Happy National Novel Writing Month 2012 everyone! Okay okay, so I will not be using this month to write a novel specifically…But I will be attempting first and foremost to post everyday even if it is just a couple sentences, to get back into the habit of working some creativity into my daily life. 

I have a few Scotland Vacation posts to wrap up, and then not sure what to write about next. BUT! For those of you interested, I have been keeping this here webspace going for nigh on a decade now. Friends I have related some of my medical stories and experiences to, as well as comments from you who follow me online seem to indicate you have all enjoyed the behind the scenes look at the making of a doctor. Therefore, my goal this nanowrimo is to actually collect all my medical stories and experiences into an honest to goodness book and become a published (if probably unsuccessful) author

That said, it will soon be time to start collecting questions and thoughts from all of you out there in the interwebs about what other behind the scenes things in medicine you would like to know, as it would hardly be fair to release a book of all reposts without something for the loyal followers…so get your brains in gear, and I will move my ass

Hope everyone had a happy halloween!

-Dr J

CONTINGENCY PLAN

nine-DECISIONS

It hadn’t been easy for Josh to escape the hospital. Weaponless, and virtually untrained in hand to hand combat, he had to creep from hallway to hallway, ducking into rooms when he saw one of the child zombies roaming. Their senses seemed somewhat keener that the others, who would only deign to notice sudden, nearby movements, otherwise to content to shuffle around their own little territory. The trickiest part had been the stairs, the initial route of infection. Josh had switched stairways several times in making it to the ground floor, and counted himself lucky that parts of them were still abandoned. Free and clear of the building, he took stock of his surroundings.

The street didnt even look abandoned. It could have been any other fall day. Cars were parked up and down the street, leaves were gathered around the trees they had fallen, and almost no one was in sight. Interesting. So outside zombies had avoided the hospital. Josh filed away that nugget of information with the others he had stored up.

His walk back to his apartment was uneventful. Once there, Josh  took the elevator, knowing that its infrequent operating caused most people in his building to use the stairs. Inside his apartment, he took a leisurely hour to eat some of his frozen food, and gather supplies while he thought. He decided to turn on the tv and see the news

“And while none know what gives them such strength, local police are encouraging people to stay indoors until the proper authorities arrive. If for any reason you are caught outside en route to a safe location, the sheriff department recommends avoiding large groups, and striking the head if forced to defend oneself…this station will continue to replay this loop while we head for a safer location. Please check youtube for any updates.”

Hmm. So they had gotten that right too. Josh was impressed. He swung the chair over by his computer and took a look. No messages from anyone on the buddy list. He sent off a quick one to each of the members letting them know what he had learned thus far. Then he packed his survival kit.

Into his bag went dried and canned goods, batteries, water, and a few other minor supplies. He also took down the sword from the wall. Even though it defied all common sense, he was going to return to the hospital to learn as much as he could before setting out to meet up with the others in California. He realized this pretty much marked him as one of the walking dead, but if it was a choice between riding his bike cross country in winter, or dying warm and full of knowledge, well that was a chance he was willing to take. No point in just giving up though…he would hold out as long as he could and if he still survived come spring, well plans could change then.

TO BE CONTINUED…?

CONTINGENCY PLAN

eight-NARROW ESCAPES

Crystal was covered in blood. Thankfully, none of it was her own, though she hadnt been sure for a while there. The one thing Crystal was sure of was that Josh’s injunction against attacking the undead no longer applied. People in Santa Barbara were attacking anything that moved, without bothering to check first if it was infected or not.

It had begun yesterday. Crystal had been packing her things up to go and head back to the valley, when Jenn had convinced her to go out for one more dinner. Crystal had reluctantly agreed. While they were at dinner, several students had wandered in the door of the pizza parlor, acting strangely. Strangely to anyone who hadnt had zombies described to them anyway. While they were milling about the entrance, another impatient student had come up behind the group and tapped one on the shoulder

“cmon dude, some of us are hungry too.”

At which point the student he had tapped turned around and bit him on the arm. His scream of pain and outrage attracted the attention of the remainder of the group, not to mention the other patrons of the restaurant.

“Motherfucker! What the shit did you bite me for! fuck man! You fuckers need to restrain your drunk ass friend so he-WHAT THE FUCK!”

The student stood no chance as the other five zombies quickly turned their attention to this easy prey.
Crystal stood up, pizza in hand.
“Time to go, Jenn”

Jenn, wide eyed, allowed herself to be led up from the table and out the back door of the restaurant, while Crystal watched as the other patrons either ran to go stop the fight (stupid of them) or went for the exits. They exited into isla vista

“Shit.”

They were surrounded. It wasnt like the movies where things were on fire, people were crashing or running around with moaning zombies chasing them. In fact, the eerie bussinesslike silence was all the more terror inducing. The zombies just wandered around wherever the mood seemed to take them, to cars, restaurants, down the middle of the street, almost as they had when they were simply students. The living were easier to identify because they were usually alone or in groups of one or two, as compared to the ever growing amoeba like mob of the infected. Even the survivors werent making a lot of noise. Many just cowered in place, hiding in doorways or cars hoping they wouldnt be noticed. And for many it would have worked were not the crowd of infected thickening by the moment. After all, even the most dimwitted predator will notice something in its personal space, and as zombies flooded the streets from who knew where, places to hide were becoming few and far between.

“Cmon, we have to get to my car, we can get out of here”
“He was right”
“What? who was right?”
“Josh was right”
“Duh, but lets focus on not dying right now, mmkay? CMON”
“I need a weapon. my stick!”
“Screw your stick, its a piece of freaking wood…I have two swords and a crobar in my car if we can make it, let;s go!”
“Must have a weapon…only way to be safe”

And Jenn went bolting off to the dorms

“Jenn!”

But her friend chose not to hear her, running instead toward the crowded dorms, a place sure to be swarming by now. Well, screw that. Jenn was her best friend, but Crystal was not losing her life or humanity to someone determined to die. She would get to her car and procure herself a weapon. Then, if she had time, she might seek out Jenn. Friends dont let friends become zombies. She set out toward the visitor parking lot, and wondered how the others were doing

…………………

Phil was checking his instant messenger like a madman, looking for any kind of communication from anyone. He didnt doubt Josh was alive, but clearly he was unable to respond. And Phil couldnt afford to wait any longer. The zombies were present in great enough numbers that he didnt dare go outside without someone to watch his back. Just the other day he had seen one of the neighbors go out to try and scare off the mob of what appeared to her to be well dressed homeless. As she repeatedly hit them with brooms, a few of the zombies did move away. Right up until the point when another walked up behind her and bit the back of her head. The moment of confusion was all it took for three more to swarm her, and down she went. The scariest part was how it all happened in silence. None of the neighbors had left their houses since then and the zombies had free run of any with open doors. The carcass of the neighbor lay in the street, mute testimony to the truth of zombie existence. With the majority of her head gnawed off, Phil didnt think she would be getting back up, either.

