by Robert Lanz, LCSW
There was a big trauma on the radio and everyone got all geared up for the worst possible scenario: a train hit a guy. I was with another patient when the paramedics arrived, and didn’t get into the trauma room immediately, like I usually do. When I did, despite my years of seeing horrible things, I wasn’t adequately prepared for what I saw. The patient was laying calmly on the bed, surrounded by doctors feverishly working in the area of his left leg. There was such a crowd around the injured young man and so many people working on him I couldn’t even see what it was they were doing. Blood was flying everywhere and orders were being barked with greater authority than usual. I scanned the room to see if there was any wallet or other property that I might have to take care of so I could start the social work part of trauma care. I couldn’t get to the patient himself so I began to look around the room to see what sort of clothes had been cut off so I could start to search for some ID or information I could use to contact a family member. Then I looked up on the counter behind the doctors and there was his leg, cleanly amputated from the knee down. It still had the shoe on. Nobody on the trauma team seemed to be paying too much attention to it so I guessed it was too late for that part of the patient. Later, when the furor had died down, everybody talked about it, but nobody knew for sure what you do with a guy’s leg when he doesn’t have it any more. And if he dies, do you send it to the morgue with him or what?
Before we could come close to answering that mind-twister, the radio went off again and we had another trauma run. These bad boys from a local Los Angeles gang thought they would go and cause problems with the bad boys from one of the Alhambra gangs. They loaded up their Honda with bad boys and a few knives and clubs then went looking for trouble. Trouble is never far away when you have the right attitude and the Los Angeles guys found it soon enough. As will often happen when things are not well planned, the outcome can be more than anticipated and it was that way tonight because the Alhambra gang, who apparently had been on their way to find some other gang, was armed with guns. When the Los Angeles gangsters realized they had only brought knives to a gun fight they tried to get back to their own turf so fast they lost control of their car and crashed into one of the area’s famous hundred-year-old palm trees. Famous old palms in Los Angeles live a long time because they have extensive root systems and they don’t move at all no matter how hard a Honda hits them.
Some of the broken and dying bodies came to our trauma center but there were so many of them that we had to send the rest over to the county hospital. The paramedics told us that when they arrived on scene the car was such a mess with parts all over the place it was hard to tell who was who and what was what. It wasn’t until half an hour later that the doctors at the county hospital realized that the bad boy named Louie, still alive, had left his foot somewhere behind. They called the paramedics and made them go back out and look for it. Unable to find it, the paramedics called us to see if we had it. I took a look around the carnage in the trauma room and couldn’t find any extra limbs, but in a moment of mental illness, I did think how funny it would be to send them the leg of the guy who had been hit by the train. We all have to cope in our own way. Later I found out the gangster named Louie died, but they never did find his foot.
Even though I never really saw Louie, I knew who he was in a generic sense. He was full of false bravado and frequently performed foolish acts of self-destruction. It was so ironic, a group of teenage boys dying on a beautiful palm tree in sunny Southern California when they could have been at the beach or in the mountains or in their own yard, safe. The real tragedy, the real absurdity, was that Louie could have said NO. Louie could have stayed home and read a book or watched TV or helped his mom or asked his dad about what he did when he was a kid — or anything. But Louie chose wrong. He chose to go looking for trouble and found more than he thought he would. Louie died for it. And he left his foot somewhere.
Some days seem to have a theme and I didn’t like the way this day was shaping up. It wasn’t even my scheduled night shift but I was willing to take an extra shift when one of the other social workers needed to do something special and I didn’t. I was thinking how lucky that person was and how I would have to be a little more discriminating with my time in the future when I got a call from one of the nurses. She was taking care of a child who had been burned and she thought he had been burned on purpose. She wanted me to call the police. No problem. I walked down to do my own check so I would be able to provide an accurate description when I contacted them.
When they showed me the baby’s leg I almost puked. It was burned to the bone; the flesh charred like it had been left on a Sunday barbecue. The baby sitter said the child had been burned accidentally but couldn’t say more than that. She didn’t have to: I knew what happened. She finally lost patience, if she ever had any, maybe she had tried other tactics, I don’t know that part, but finally she fired up the stove and took the screaming three-year-old and held him over the flame. When he didn’t stop screaming she lowered him until the flame touched his leg and when he still screamed she held him there until she was tired then she hit him in the face and put him in bed. He was still crying when the parents came home. It was obvious to them what had happened and they called the paramedics. Nobody could understand how a person could do that to a child. I did, but I wish I didn’t. Stay in the ER long enough and you too will believe that anybody will do anything to anybody. There is no thing that somebody won’t do to another person. NOTHING. NO THING.
What I will never understand is why the father of that child didn’t take the babysitter into the back yard and beat the woman until he was too tired to continue. That seems like a natural act to me. We all agreed that there is something seriously wrong with someone who wouldn’t do it….
I wanted to go home and start the day again somewhere else. I wanted to change my mind about taking someone else’s shift, and then I wanted to change my mind about ever taking one of my own shifts again. Too late. There I was and there was yet another patient to take care of.
I guess this guy’s boyfriend had cheated one too many times and in the age of AIDS this was truly worth worrying over. I guess there is a point where worrying and complaining and threatening are seen as non-effective and there is a need to move to action. I’m sure that’s what the guy was thinking about when he boiled up pancake syrup, molasses, honey and oat meal, pulled the blanket off his errant lover and poured the home made organic napalm on his face, chest and genitals. Sometimes you have to make a strong statement before people realize you’re serious about what you say.
When the cops hauled the man away I asked him if he had anything to say about the situation, if there was anything he wanted me to tell the now sexually useless lover.
“Yeah,” he yelled back over his shoulder. “Tell him I’m serious.”
Rather an understatement, I thought…
According to the police, the neighbors heard the little girl screaming for half an hour before they called 911. It was that kind of a neighborhood. Too bad, it would have worked out a lot better if they had called before the crazy mother, racked by hallucinations and religious delusions, wanted to exorcise the sexual evil from the two year old. It would have been easier to just take the child away and put her with a sane family but it was too late for that. Mother thought she had to cut the demons out, so with her twisted mind she started in the logical place. She put a large butcher knife in the girl’s vagina and hacked away until she felt the evil was gone. The screaming was finally too much for the neighbor who originally didn’t want to interfere and she called police.
Some of the best surgeons in the country put the little girl back together again and thought the surgery would be successful. Some of the strongest police in Los Angeles either puked in my office, cried in the hall or fingered their gun while we tried to medicate the mother enough to get her locked up somewhere. A policewoman fainted, but no one made fun of her. After all that, it was a quiet night in the ER. Too quiet. We all wanted to go home and go to sleep, wake up this morning and try to do the day again and have it turn out better.