The Hamptons: Exile or Refuge?
Life is funny. Just when you think you have it figured out, a curve ball comes your way. For me, it came down to a single word: Triage.
An odd word, for sure. But then we got it from the French so what do you expect?
In a medical setting, it saves lives. Most of the time.
To the French, triage means “to select,” or “sort.” In medicine, it means to prioritize patients by need.
Every busy emergency department has a triage system. The one I had worked at did. A physician or nurse would perform a quick cursory exam of each patient that came through the door and rather than rushing them into a treatment or trauma room on a first come basis, the ones in the most precarious situation jump to the front of the line. Just common sense and good medicine.
Such a system becomes critical when the ER is overrun. Like when the Friday-night-knife-and-gun club kicks into gear. You know, too much to drink, someone looks at someone the wrong way or hits on the wrong woman, and the weapons are hauled out. Soon the ER is smothered with the dead and the dying, the bleeding and the screaming, the angry and the frightened.
Seen it a hundred times.
So triage is your friend. Right up until it isn’t.
That’s what happened to me. Triage bit my butt.
I’m Hank Lawson. Doctor Hank Lawson. I now run a concierge practice in the Hamptons, but not long ago I ran an ER. A very busy ER.
One day we got hit. Hard. I was working on several patients at once, focusing on the most needy. Two in particular: a teenager who had suffered a cardiac arrest and an elderly man with an evolving heart attack--an acute MI to those of us in the profession. I moved both to the front of the line. The kid’s CPR was successful and I managed to stabilize the MI patient.
So far, so good. Or so I thought.
In medical emergencies, stable is a relative thing. Often temporary. It can change in a heartbeat. Literally. A patient spiraling downhill toward death can be yanked back from the brink while another that seemed to have weathered some crisis suddenly begins the death spiral.
The kid was the most fragile, the most likely to take a turn, the one that most needed my attention. He got it. His life was saved. While I was doing that, the MI guy wasn’t so lucky. His condition headed south and ultimately he died. It happens. An MI kills someone every minute of every day. Even in hospitals.
The real problem? Mr. MI was Mr. Clayton Gardner. A very important man. A pillar of the hospital. A billion-dollar bank account and huge hospital donations will do that.
The next thing I knew, I was in front of a hospital review board, defending my “mistake.” The board’s take on it. To me it was a judgment call, and those can sometimes go wrong. I did it. I’d do it the same way again. The board thought differently and I was fired.
For the first time in my life I didn’t have a job or school or somewhere to be or something to do.
Scary.
Things got worse from there.