Well, he wasnt staying here anymore. Crystal wasnt coming back to this neighborhood even if she had made it out of Santa Barbara, and he only had enough food supplies for a few weeks. Phil was going to set out for Santa Barbara himself, though not before making sure he was better prepared. So Phil went down to the garage, hooked two bicycles onto the back of his civic, and put half the food and weapons in the trunk. He kept the other half of the food in the backseat, and a hammer and wrench on the dash. The last thing he grabbed from his house was batteries, and every available cell phone. He may not be able to wait by the computer, but with AIM availble on most phones, any messages Josh left would get forwarded to whichever phone he happened to leave on, at least until the power cut out.

Phil got in the car and opened the garage. The noise attracted the attention of about 15 zombies, who had lined up in front of him like tenpins by the time the door was fully elevated. Phil took a deep breath. “They’re already dead man, you can do this.” Then he put the pedal to the floor and drove through the crowd. Two went over the windshield and one under the tires with a sickening crunch. But Phil was clear. Despite knowing he shouldnt, he looked back to see a man cut nearly in half, intestines spilling out but trying to crawl toward the car nonetheless. Phil breathed a sigh of relief…that sight, disturbing as it was by itself, meant he had been right. He hadnt risked killing innocents and these zombies, like the stories said, probably had to be taken out by head shots. He eased back in the chair and took a moment to gather himself. It was almost his last.

A fist crashed through the driver side window, showering Phil with shards of glass. While he had been staring behind him, another zombie had come up in Phils blind spot and with one attempt broken through the window. This one looked like a teenager, but no teenager phil knew was that strong. While the arm missed Phil, it did grab the steering wheel, Phil slammed on the gas, but the zombie merely got dragged along down the street, not loosening its hold in the slightest, reaching for Phil with its other hand even as the first one continued to maintain a death grip. Phil knew he wouldnt be able to shake the zombie like this, but he wasnt abandoning the car…he needed it, at least for now. So Phil hit the breaks, and as the zombie swung forward, it’s free hand missed Phil by inches yet again. With the car stopped, Phil grabbed the hammer beside him, kicked open the driver side door and jumped out. The zombie turned toward Phil and released the steering wheel. Phil let it follow him several steps away from the car, all the while watching as other zombies closed the distance. Once the first zombie was four paces away from the civic, Phil ran in close and ducked. As he predicted, the zombie made another grab for him, its arms closing over empty air. Phil popped up as they closed their loop, and used one hand to hold the zombies arms against itself so it couldnt grab him. The other arm brought the hammer down right at the bridge of the zombies nose as Phil attempted to smash its head in. The first few times, he heard a crack a bone, but the continued movement told him he dare not release his grip. Instead he continued hammering in a straight line up the zombies skull. Just as he was beginning to fear that he had been wrong and these zombies were immune to head injury, Phil heard one more crunch and the thing in front of him went limp and heavy. Phil wasted no time examining where the sweet spot was, instead running for the car as other infected closed the distance. He made it in, closed the door and peeled out down the street, his last view of the curtains of another house parting as he sped off to a more relative safety than his neighbors were likely to have. He may be safe for the moment, but those injuries would slow him down considerably, especially if they got infected. Luckily, he knew of a hospital nearby where he could pick up medical supplies, and hopefully a medic. For the moment, at least, saving Crystal would have to wait.

………………………………

Brian was enjoying himself. All of a sudden, it seemed it had become socially acceptable to hit people with baseball bats. Now Brian was not by nature a violent person, but dude, this was just like playing a video game. Brian had returned to his apartment to find it surrounded by a mob of zombies, too thick for him to make it through. That meant his survival for the moment depended on what he was carrying in his backpack. His list of supplies numbered thus: 3 packs of batteries, 5 boxes of shotgun shells, a metal baseball bat, 12 nutrigrain bars, a pack of beef jerky, a flashlight, a cell phone, and his digital camera along with 5 dv tapes, only one of which was even remotely full. Sadly, the shotgun was in the apartment, so Brian was without his preferred weapon, but c’est la vie. He grabbed a bicycle from the rack, and headed back toward the hospital he had seen last time and the nearby Wal-Mart. The police were there and clearly uninformed about the threat they were dealing with. One policeman was already down and surrounded by a mob who were devouring him like a blue light special. The other had opened fire on the zombies poring out of the walmart, but it was only serving to draw attention to himself from the zombies both in and out of the shopping complex. Brian watched as they put bullet after bullet into the chest of each of the zombies, wounds which bled, but neither slowed nor stopped the inexorable advance. Brian coasted down the hill and shouted, “GO FOR THE HEAD” As he gave one of the infected a good solid whack, dropping it like a sack of bricks. The terrified policeman quickly complied and began having a much higher success rate. Right up until he ran out of bullets. Brian and the policeman locked eyes and in that instant, Brian knew he couldnt make it in time. Nonetheless, he was determined to try, and as he pedaled toward the mob, he saw the policeman pull a shotgun from the back of the car and use it as a club. However, his angle was bad, and he couldnt deliver the force needed to crush skulls. One of the zombies finally got a hold of his foot and pulled him down. As it sank his teeth into the policemans leg, Brian made one last desperate shout-”Throw me the gun! I have ammo!”

The halfhearted toss landed amidst 4 zombies in the middle of a shopping cart. The effect would have been comical if Brian hadnt wanted the firepower so badly. He couldnt count on his drive by technique to take out the zombies, they were too close together. So He stopped the bike well back of the line of scrimmage, and ran toward them screaming. They didnt react. He didnt expect them to, It just made him feel braver. The first one dropped before it even got an arm up, and the second shortly after. Brian just missed the third zombie and instead landed the bat on its shoulder. He spun and smacked the legs of the fourth, knocking it to the ground just as it was leaning in to bite him.

“Wait your damn turn”

Brian turned back to deal with the third zombie. He waited til it came slightly closer, then he feinted left. As the zombie took the bait, Brian went right, came up behind it and caved in its head. He then grabbed the shotgun from the cart, and quickly loaded a few shells into it. Just as he finished, he felt a hand on his ankle. The fourth and final zombie had crawled over to him, and seized his leg. Brian sighed, more exasperated with himself than anything. As the zombie pulled itself closer, in an attempt to bite Brian, he twisted his body, turned and pointed the barrel right at the zombies face.

“This. Is. My. Boomstick.”

