Thank you, dear friends and readers, for your comments on my July 4th shift.  It was, like most shifts in any emergency department, somewhat surreal.  Expecting fireworks injuries, I saw none, nada, zilch, zip.  Urticaria?  Six in one shift.  Insect bites, medication reactions, and who knows what else seemed to cause everyone to break out in  blazing-red fits of itchiness, for which I gave epinephrine, steroids, antihistamines and the rest.  One of them was also the proud possessor of a fifth of liquor, previously consumed and circulating happily through his inflamed system.

There were, of course, wounds from altercations, wounds in both an apprehended criminal and a new police officer.  There were fevers, abdominal pain, and a case of mild post-operative bleeding which led to a patient’s remarkably inappropriate response to an attempted (but immediately discontinued) pelvic exam.

The only real problem, the only true annoyance, was the constant query from patients in doorways who asked, ‘can you tell me how long it’s going to be?’  And the one drunk man whose forehead was split in a fight, who didn’t understand why I was taking so long when I could have been devoting all my ministrations to his face.

The one great joy the elderly woman whose scalp was laid open in a fall, and who patiently let me place 15 sutures and 14 staples in her lovely, gray covered scalp, and who tolerated it all with kindness and equanimity.

It was a steady night, for a mid-sized department, in which I saw 25 patients over my nine hours of doctoring.  Not a huge number, but enough to keep me moving the entire time.  And certainly enough to keep me from the sweet slumber of the recliner in our office.  But then, I tempted the fates.  I called down the wrath of the ER deities by daring them to come to me.  I waved my axe in their faces and they came.

But I went home, slept and survived.  That’s how it always is, isn’t it?  We work, we consume our daily requirement of caffeine and chocolate, we rush, we make decisions, sew, intubate, x-ray, record, report, call, consult, admit and discharge.  We try to do the right thing, and when dawn comes, we have survived.  Exhausted, we go home, leaving the weirdness behind.  We kiss our spouses and kiss our children, fall into odd dreams and we’re up again.

It’s a frustrating and wonderful thing, to have a job so necessary that the shop must be manned around the clock, every day.  And despite the problems, the frustrations, it’s a proud thing, a holy thing, to know that we’re the ones who have our hands in blood, our faces next to the febrile, the wounded, the crazed, the dying.

I survived the Fourth of July.  It wasn’t the worst, it wasn’t the best.  But it was what I do, and what we do. And it was a thing that fills me with a sense of good and accomplishment.

The tingling is gone.  Long live the tingling.  I know my ancestors are proud.  My wife and children are proud.  I think I served my God with honor.  I didn’t punch anyone, or even yell.

It was a good night.   May your nights and days be good ones, as well.

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