted suicide go (4).

It was my second day working in the crisis ED and I really thought that I had a hang of everything that went on there.  I knew how to talk to the depressed people, knew what to do with the really angry people, and even sang along with the super drunk people if it got them to calm down and cooperate (5).

Then Clarice came through the doors.

Clarice had a very flat affect (5) and looked like she had been crying for years but had recently decided to stop.  Since my attending was busy working on discharging a patient, I was given the assignment of talking to Clarice and figuring out what happened.  The EMS crew that brought her told me that Clarice had been found by her mother after she drank a couple swigs of Drano.  They didn't know much beyond that.

Fuck.

I had never dealt with an attempted suicide before and I didn't really know how to begin (7).  In my nervousness I must have stood silent as a rock in front of Clarice for an eternity before I even uttered hello.  After hearing my voice Clarice simply turned her head at me and gave me the loneliest stare I had ever received in my life and then went back to staring at the wall.  I tried for a solid half an hour to talk to her but she wasn't having any of it so I decided to go get some help from my attending.

"Everybody's left me...aint nobody here for me no more."

I stopped dead in my tracks.  It had been barely audible but she had broken the sound barrier(8) and it meant that she was ready to talk.  Over the next hour or so, Clarice told me her story and pretty much for the entire hour I stood there with my jaw dropping lower and lower to the ground.

Clarice had been a mother of three:  Tim and Sean, twin boys - 13 years old each, and Rianna, her 7 year old daughter.  She had loved her children with all her heart and had tried to raise them as best as she could.  They received good grades in school and never got into any fights.  She felt that she was one of the most blessed women in the world.

Three months ago, she had been walking home from a parent teacher meeting with the twins when she noticed that Tim had fallen a little bit behind while crossing the street.  She laughed at him to hurry up and that is when the car came out of nowhere and struck her baby boy.  They raced him to the hospital but he was pronounced dead on arrival.

The driver had been drunk.

Clarice quickly fell into despair and depression followed shortly after.   Two days before she attempted suicide, child protective services had to take Sean and Rianna from her because she had become unable to look after herself, much less her children.  She moved in with her parents to get better and thankfully that is how her mother was able to get to her before she drank enough Drano to kill herself.

After hearing her story, I was in tears.  It was the most heartbreaking story I had ever heard and to hear it from the grief-trodden mother herself was something that will never leave me.

We were eventually able to help Clarice by helping her realize that her remaining children needed her; this fueled her recovery far more than our interventions.  She was discharged three weeks later from the inpatient psychiatry ward to an outpatient facility where she overcame her depression and was reunited with her children four months later.

To say that her story changed me is an understatement.  But what I hope to accomplish by telling you her story is to prevent you from even THINKING about drinking and driving.  When you have a drink and choose to get behind the wheel, you are agreeing to ruin not only your life or the person that you hit but also EVERYBODY who is attached to both you and that victim.  Think about it, not only was Tim killed, but his brother and sister were almost put into the adoption system and his mother almost committed suicide.

Dwell on that next time you think its worth it.

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1. Obviously I'm talking about the emergency department, I have NO idea what YOU might have thought upon reading "ED" and "many flavors."  Pervert.
2. A lot of hospitals don't have a dedicated section for the crisis ED, sometimes its just an area in the hallway that's partitioned off by standing curtains.  Happens.
3. Yes that happened.  Had to restrain the guy and everything.
4. Clarification, this is where people who attempted suicide but didn't really hurt themselves too badly go.  The people who REALLY get hurt go straight to the regular ED on the way to the OR.  While that is pretty sad, the cases that end up in the crisis ED are sadder because here you get to talk to the patients while they are still really really depressed and you get an idea of what drove them to it.
5. I have the voice of an angel, numerous drunk people in the NYC area will verify this claim.
6. An affect is your mood as other people perceive it, flat means that its very subdued.
7. Sometimes even really verbose people forget how to talk and this was definitely one of them.
8. A little observation I learned when I was a car salesman:  When one person who had previously refused to say a single word finally chooses to do so, it means that they are ready to talk...a lot.