Then he pulled the trigger, and the hand on his ankle released as the excuse for a mind controlling it got spattered over the pavement. Brian looked around at his options. The Walmart was out of the question, since most of its shoppers were either zombies, or too stupid to leave a walmart full of zombies. The hospital however still only had a few zombies in front of it. There were undoubtedly more inside, but there was also a cafeteria. And Brian was famished. Until he could find a place to stock up on non-perishables, he could sneak in for a quick meal of hospital food, maybe some medicine, and some survivors who might be able to help him. Brian walked the bike over to the hospital, leaned it against the wall, and entered the lobby. As he headed down the deserted hallways in search of survivors or sustenance, he wondered how his brother was doing…

TO BE CONTINUED…

70%

Slow days lately in surgery. Once there is something to update, be assured i shall

CONTINGENCY PLAN

seven- IT BEGINS

Less than two weeks since Josh had sent out the email and things had taken a quite predictable turn for the worse. The zombies only seemed to gain in strength and brutality. There were no more restraints left in the hospital. Not that it particularly mattered because there weren’t that many people left in the hospital either. Living ones, anyway.

With every level full of the infected, things had pretty much played out stereotypically by floor. In pediatrics some infected kid had managed to bite one of the hospital staff, who of course kept it silent because goodness forbid she be placed in restraints like the other patients. Managed to hide the sickness pretty well too, right up until she collapsed into the telltale seizure in a patient room. When the other nurses on the floor came to check, she just appeared passed out, but with everyone paying attention to the downed rn, no one noticed the patient free of his restraints until he had sunk his teeth into two nurses. Well by the time they got him restrained with the help of security, the previous nurse was up and moving, and while uncoordinated, still able to bite several more staff. In a matter of hours most of the ancillary staff had collapsed into seizures with relatively little communication between the floors, anyone who wandered in for something as germaine as a shift change was quickly confronted by a floor full of the chronically infected and recent converts. Now the newly bitten may not have been used to their abilities or particularly strong, but it doesnt take much strength OR coordination to stand in a doorway while a bunch of highly energetic small children zombies go rocketing past into the stairwell and elevator.

That was one thing Josh had learned. The shambling gait was unique to adults. Child zombies had all the mobility available to them they had had as living, which made them far more dangerous. In a matter of hours, most of the floors had been overtaken as kids zipping around bit who they could, often pausing to feed, while those who had been infected longer took advantage of the lull in security to make their way free of restraints. Most of the medical staff who were bitten were the ones unwilling to hit children to defend themselves.

The majority of the surgery and ER made it through just fine. Doctors and nurses used to making split second decisions saw what was happening to others, and acted in self defense. Most of them simply knocked the kids back a couple yards, and the zombies were usually easily distracted by some fresh downed body, upon whom they would pause to feed.

That was the next thing Josh noticed. Brains truly must be a zombie delicacy. Anyone bitten on the extremities tended to suffer the same sickness, and become a zombie, while those who made their cranial cavities available for food tended to stay dead. The third thing Josh noticed was that the longer a person had been in a zombie stage, the faster their bite was likely to turn someone. Patients who had been infected for two months would have bites leading to infection and seizure within 24 hours. Newbies still took the full two weeks to turn people.

Of course, a few hospital floors managed to remain contained. Mostly the ones behind thick doors with ID badges required for entry. On those floors, the survivors of the initial overrun considered themselves on permanent call. Every patient was monitored, and any of those with the signs of infection received the highest priority care-right up until the moment the seized. Then they were placed in one of the isolation rooms with the other infected, or kindly deported into the hallway while they were dead and immobile. For while as far as they all knew, there might still be a cure, that was no reason to risk unneccesary exposure.

Josh had been working in the ICU, one of the secured floors through the whole overunning of the hospital, and thus had not realized the initial attack had begun until staff flooded the floor, many in shock, and others, more pragmatic, assessing the surroundings. With no opportunity to grab a weapon, and thus no way to get past the infected milling about on the floor, Josh had been effectively trapped at the hospital for the moment, making his observations based on the floor security cameras of the hospital, and conversations with people on the other two floors. However, with the cafeteria overrun, the food supplies would quickly dwindle, so Josh knew he had to figure out some way out of the hospital and back to his apartment. Once there he could begin the self defense part of the contingency plan.

…………………………..

Phil was worried sick…Crystal was almost 3 days late back from Santa Barbara, and he had no word from her in almost a week. Not to mention which he had begun seeing infected in the neighborhood. They weren’t hard to identify-they looked a lot like the homeless with their strange, shuffling step, except the homeless dont keep walking into walls or motion tracking small creatures for food. Thus far, Phil had done as Josh suggested and not attacked…but with more gathering everyday, it was only a matter of time before it became a question of survival. Phil decided he would wait a couple more days for any more tips or knowledge…then he would take his survival kit and head to Santa Barbara. It wasnt specifically part of the plan, but then, the plan entailed more than 1 person to survive

………………..

Brian had been getting the best footage of his life. Sure the zombies began targeting him whenever he stepped outside, but they were so few and far between it was no effort at all to dodge them. And if any did get to close, he simply used the baseball bat he carried to give them a good slug to the legs. Once they were down, he retreated to a safe distance and continued filming. And the best part was, he had evidence of his self defense all on film!

“This is Brian Dee, documenting the end of the world as you know it. As you can see, this infection seems to have turned the sick into mindless zombies. Well perhaps mindless isnt the right word. They do seem to have some sort of human memories, as the largest groups are currently located at common gathering places for people-malls, supermarkets, parks, anywhere that people may have been found. Or perhaps they are just hunting for food, since whenever they find crowds of people they attempt to converge on them, like so.”

Brian knocked another couple zombies down, never stopping his monologue as he once again retreated

“Of course, your’s truly isnt phased by this at all, and is attempting to document it so one day you will all know how it began. Once I find a companion to help fend off some of the more aggressive roamers, we will enter into the very den of the sick, a hospital and see how the medical community is dealing with this new threat. As you can see…”

Brian swung the camera over the horizon and zoomed as much as possible

“There doesnt appear to be much activity at the hospital, perhaps because under normal circumstances, even healthy people avoid it. But when a more reliable means of transportation presents itself, be assured the continuing saga of Brian the bonecrusher will give you all the knowledge you need to fend off the undead. Eat your heart out Spielberg-unless someone does it for you!”

With that Brian turned the camera off. If he ever found a way to broadcast his videos, or at least upload them, he would quickly become a very well known film maker. Who cared if it was a documentary-save peoples lives and the fame would come rolling in. Though he should probably make sure there were people alive to save. He hadnt seen anyone other than zombies in this area for almost a week now…and there were more all the time…

TO BE CONTINUED…

CONTINGENCY PLAN

six-PREPARATIONS

It was one thing to realize he was surrounded by undead. It was quite another to try and convince people of the danger. It wasn’t as though Josh could very well go to his attending or resident and say “pardon me, but I have this new bug all figured out, and the only cure is to behead those infected.” He could imagine how that would play out.

