A/N: Dialog and situations from "Nurses Wild," Season 1 episode 7, written by Fred Freiberger. Dr. Morton makes an incorrect assumption, and learns a lesson he wouldn't have thought he had coming to him.
All You See Is A Trip
I could tell as soon as I looked at this guy that he was in bad, bad shape. He was just lying there, in the back of his hippie friend's van. A VW camper van—just classic. His breathing was slow and labored, and his pupils were constricted. Add to that his low BP and weak pulse, and it all added up to an OD. But his friend just wasn't helping at all. If he'd just tell me what they were doing, I could safely administer an antagonist. But he kept it up—just kept saying they weren't doing any drugs. Yeah, right.
"You're looking at Billy's hair and all you see is a trip!" The hippie friend of my hippie patient was practically accusing me of negligence. Standing there, looking like John Lennon in his round glasses and suede-fringed denim tunic, acting like he thinks I don't know what I'm doing. If he'd just get out of my way, I could get on with it and find what I was looking for.
"No needle marks, Doctor," said Nurse McCall, her eyes shooting me deadly arrows.
When I look back on it, I think Dixie already knew—probably even before she started looking for the nonexistent needle marks—that I was digging myself into a hole. Lucky for Billy Martin, there were other people around, smarter ones than me, so no hole had to be dug for him.
Like Dixie. She knew I was on the verge of a major screw-up, but she also knew if she said anything about my medical procedures, I'd take her head off. Because she's just a nurse. You can tell by the cap.
Next thing she did was totally right—getting a spinal tap tray ready, since the cause for this fellow's central nervous system symptoms was unclear. If I'd had my head on straight, that's exactly what I would've ordered next. But instead?
"There is no doubt," I said, quite confidently. But I was wrong, wrong, wrong.
Brackett stepped in to the room, just as I said that. Fortunately.
"About what?" he asked. And I didn't miss the look that passed from Dixie to him. The look that said, 'you handle this one, Kel.'
"And for sure the blood will show signs of drugs. My guess? Is heroin." Looking back on it, I can't believe my audacity. I was so, so sure, but why? Respiratory depression, constricted pupils—sure, those are classic signs of opiate overdose. But I didn't even look for anything else.
Brackett knew I'd missed something as soon as he saw the patient's condition, but didn't say anything to me. And a minute later, when the lab report came back—no sign of drugs—I knew it too. I watched as he did the spinal tap—I couldn't blame him for not letting me have a crack at it. But that came back normal, too. So Brackett did what I should've done the second that patient came into my care—checked him over carefully, for any signs of … anything. And it only took him about twenty seconds to find the huge insect bite.
Which I had missed.
I completely missed it.
Billy's friend was right—I couldn't see past the guy's hair. His clothes. The van he arrived in.
And you'd think I'd know better, wouldn't you. How many times have I been judged by my own appearance? More than I can count. In fact, just the other day, while I was walking home from the bus stop after a long shift at the hospital, a woman walking towards me on the sidewalk crossed the street in the middle of the block, just to avoid passing next to me. I could see her eyeing the bulge in my jacket right over my chest. If she'd been able to see through the fabric, she would've seen that it was just a stethoscope.
Would she have made the assumption that it was a weapon if I were white? How would I know? I've never been white, and I never will be, so I won't ever have the experience of having grown up white, in a white man's world.
And who knows—maybe that lady wasn't assuming anything. Maybe she just realized she was on the wrong side of the street for where she was going. So there I am, assuming again. I assumed that she assumed, et cetera et cetera et cetera.
Now this might seem like it's coming out of nowhere, but one thing I really loved about being in the Navy was that it was always obvious who was who. I mean, if nothing else, uniforms and rank insignia sort people out pretty quickly. All you had to look at was a collar or a sleeve, and you knew where you stood. At least in theory. For me, the stripes on my sleeve were a relief—visual proof that I wasn't worthless.
But in the real world, things don't work that way.
Brackett looked through the vials of antivenin, and chose the ones the patient needed. He looked at me carefully, purposefully not saying a thing. Not yet. A smaller man might've called me out on my mistake right away. Hell, maybe that's what I deserved. But even though he's a hard-ass, Brackett knows people. He knew to wait to let me admit my own mistake. He handed me the vials of antivenin, almost like a peace offering in advance of the chewing out I deserved. And by doing that, he opened the door for me to fess up.
"I examined him thoroughly. Why didn't I see that insect bite?" Well, that wasn't quite an admission. I could've done better.
"Because you were too convinced you were gonna find something else. Where diagnosis is concerned, Mike, you've gotta keep an open mind." And he was right, as always. He hit the nail on the head. I always thought I had the openest mind on the face of the planet. I guess I learned a thing or two today.
I apologized to Billy's friend, whose name I never did catch.
"It's okay, Doc. You can't help your prejudices. Nobody can."
But he's wrong: we can help our prejudices. Or at least, I think we can. All I know is, next time I see a patient, I'm gonna look with my whole brain—not just the parts that fire up first.