My Patient, Their Suspect

The patient arrived in the emergency department with a severe head injury. I was told he had struck street vendors with his car. Some said he had been driving drunk, though that had not been established.

The police were there. They wanted to take him for questioning, and they did not understand why we needed more time with him. Around the minor theatre, other people had heard the account of the collision. They spoke of the vendors, of what the driver might have done, of the possibility that he had brought his injuries upon himself.

I understood why they were angry. I did not know the full circumstances of the collision, and I did not know the condition of the people he had hit. I had no reason to dismiss their suffering. But the man in front of me had a head injury that I could not dismiss either.

I examined him and ordered further tests. He needed a CT scan and care beyond what we could provide there, so I arranged a referral. While I worked, the questions around his bed continued. Why should we do so much for him? Why should the police have to wait?

I could not answer for what he had done on the road. I could answer for what I did in the emergency department. I told the police that he needed medical care before he could be taken for questioning. The vendors had a claim on our concern; so did the man lying injured before us. Treating him would not erase what had happened to them.

After arranging the referral, my shift ended. I later learned that he had died on the way to the referral hospital, travelling under police escort.

I was not there during the journey. I do not know what happened in the vehicle, or whether he would have survived had he reached the hospital. I have resisted making that ending mean more than I know. His death cannot tell me whether he was drunk. It cannot tell me the full story of the collision, or what became of the vendors.

What I remember is the argument around his bed, and the fact that his injury did not become less urgent as people told me who they thought he was. He could be questioned if he survived. The collision could be investigated. In that room, while he was still alive, I had to treat him.