And technically, he wasn’t in a movie…he didnt know for certain if it was impossible to cure…heck, nobody even knew who patient zero was yet. So Josh decided he would implement the contingency plan among those he could trust, and continue to work his assigned shifts at the hospital, the better to learn his enemy.

The first thing Josh did was to go and check on Mr Greenberg in the Intensive Care Unit. Still intubated, still comatose, with a body tempurature below the point of hypothermia, Mr Greenberg was probably the longest dwelling resident of the hospital with the superbug, and yet the only one who had not yet undergone the seizure stage before the final transformation. That meant he bore closer examination than any other infected, since any potential cure, cause, or treatment would likely lay with him.

When Josh returned home that day, he redecorated his apartment a bit, loosening the window frames so he could easily leap to the next building should the street become too dangerous to maneuver in. The he moved the sword hanging in the common room to his bedroom, where it would be close at hand when, not if, he needed it. Then he sent out an email first to those he knew would believe him. The list was depressingly short.

To: Phil; Crystal; The machine; Tammy; Brian; Aytch;
Subject: Contingency Plan

Hey all,

So here is the deal with the new superbug: we are talking zombies. I have been denying it to myself for weeks, but there can no longer be any doubt. These people, once reaching a certain stage of infection, suffer a seizure and become the shambling legion of undead that we all know from films and comics. Now they wont appear to be rotting…it’s still too early, and I admit I dont know if they are actually dead, or more like the rage or solanum virus. But I can tell you they do gain increased strength, the traditional shuffling gait and the semi conscious awareness of their surroundings without apparent higher thought functions

Right now, you are the only ones who know the truth, and that is because you either have contingency plans of your own, or we have discussed your roles in mine. We have a chance and privilege few horror film characters ever receive, and that is we know what is occuring with enough time to prepare. So that is what i am telling you to do. Make sure you have your alternate methods of transportation and food preparation…once this becomes bad we dont know if we can rely on modern conveniences. Have both your ranged and melee weapons…you all have basic marksmanship, but ammo is not unlimited.

By the same token, do not yet make any aggressive moves toward zombies yet. The general public has not yet realized, nor would they believe the danger facing them. Once they do, we will be the best equipped to deal with the problem, but until then, we dont want any of us going to jail for what would appear to be brutal murder. Bide your time, prepare, and stay in contact…everyone should leave their AIM on so we can keep each other updated as long as possible. I will continue to stay in the lions den and see if i can learn more about the zombies and what we can do…the rest of you, buddy up when traveling, and make sure any one who can realistically be convinced of the problem is. If you tell them, and they are not, well at least we have our decoys in case of emergency. You all know what to do…the world as we know it is about to change…

Now that he had sent off the email, he felt much better. He was ready for the coming storm. It only remained to prepare others…

………

Phil read the message, tabbed over to the latest news report, and tabbed back. Yep, it was true. And that meant that those who took the threat seriously would be few and far between, at least for a while. Well terrible as it sounded, the general populace wouldn’t be ready until humanity’s numbers had been thinned a bit. And by that time, the majority of the media would probably be panicking too much to do anything useful. Phil went to go ready his safehouse and advance his planning preparations. When Crystal returned, they would be ready

…………………

Crystal was up in Santa Barbara visiting Jenn, a friend of hers and Josh’s from college, when she read the email. She told Jenn what Josh had said, and, as predicted, Jenn didnt believe it.

“Crystal, zombies aren’t real. Josh is playing a prank, although an admittely well thought out one. Just because the sickness makes some people walk funny and spreads like wildfire does not mean they are the dead and have to be killed.”

“Could you at least consider what you would do if it was? I mean you have that homemade mace from Japan already. And it wouldnt take that long to teach you basic marksmanship-we could go to the firing range and do it over the next few days, so when things get bad, you can be a valuable asset to the team.”

“First off, I told you, i am not learning how to shoot a gun. We have been over this before. Second, isn’t being your best friend enough of an asset? and third, even if this cockamamie story was true, which i seriously doubt, I have my stick with nails in it. It was good enough to intimidate small japanese children, and it will be good enough to scare off any of your ‘zombies’. Not to mention that there aren’t any in santa barbara anyway. We have just had a run of the flu or mono or something.”

“Dont you see? Any sickness is suspect now! You are in a college town, which means you should be more prepared than any of us. When the infection goes south, this will be one of the most dangerous places. I am not telling you to abandon it now, just to be prepared, so when the time comes, you can meet up with Phil and I”

“I am sure if it got that bad, the government would do something about it. Isn’t chicago quarantined by the cdc right now anyway? How would you guys meet up with Josh?”

“Josh isn’t our leader-him and Phil are just both best prepared for this kind of situation and trying to make sure as many of us are too”

“Well, I will think about it…in the meantime, let’s go get some ramen.”

………………..

Phil “The Machine” Szeng just put his head into his hands on reading Josh’s email. Sure Josh might have exagerrated or gone off the deep end just a little bit, but he had always had an overactive imagination. And there was no doubt about the actual results of the sickness he was describing. Phil had been seeing it in his hospital too. With the city under quarantine, and the situation likely to get worse, it couldnt hurt to follow most of Josh’s advice. At least he wasnt saying to strike off the heads of any of these patients yet. Phil would call Tammy and Ryan later and let them know he was going to at least prepare for some kind of crackdown.

………………………..

Tammy out and out laughed when she read the email. At least, initially. She and Josh had talked about the plan before, and she was glad to be included in it, but she had never really taken it seriously. However, while she wasnt as familiar with zombie films as Josh, she HAD seen the patients, and had to admit that they did measure up pretty well to what he had described when compared with zombies. Couldnt hurt to do what Josh suggested. Didnt look like things were getting better anyway, and at least she could feel like she was doing something.

…………………..

Brian went out immediately after the email, and purchased shotgun ammo, an ax, batteries and a bunch of rolls of dv tape for his camera. He trusted his brother, and dammned if he wasnt gonna be prepared, or get the best story ever. Think how much money he could save on special effects. It was like army of darkness, only he would get to be ash AND sam raimi. Now if could just figure out a way to safely film patients in the nearby hospital. Maybe if he set it up as some kind of community interest documentary. that might work…

………………….

Aytch turned to Andy.

“Josh says there are zombies in America now”

“Really? Neat. from what?”

“Some infection. He was just letting us know the contingency plan is being activated…you have a weapon?”

