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Sunday, November 09, 2003

Things are not always what they seem

Saturday night was an interesting lesson in the not-so-obvious. I was driving down Abel Street towards the Great Mall around 7pm. It was pouring rain, and all the cars on the street were moving slowly. In front of me, I witnessed two SUVs, one slowing down to turn, the other, not slowing down fast enough. Crunch.

It was a relatively low-speed collision. The vehicles didn't spin out, and I saw the front SUV pull off to the side of the road. For a second, I thought about just giving my business card as a witness and continuing on. But I thought better of it when I saw the rear SUV remaining in the left lane. The driver wasn't moving it off to the side of the road. Strange.

I checked on the family of four in the front SUV, and they were fine. As I approached the rear SUV, I saw white smoke in the passenger cabin. (Fire ? Airbags ? I couldn't tell.) I knocked on the window, and the lone occupant opened the door. The smoke was the powder from the air bags. Both fully deployed.

It wasn't such a minor accident after all.

She complained of neck pain. I had the first police officer on scene do a C-spine. She was only A&O times 3. And when I looked at her face, something wasn't quite right. Her eyes were fixated, looking up. She didn't look anywhere but up. When I asked her to follow my finger with her eyes, they were jumping all over the place. She didn't look at me or anywhere else except up. I found out rather quickly that she was on two medications for anxiety, and this was one of her reactions to highly stressful situations.

I got as much information as I could (vitals, history, partial secondary exam) until the Milpitas fire department arrived. Guess who ? Two of the guys that we normally see at [my company’s] emergency calls. One of them recognized me. How cool.

The patient wanted to sign a form to be released. But she signed it in the middle of the page. The FD cleared her spine, then AMR led her to the ambulance. Even when walking to the ambulance, her eyes were fixated up, and she was slow and lethargic, as if in a trance. Good thing the FD convinced her not to drive to work that night.

When I first saw the collision, I thought I was dealing with a very minor fender-bender, but it turned out to be much more than that. It just goes to show you that things are not what they seem on the surface. Sometimes, you have to dig deeper to find the real truth.

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