Internal Affairs

One night on adult trauma at Brackenridge

Internal Affairs
Photo By John Anderson

My day job is nursing at Children's Hospital. A corridor connects Children's to Brackenridge Hospital, which is the regional trauma center. Some pediatric nurses refuse to work with adults, and many adult nurses have an irrational fear of taking care of kids, but the rest of us move back and forth between the two worlds, from one end of the long hallway to the other, giving shots and wiping asses of adults, infants, and anything in between. A year or so ago there was an extra shift open on adult trauma, the eighth floor of Brackenridge, and it just so happened that my cupboard was bare. The extra pay included a differential for working in the evening, in this case 3-11pm. Wasn't much, but it would help put food on the table. I signed up.

Brack's eighth floor includes two nurse's stations and 42 patient rooms. The trauma floor is where anyone comes who's been shot, stabbed, or in a car crash. Once, not long ago, there was a guy who'd been gored by a longhorn: He was out in the country and he held his guts in long enough for a helicopter to pick him up and bring him to the emergency room. There's also the occasional construction worker who ends up on the wrong end of a nail gun. People fall from buildings. A lot of people fall off horses. Mostly, they get in car crashes without seat belts, or motorcycle crashes without helmets. There's a lot of blood and tears. The sweat mostly comes from nurses and therapists. All that heavy lifting, first thing that goes is your back. That's why we call it trauma.

Melanie was the charge nurse the night I was there. Melanie's last name is Martínez but your great aunt Oveta in Nova Scotia knows more Spanish than Melanie does. Nurse Martínez is pretty hot, and you know how sometimes you can tell a woman she's beautiful and she'll suddenly forget that she was going to kick your ass or fire you or elevate her knee to your balls? Melanie isn't like that. If you tell her she's hot she'll just say, "Oh really?" or she'll say, "You don't get out very much, do you?" and then she'll go ahead and do whatever she was going to do in the first place. It was getting near the end of the shift and I was trying to finish my work so that I could get out on time, which is a rare privilege at Brack. Melanie came up to me, a very purposeful walk, which usually means she's about to assign somebody another patient. I told her she had beautiful eyes and she said thanks, nice try, but I still needed to get ready because there would be an admission coming to the floor in the next few minutes. She told me to call the emergency room and get a report on the patient's condition.

Then she said, "It's a police shooting."

The ER nurse said that the guy the police had shot was dead. I was confused. I mean, if he's dead he's not going to require much nursing care, is he? The ER lady said the person coming up to the eighth floor was the victim, whom the bad guy (now dead) had been cutting on when the cops blew the bad guy away.

The weapon used in the assault was a box-cutter. The victim was lucky, the ER nurse said. He wasn't hurt badly, and he'd probably go home when the interns made trauma rounds in the morning. She finally got around to the most important detail, which was that the victim already had an IV: he was lucky, because he wouldn't know the real meaning of fear until he'd seen me coming at him with a needle in my hand. Working at Children's, I've gotten a little better at sticking people. If you can hit a kid's spidery little veins, him crying and squirming, his mother breathing down your neck, you can do most any adult -- but, like the ER nurse said, he was still lucky.

In nursing school our instructors always impressed us with the need to have a "plan of care." My plan that evening was to get the guy comfortable in bed, start his IV fluids running, do a quick assessment, offer him pain pills -- morphine if he was really hurting -- report to the oncoming night nurses and get the hell out. Melanie checked to see that the room was clean and ready for an admission, and then we sat back to wait. Working at Children's is a little hard on your nerves because a kid's condition can change really quickly. The patterns with adults are, generally, more stable and more familiar. In fact, my first year after nursing school had been spent on the eighth floor. Saw my first "code" there -- the patient didn't make it; the surgeon cried when he was informed. Another time, a widow sent me into a room to remove the wedding ring from her dead husband's finger. Wasn't even my patient. The lady just couldn't bear to do it herself. Took some effort, but the ring came off in my hand. Spooky.

How people arrived on the floor always interested me most. I was talking to a brother one time who had taken an ice pick in the chest from another man's girlfriend (whom my patient also happened to be balling) and he said that the first thing he was going to do when he got out of the hospital was to visit her in jail, because it had to be true love for her to feel strongly enough to try to kill him. He said they had sat out on the sidewalk and talked, him bleeding, while they waited for the ambulance to arrive. Romantic, huh? Must have been a very special moment.

Talked to another ice pick victim, white dude, stabbed by his wife. Why'd she do it? He had no idea; said he didn't know what had come over her. Whole time he was telling me he didn't know, this woman was kissing him and cooing and fluffing his pillow. When she stepped out of the room I asked, didn't they put her in jail? "That's not my wife," he said, "that's my girlfriend."

There were a few cultural differences I noticed among the patients. You'd get a Mexican guy with a knife wound and you'd ask who did it and he'd invariably say he didn't know. Bronze-skinned, tough little men, the Mexicans never complained about anything -- they'd lie in bed looking at the ceiling, didn't matter what you had to do, they'd never let you know it hurt. An awful cut or laceration, nail gun injury (they all seemed to be working in la construcción), something in the eye, you had to beg them to take pain medication.