“Aikido staff and bow. I can be a samurai zombie slayer if they make it out here to okinawa-do you have a weapon?”

“Andy, I’m a marine. I AM a weapon.”

Ken had heard reports from his commanding officer. The U.S. government had pretty much come to the same conclusion Josh had, on the basis of much less evidence. As such, Kens unit was on mild alert for any outbreaks in Japan or Okinawa, where he was stationed. Once the situation was controlled here, they might be recalled back in to the quarantined cities to help contain the fallout. Ken only hoped Josh’s plan would be good enough to see him through that time. Because if projections were correct, Josh wouldnt have long to wait before people were a LOT more convinced that he suspected…

TO BE CONTINUED…

CONTINGENCY PLAN

five-EPIPHANY

All hell was not quite breaking loose, but it was certaintly testing its restraints. The city of Chicago had been placed under quarantine by the CDC, along with New York and Los Angeles, whom, while they were not as bad as the windy city, were well on their way, being unable to control their infections either. In the last month all of the Metropolitan Group Hospitals had filled up with the new superbug patients. There were no more beds left, and even people with the disease were being turned away unless they were severly symptomatic. With the exception of one or two hospitals, nursing staff weren’t even bothering to put patients under isolation conditions anymore…precautions had gone from airborne to droplet, to simply contact, mostly due to the lack of room. The real isolation rooms were saved for the patients who had progressed into severe stages of the disease.

The intial stages of the infection were fairly vague…an initial high fever followed by progressively lower tempuratures, maybe some myalgias, but overall nothing specific. Of course, studying the disease progression in age ranges was much easier now since so many were infected.

After an inital week of infection, most of the patients had several seizures. This was where they began to differ in their course. The very young, 3 and under, simply died. That was it. The bodies were burned and returned to the family.

The Elderly would often have one or two severe seizures, and then lapse into a persistent vegetative state. PVS was a much better phrase than the layword “coma” mostly because coma implies the person is not moving. Post-ictally, the infected seniors would perhaps be comatose for an hour at most.Then they would be up and around with that same shambling gait and altered mental status, unable to communicate beyond grunts and often combative as well, attempting to strike or bite. Since the hospital had long since run out of restraints, most of these patients unfortunately had to be discharged if there were no more isolation rooms. After all, the nurses werent able to check vitals on any of the ambulatory patients…they kept biting the thermometers in half. Had the elderly’s muscles not been so atrophied from aged and prolonged hospital stay, several of the smaller nurses might even have been overpowered.

But the most disturbing was the average healthy adult, obese or otherwise. They tended to last almost a full two weeks with the infection, getting progressively worse each day, not knowing why, but knowing where it was going to lead. Initially a code blue had been called when these patients seized, but now it was mostly ignored. It was too unreliable. Every patient suffered an eventual seizure. The healthier the person at the time of infection, the worse it seemed to be. And while most also went into cardiac arrest, the application of ACLS protocols did nothing; the defibrillator, the epinephrine, the cpr…whether instigated or not, the patient would regain consciousness within several hours with the same damn symptoms. Three patients had been pronounced dead only to be seen up and wandering the floors within hours. The first couple of times it frighted the daylights out of everyone. Now if a code was called, the charge nurse just waited for the coma period to restrain the patient.

Josh had been present at the code of one of those first three patients. The young woman suffered a seizure that was almost similar to the textbook clonic-tonic, or “grand mal”. Spastic muscle convulsions, limb thrashing, complete unawareness of surroundings.

Similar as it seemed to a classic seizure though, there were a few differences Josh didnt recall from any textbook. Instead of having to worry about the patient biting her own tongue or injuring herself, this patient had to be restrained so she wouldnt injure others. Her head whipped back and forth, snapping at anything in reach. She managed to break restraints on one arm and scratch at one of the residents, opening a small cut. Now those restraints were tied down securely, so either the woman had gained a great deal of strength, or a complete inability to feel pain sometime during the course of the illness.

She had gone into a cardiac arrest. CPR was performed on her for a full 45 minutes before time of death was officially called. The patient wasn’t breathing, had pulseless electrical activity on the heart monitor, and temperature at time of death was 88 degrees farenheit, only several degrees away from pre-superbug temperatures of those who resided in the morgue

And yet, two and a half hours after the code was called, screaming was heard from the room. One of the nurses who had gone in to obtain supplies from the room saw the patient up and thrashing against the restraints. On observation the formerly deceased patient appeared to be confused (although, who wouldnt?) and moving her limbs randomly, like one discovering them for the first time. No outward hostile actions were noted, yet any motion near the patient’s head elicited a rooting type reflex…the patient would turn the side of motion, and attempt to bite, rather than suckle. It was like watching an infant, albeit a potentially dangerous one

Josh could ignore this no longer. While he didnt know the origin of this bug, he could no longer deny its conclusions…zombies. He knew what he had to do next…

TO BE CONTINUED…

P.S.

Remember, if you would like to be FEATURED in the ongoing Novella Contingency Plan, all you have to do is
1)Comment on the site with the name and location of your character
2) in the comment include what ability or knowledge YOU could contribute to a contingency plan (i.e. marksmanship, cooking, anything that would help a small band survive in a world filled with the walking dead.)

best responses will be introduced in later portions of the story

Woke up this morning feeling amazingly refreshed. You ever have those mornings, where you wake up without an alarm, you feel good, and you know you had just the right amount of sleep? That was me today. Of course, it was 4:30 am, but hey, what can you do, right?

Saw two surgery cases this morning. The first was an open appendectomy. I scrubbed in and then watched as a 7cm incision was made straight down from the navel. It’s amazing what a handy landmark the belly button is for surgeons. Could be because that is where the linea alba is, and an area of weakness ideal for entering the peritoneum. Or it could be because everyone knows where the belly button is and it helps make procedures standard. Regardless, I got to fell the underside of someone’s belly button. It was neat.

The remainder of my job on this surgery was basically to hold retractors while the surgeons manipulate bowel folds out of the way to get at the appendix. The smell was god-awful, due to the ruptured appendix and pus filled abscess that had resulted. And yet, while being utterly revolting, it still was not that bad…maybe i am just used to terrible smells now…future pre-meds be aware…kiss your nose goodbye.

Retracting is basically waterskiing. You hold tension on these large metal pieces like big people shoehorns that pull back the fat and organs, giving the surgeon a clear room to work in. An open appendectomy is a lot different from a laparoscopic one…it is more raw, gritty and feels like real surgery. I speak in contrast to the video game feel of the lap appy i previously had seen, which was no less a real surgery, but is seen on a screen and doesnt involve the surgeons grabbing your finger and shoving it onto a bleeding artery to hold pressure while he takes care of his business elsewhere in the bowel. Good times.

