What’s That Noise?

On an unspecified day, in the month of October 2009, I heard a noise. 

I was fresh out my residency in Orthopedics, and in those days, I utilized the better half of my time helping out in a 6-bedded ER by doing things I was trained in; like staying away from ECGs and staring without blinking at mechanical ventilators.

On this day, like others, I found myself looking at a man whose face had been strapped on and connected to a ventilator by a large mask. There was a loud, constant alarm emanating from the machine. And the man was rasping. 

Of course, I’d promptly assessed the situation, and intelligently surmised that the man was afflicted by a femur fracture. That was the easy part. 

I asked the medical officer seated nearby, “What’s that on his face?” You see, I’d been called for the broken bone. 

“NIV,” came the reply, through pursed lips as they sipped loudly from a little Styrofoam cup. His eyes never met mine. 

Three alphabets, I thought. 

“But what’s wrong with him?” I pursued. 

The medical officer pushed forward a piece of paper with an ECG tracing. I remembered my training, and looked away.

The mystery of the persistent alarm remaining, I approached the ER nurse, and asked her, “What’s that noise?”

She glanced casually over at the patient, who by now had slumped over, and exclaimed, “Oh no!”

This was nearly 20 years ago. 

I’ve been practising Emergency Medicine for nearly 15 years out of that. 

People often ask me why I left Orthopedics to train in, and then devote my time, to Clinical Emergency Medicine.

My answer is always the same.

“I heard the noise.”