Most were sent home in the morning, I suppose, but if it was a deep upper body wound it invariably meant they'd have a chest tube bubbling at the side of the bed, and if it was a gut wound they'd be fed through a tube, which is messy. But they never complained, and almost never talked.

But that night, the guy who came up from ER was a talker. He was Chicano -- Tejano. Practically the first thing I did, after the ER transporter dropped him off (the patient was able to walk from the gurney to the bed, a good sign) was ask what happened. He said, "They killed him, man!" "They" was the police and "him" was his assailant. The patient wasn't in shock, but he did seem amazed. It was as if his life had more value now, because the police had killed someone to preserve it.

 Following the gurney into the room was a white guy, dressed real casual, a cap and running shoes -- a vest too, although it was July. If my recollection is correct, he was chewing gum. I thought it was the victim's compadre, his homeboy. Actually he was the heat: internal affairs, homicide, officer-involved unit, whoever. He had a little tape recorder in his hand.

Introduced himself as Detective So-and-So and asked if the victim felt like answering a few questions. Asked if I was cool with that. I half-expected the cop to try to get me to leave; but after asking permission he never really seemed to notice me again. There's a kind of odd symbiosis between cops and nurses. ER nurses have told me about getting stopped on a traffic violation and mentioning where they work and the officer saying have a nice day and getting back in his car. Part of it is that the police want good treatment if they ever end up in Brack -- everybody gets that anyway -- but there are also similarities between the two professions. Both cops and health care workers go through bouts of extreme boredom interspersed with excitement. Both see people in tight squeezes, and both are squeezed in turn. A lot of stress.

The victim's story was short. He'd been coming out of a convenience store when three or four guys in a car started to give him a hard time. They were drunk. He tried to ignore the verbal hassling, but then somebody started after him with a box-cutter. The police were called and by the time a cop arrived the box-cutter had disappeared but one of the assailants had a claw hammer. (Apparently he was also working in la construcción.) Part of what I was picking up was kind of a bad vibe you hear about sometimes between Mexicans from the old country and Hispanics born in the U.S. Apparently the Mexican-born sometimes think they're superior -- that Chicanos are only sell-outs to the Man. (Black Americans sometimes get the same rap from Africans, who try to pretend that Nigerians and Kenyans are the real thing, and Malcolm X and Muhammad Ali are just the diluted descendants of niggers who didn't fight slavers. In other words, a load of crap.)

Anyhow, the cop told the Mexican guy to put down the hammer and he didn't. Bam. One in the chest, just right of midline. Somewhere along in there pepper spray had been used, but to no effect. I never saw the police report, but if you read the police account of most police shootings the weird part is always where the cop fires a cannon into somebody's chest and then runs over and starts doing CPR on the guy. That's fucked up, I think. I mean, if you want to preserve life, shoot him in the ass, shoot him in the leg, shoot him in the foot -- but don't shoot him just right of midline. Or left of midline, for that matter. That way you don't have to bother with CPR. In this case I was curious, so later I went and got the dead man's autopsy report. Blood alcohol was 0.24. No wonder the pepper spray wasn't a viable option. That kind of alcohol level is like anesthesia. Probably didn't even feel the bullet.

The best part of the evening was watching the detective. I took my time with my assessment and then I pretended for about ten minutes to be checking the IV. At first Detective So-and-So seemed like he was bored or tired or whatever, but after a while he got into it. The verbal interaction between the assailants and victim had been in Spanish, and the officer who fired the shot apparently spoke Spanish too, but the detective in the hospital room didn't. It's like that at Brack sometimes too: many of the nurses don't habla but many of the patients do.

The victim said that the cop told the bad guy to put the hammer down and the detective asked if that was said in Spanish and the victim said yeah, and the detective asked how do you say that in Spanish and the victim said, "Ponlo abajo," and the detective really liked that ("Ponlo abajo!") and he asked the victim to repeat it a couple of times. The detective had livened up a little by now. He already had what he needed: a weapon, a weapon being used in a threatening manner, and a police officer's command to put it down. Bam.

Was the detective biased? Yeah, I think so. But not in a bad way.

When he first came in the room I thought he was tired or whatever, but thinking about it later I'd say he was really more apprehensive: He was probably wondering, oh shit, an officer-involved shooting, is this going to turn into a big stink? The bored manner hid the apprehension. He asked his questions and they were fair questions but he also seemed pretty relieved that a fellow cop wasn't going to get an apple stuck in his mouth and be roasted by the press. As it turned out, nobody cared; it was a one-day story. The detective turned off his little recorder, thanked the victim for his time, and headed out. I clocked out too. It was almost midnight. My patient, someone told me later, was discharged the next morning.

Anyway, whether you wanted it or not, that's a little background on the last moments of José Luz Mares-Navarro, a Mexican national, who got dusted by Officer Steven McCurley, near the Diamond Shamrock convenience store on Parkland Drive, on July 27, in the Year of Our Lord, 2001.

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Brackenridge, Children's Hospital, trauma center, nursing, Melanie Martínez, emergency room, Austin Police Department, APD, CPR, José Luz Mares-Navarro, Steven McCurley

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