Once the surgery was completed, the wound was left to heal by delayed primary intention. Basically, the sutures were placed, but not tied, as the wound will be left open for the next couple days and allowed to granulate back together by itself slightly. Then, if it is still clean, the sutures will be tightend and the patient is free to go without their entrails falling out.

Second surgery was a laparoscopic cholecystectomy, or lap chole for short. Similar to the lap appy, but this time it was the gallbladder being removed. Similar to a lap appy, several small incisions are made, the peritoneum is infused with carbon dioxide to inflate the chest giving the surgeons room to maneuver, and then a small camera and several tools are inserted through tubes placed in the holes. Once again, i got to drive the camera, this time with no outside meddling, just directions about where to look and zoom. Had no trouble with the controls this time, and at the end of the procedure, I even got to suture two of the cuts closed all by myself! This is why it’s called practicing medicine my friends…because every time you get just a little bit better. And for the record i suture equally well both right and left handed. Right handed in ED, but left handed due to ease of angle in OR. Southpaw pride. w00t.

The interesting thing to me about this case (well unique-its all interesting) is that this patient was essentially mine the entire way through. I admitted her from the ED, took her history, participated in pre-op care, scrubbed on the case, and I will be following her post op care tomorrow. All with minimal looking over my shoulder at least where my responsibilites are concerned. It felt good. Almost like i was a big boy. And just like popular TV shows, a little bit of politicking had to occur for the patient to get the surgery. Since she was uninsured, an elective procedure like this normally would not have been covered. However, she was also two month post partum, and with a little tweaking of the wording, this becomes covered as a post pregnancy complication and the patient is able to get a surgery she needs, but otherwise wouldnt be able to afford. Yes, ultimately it is our tax dollars paying for it, but it still feels darn good to beat the system.

And Now we continue

CONTINGENCY PLAN

four-THE CAST

“Damn Damn Damn! Why did it have to be clowns! I freaking hate clowns!” Crystal shouted at the TV. She had been playing dead rising non stop for the last few weeks, ever since her boyfriend had beaten the game. Crystal had always had a healthy fear and respect for zombies, but playing xbox was slowly diminishing that. She just imagined each zombie as one of the people she had to deal with working for the IRS, and BOOM! she didnt even have to think about killing them, it just happened. Until the game threw a chainsaw wielding clown at her anyway.

“Phil! come beat the scary clown for me!”
“Just shoot it, it’s only a clown!” Phil laughed as he walked into the room.”What would you do if it was in real life, call for me to help you?”
“No, I would probably kick his clown ass with my aikido so hard he would think he was being shot out of a cannon”

“That’s always the first resort for you asians, isn’t it? Kung fu the problem away”
“Whatever mister…first off, I’m Thai, not ‘asian’, second, i’m a blackbelt in aikido, not kung fu, and third, you’re korean, so you would have to kung fu him too-or would you just world of warcraft him to death.”

Phil lauged good-naturedly. “Of course not…i would pick up the nearest object…” He grabbed the controller from Crystal, “like so, and bash his zombie brain in.” As the clown finally went down for the count, Phil tossed back the controller to Crystal. “Of course, that is why I am the one with the zombie contingency plan, and you are the one running from clowns. Speaking of people who fear clowns, you talked to Josh lately?”

Crystal saved the game, shut it down and turned on her computer. “Yeah, he’s doing his surgery rotation in Chicago.. learning a lot of cool stuff, but he is swamped right now with a bunch of patients who have that bug we keep seeing on the news. Apparently it’s a lot worse in close-knit cities like chicago where everyone is in such close contact.”

Phil rolled his eyes. “Oh good at last Los Angeles’ complete lack of public transportation and city organization is good for something. Everyone who gets sick is quarantined off because they are too weak and disorganized to drive. I hope they find some way to treat it soon though, it’s been a couple months and it just keeps getting worse.”

Crystal checked her email while responding to Phil. “I’m sure Josh will be the first to hear about it and let us know if anything happens. It pays to have medical friends. Oh hey, he sent an email.”

“What’s it say?”

“Nothing much. Hello, how are you, still no word on the epidemic. Oh wait, he said the method of spread is unknown, but a lot of patients have had bites or scratches. He also said that we should probably stock up canned goods since the CDC is trying to figure out if fresh meat could carry the virus. The he says hello to you, and tells us both to make sure we have bikes just in case. Heh, it’s almost like he’s preparing for some sort of nuclear disaster without really thinking about it. I guess med school makes you see the worst possible outcomes.”

Phil had a strange look in his eye when he answered Crystal. “It never hurts to have a contingency plan…”

………………

Brian was chatting on AIM, and dicking about on the computer, as usual. He should have been out looking for work, but he was in between films right now, and with the writers strike, studios weren’t likely to be hiring. However, he still had some money left from his last couple of films, a low budget sci-fi flick that had gotten picked up by Warner Bros, and a documentary that had won him an award at a local film festival. So he felt he was entitled to a bit of R and R. Making movies was hard work. Suddenly he received the tone that told him of an incoming message. It was his brother, Josh.

coffeeweasel: hey little bro
teamonkey: shouldn’t you be working?
coffeeweasel: shouldn’t YOU?
teamonkey: touche. So what’s going on
coffeeweasel: not much…wanted to see how you guys are doing with this whole superbug thing. We are swamped here, and I think the city is only another few hundred cases away from quarantine
teamonkey: really? It’s not that bad here yet…a bunch of nursing homes have shut down, and a few daycare centers, but the hospitals as far as i know are not overflowing yet
coffeeweasel: well that’s good. Just do me a favor will ya?
teamonkey: sure…what?
coffeeweasel: get my old bike repaired and make sure you got plenty of food okay?
teamonkey: okay, cuz that’s not a weird request or anything
coffeeweasel: whatever, i just have a feeling about this disease. For that matter why dont you make another documentary about the course this bug is taking…i am sure it will be a hit once this all resolves
teamonkey: not a bad idea actually
coffeeweasel: oh and one more thing…if you decide to do any interviews, please don’t get bitten or scratched…the bug seems to spread through wound infections, or at least that is the working hypothesis
teamonkey: yeah yeah yeah
coffeeweasel: just do it to humor me. gtg ttyl

Brian went back to his browsing. Don’t get bitten? weird…

 TO BE CONTINUED…

BUT WAIT! THERE’S MORE! So I think I know what direction I want to take this story in, but I need one or two more characters. So if you would like to be featured in the ongoing Novella Contingency Plan, all you have to do is these easy steps

1)Comment on the site with the name and location of your character
2) in the comment include what ability or knowledge YOU could contribute to a contingency plan.

The story will continue on from here, but the best responses will be introduced in later portions of the story.

oh the things i do for readership

-J

Finally after two weeks of trauma, I have been able to begin general surgery…from here on out i am down to my last possible rule in/out career choice. After being on call all night (and getting a ludicrous 6 hours of sleep-clearly not a trauma call) I was able to observe a radical mastectomy for breast cancer. It was frankly, how do you say, amazing. Only two relatively small incisions were made and from there the remainder of the breast was just electrocauterized out…the subq, the fascia, everything cut throught until nothing more than a fatty lump was left behind for pathology to examine and a number of horizontal mattress sutures were place to hold closed the giant gaping hole in this persons chest. It basically rekindled the interest in surgery that trauma had been sucking out of me. Lets see how the next 6 weeks go, shall we?

And speaking of beginnings…

CONTINGENCY PLAN

Three-PROGRESSION

It had been almost one month since the superbug had finally made its way into the hospital system. And the long and short of it wasnt good. None of the patients had technically been cured. Oh sure, on a few of the younger ones the fever had finally broken, but all that seemed to mean was a few seizures and neurological damage leading to an altered gait, decreased mental status, and that damn persistently low tempurature. It was enough to drive any resident mad, forget about a medical student. The entire SICU and MICU wings were filled with patients in isolation from the new superbug, and new cases were coming in all the time. In fact, Josh was becoming uneasy in general about this epidemic

The majority of new cases presented with in with bites or scratches. Oh sure, every individual case sounded reasonable, especially considering the number of drunks admitted. A cut on the face here, a minor bite on the shoulder in a barfight there, but nonetheless a disturbing number were being admitted with rule out eikenella infection per ID (infectious disease) on their differential.

And the presentation didnt help. An infection that intially had its greatest toll on the elderly and infantile, that led to a progressively decreased tempurature and deteriorating condition, ultimately only semi-resolving with seizures and an altered gait and mental status. Since this infection fell under the authority of the CDC, universal precautions were of course being followed and the majority of infected remained in isolation, but with no way to tell how the infection spread, it was only a matter of time before someone outside contaiment became infected, or, even more likely, an unknown infected in the community spread it to others

Under any other circumstances, any budding infectious disease student would be creaming their pants. But there was something about this infection that seemed just a little too familiar for Josh to write it off as inconsequential. So he began sending out a few emails to friends here and there, mostly with subjects of just catching up, and the occasional advice thrown in…

“Hey amigo, how you doing…haven’t written in a while, so thought i would say hi. What you been up to? Superbug all over the place in your town too? Well you know what they say about good health and exercise right? You should look into getting a bike or something, give you an excuse to stop watching all this depressing news. Or maybe take up a hobby…fencing, shooting, martial arts. Anyway, let me know how things are going your end…”

…

Each week, things seemed to get a little worse, and the healthcare community less able to handle it. Most of the superbug patients now had to be restrained, and the young and otherwise healthy were becoming infected as well, and still no one knew how. Josh was checking Mr Greenbergs;s vitals religiously. His tempurature was into the ranges of hypothermia now, and yet his pulse and saturation and blood pressure were still those of a normal healthy adult. At the same time, the gentleman in the wheelchair, who had been admitted the same night as Mr Greenberg required restraints and a sitter, having thrown himself out of the bed several times in an attempt to attack hospital staff. He had even managed to bite one of the nurses, who was on enforced leave given the situation.

More and more in the recent weeks, a thought had begun to tickle at the back of Josh’s mind. Nothing he had chosen to articulate to others, but a nagging feeling that had caused him to double check the tire pressure of his bike, buy extra canned food, and “borrow” medical supplies at the end of shifts. The more he sat and joked about it with friends and family, the more uneasy he began to feel. This disease just seemed too predictable, despite the fact that nothing was known about it. It was almost as though he had encountered its like before, yet he couldnt recall where…

Nonetheless, while Josh was continuing his subconscious preparations, his tension was transmitted to those close to him, and others were also not unaware of the growing danger…

To Be Continued…

but before that here is my halloween costume



Yes I was facebook. Drunken facebook. I was super poking people all night long, as well as having my wall written on, and occasionally hacked


Found you waldo. More photos when i damn well feel like it. But now on with

CONTINGENCY PLAN

Two-POST CALL

Alarms and buzzers were going off everywhere. Josh flailed about,
seeking his pager, before realizing it was his cell phone. He shut off the alarm and glanced at the time. 5:00am November 1st. Time to begin pre-rounding on patients. It had been a long night of call, not entirely unexpected given the holiday. Multiple people had come through the ER, but he only had to deal with the traumas, most of which went to county, bless their overworked little hearts. Therefore, no shootings, and almost no motor vehichle accidents, just a couple drunken lesbians who hit a parked car, one wheelchair bound gentleman with some kind of animal bite, and of course the intoxicated zombie.

So down to the floors he went, waking up each patient, and going over the standard 5 questions that are pretty much all any surgeon cares about.

“Good morning mr/mrs [whatever]. Any problems during the night? Did you eat? Did you pass gas? Did you have any bowel movement? Have you been able to walk at all?”

Almost every patient usually responded positively to the questions unless they were fresh out of the OR or had something really serious. Surgical notes weren’t particularly hard to write, especially after medicine. Last stop was 3rd floor, Mr Greenberg, the intoxicated undead.

“Heh. With all those stitches in his chest and neck, he looks a lot more like a zombie now-too bad halloween is over buddy.” Josh didn’t waste time asking the surgical note survey, partly because he was tired on only 2 hours of sleep, mostly because Mr Greenberg was still intubated in an induced coma and unlikely to answer anyway. However Josh still went through the focused exam, hearing a regular, if slow rate and rhythm of the heart, clear breath sounds, and intact deep tendon reflexes. According to the computer monitor, the vital signs were stable, but the oxygen saturation and tempurature were a little bit lower than they should be at 92 and 97.1, respectively. “Hmm…he should be satting higher than that, but it’s still within normal range. guess i will let the nurse know”

Bright told Josh not to worry about it as he had been consistently satting low, probably due to his asthma, and the temp was most likely due to a low fever, since his white count clocked in at 11. Josh finished all his notes and went off to meet with his resident for rounds.

…

Rounds passed by without too much pimping, mostly just a few questions on MRSA management, probably because everyone in the hospital was talking about the new outbreak of whatever the new super bug was that was resistant to drug treatment, and how much work it was going to end up creating for the entire hospital and ancillary staff. Josh went to chat with his intern about the plan for the day’s patients, aka “running the list”

“Hey Raj-so what do you want me to take care of today?”
“Hey Josh-not too much, just call radiology for the reads on those x-rays for the lesbians, talk to ID {infectious disease} regarding the bite on our guy in 72, and oh, what’s the status on Greenberg?”
“Meh…white count’s 11, but we’re pumping him full of avalox and cefotaxime, should clear up. He’s satting kinda low for someone who’s tubed, but bright said she would keep an eye on it and call you if anything changes”
“Screw that-she can call hector, today you and I are post call, and that means we are out by noon”
“Fine by me, just letting you know”
“Alright then let’s take care of this shit and call it a day.”

…………….

The next couple of days went by as usual. The lesbians got discharged, wheelchair bite was transferred to medicine’s care under ID’s recommendation, new patients came and went. Actually, more patients were coming than going, at least for those stuck on medicine. Apparently the new superbug had finally worked its way over to the northside, and several patients were on the floors in isolation rooms while the hospitalists tried to figure out what the heck to do with them. Also somewhat disturbing was that Mr Greenberg’s white count had continued to climb, reaching 15, well outside the normal range of 4-10; yet rather than being febrile, he was actually dropping in temp, far closer to hypothermia than anything else. Josh continued to exam his wounds for any signs of infection, but aside from the high white count, and low temp, everything appeared stable. It looked like Senor Greenberg was setting himself up for a long stay in the SICU.

………….

Two weeks later, Josh was relaxing at Mickey’s, throwing back a few beers with friends and fellow med students Phil and Tammy. They were doing what they usually did, what all med students do when they gather: bitch about med school because they simply have no idea of other conversational topics anymore.

“So Phil, any horror stories from peds?”
“Where to start-I swear pediatrics might as well be vetrinary medicine. You are treating a bunch of animals who cant tell you what’s wrong, when it started, and the only way to treat them is to put up with their handlers…erm i mean parents, most of who are too obnoxious to teach their kids how to behave.”

“Heh, well at least they don’t lick your face, man. What about you Tammy?”
“Nah, ER is same ol’, same ol’. Lot more people with that new MRSA coming in and getting transferred to medicine”
“Yeah we have a bunch of those people too…what have your docs been doing with em?”
“Truthfully, nothing much…they come in sick, we give them drugs, it doesnt help and they either sit on the floor while ID shits their pants, or they spike a fever and die, clearing a bed for the next one in with the same problem”

“You have had them die?”
“Well, yeah, but mostly its the elderly and kids who are coming to us, and its not like they’re in great health to begin with.”
“So what are you doing with them?”
“I just told you.”
“No, I meant the dead ones”
“Oh, we kept one or two for autopsy, but the rest are either returned to their families for burial or burned”

“You guys want to hear a freaky story?”
“Yeah Phil what’s up?”
“We had one of those kids. Caught the bug, spiked a fever…except you know how it is with young kids, you spike a fever to high you can go into febrile seizures. Well the parents swore up and down the kid died right in front of them, shuffled of this mortal coil, ya know? But while they were mourning in the other room, he up and crawled in walking a little funny but otherwise good as new. I reassured them that he seized, not died, but we admitted him to the MICU anyway…mostly to monitor, since no one else has managed to cure themelves of the new MRSA. I mean the fever is clearly broken, his temp is like 94, low if anything, but you know these hispanic parents and how every little thing gets blown out of proportion.

“Alright guys, well I gotta go, things to study, lives to save, you know how it is…same time next week?”
“Yeah, see ya later Josh”
“Later man”

…but it was only the beginning…

TO BE CONTINUED

Well folks, its November is National Novel Writing Month, or NaNoWriMo for short. This year I have decided I will try and participate, and while I am not promising an entry every day, I will attempt to give you all at least a complete short story. So if at any point you would like to read this in its entirety, it will be tagged as NaNoWriMo

Here are the only rules I am setting for myself-
1)No matter how long it takes me, I have to bring this story to a conclusion I am satisfied with
2)All characters must have logical reasons for their actions
3)Frequent commenters earn at least a cameo in the story

So here I go

CONTINGENCY PLAN

One-ON CALL

Alarms and Buzzers were going off everywhere. Josh flailed about, seeking the source of the noise, finally realizing it was his pager going off again. 2am, October 31st. All Hallows Eve.

“Great. Just great-another code yellow. How the heck did I get call on halloween” He muttered shrugging his lab coat on and heading toward the emergency room. ” Ghosties and Ghoulies and Four legged beasties and Drunks that go bump in the night.” Then he chuckled. Everything’s funny when you are sleep deprived. On his way he passed the nurses station, where Bright was watching something on the news about the latest deadly infection to run in terror from, according to FOX.

“Hmmph.” The real miracle will be if i DONT have tuberculosis or MRSA by the end of this year”

Down in the trauma bay, he gowned, gloved, and shielded, then waited for the paramedics to arrive. 5 minutes later, in came the pt, secured to the backboard, c-collar on, dressed in zombie makeup with blood dripping from his mouth and down his neck. The paramedic started giving the history to the attending while the rest of the trauma team began the primary and secondary survey.

“26 year old male with a history of asthma was intoxicated at a halloween party where he was involved in an altercation with another partygoer. He bit the person, and was stabbed with a broken beer bottle in the chest and neck. On scene, airway was intact, breathing was rapid and shallow, pulses were strong and equal bilaterally. Glasgow Coma Scale was 13. He has no known allergies and is not on any medications.”

The paramedic continued to talk, while the trauma team finished the primary and secondary survey. Once exposed, the patient had two small clusters of wounds in the left anterior chest with some small glass shards visible and one vertical incision approximately one centimeter in length on his right lateral neck. The blood from the mouth was apparently from a small cut in the gums, most likely sustained from biting the other person.

“Sir! What is your name? Tell me your name”
“Where do you live?”
“Have you been drinking tonight?”
“What is your name?”

Nothings but moans and the rank smell of alcohol came off the patient.

Suddenly he became wild, began flailing about, snapping at techs, and repeatedly trying to get off the bed.

“Dammit, he tore out his line”
“Someone help me hold him still for x-ray”
“He’s too combative right now, we need to intubate him!”
“Get the med students help, we are having enough trouble with him”

“Josh! get me Some Etomidate and Suxx.”
Sedated and semi-paralyzed, the tube was placed down the patients throat to his trachea, checking for proper placement by observing the CO2 monitor.

While all this was going on,still other members were performing the focused abdominal sonography for trauma (or FAST scan) to assess for organ injuries or intraperitoneal bleeding, and still others were suturing up the wounds in his neck

“Alright everyone, send him down to CT to check for any glass shards and proper tube placement and then up to OR. We need to close those wounds and stabilize him. And everyone- let’s keep a close watch on this one”

…in retrospect, those words would ring deadly true…

TO BE CONTINUED