the victim, who was lying naked on the gurney, her legs spread slightly apart. He noted that she was a thin, well-proportioned girl with muscular legs and a flat stomach. She had four or five superficial wounds—cuts and scratches—on her arms and face, then a deeper cut and bruise on her right shin that an intern was attending to.
“How’re we doing, Cynthia?” Cogan said to the X-ray technician.
“Ready when you are, Doctor.”
“Pam?”
“BP 90 over 60. Pulse 130.”
“OK, Cynthia. Gimme a Kodak moment.”
The X-ray technician moved the portable X-ray machine over to the victim. When it was in place, she told everybody to clear the room except for one intern, who was putting on a lead apron, preparing himself for the unenviable task of pulling the patient taut (by the feet) during the cervical shot. Cynthia took several X-rays, repositioning the machine for each new shot, always making sure to remind everybody to “clear” before she pressed the remote switch from where she stood behind the lead screen that prevented her from being exposed to the radiation.
As soon as she was done, the rest of the trauma team came back into the room and resumed their duties. A couple of zealous interns whose names Cogan always got mixed up started firing questions at the girl, who mainly responded with groans and grimaces.
Intern #1: “Do you know where you are? Do you know how you got here?”
Intern #2: “Miss, are you allergic to any medication?”
Intern #1: “Are you allergic to antibiotics? Penicillin?”
Intern #2 (touching her leg with the needle): “Can you feel that?”
Intern #1: “Miss, I’m going to have to give you a rectal exam. OK?”
“80 over 60, Doctor,” Pam Wexford said. “Pulse 150.”
“All right,” Cogan said. “Do we have a name for her yet?”
The nurse glanced at the paramedics’ paperwork. “Kristen,” she said. “Kristen Kroiter.”
“Kristen,” Cogan said, speaking to the girl. “Is that your name?”
She didn’t answer. She just opened and closed her eyes.
“OK. I’m Dr. Cogan and this is Dr. Kim and we’re here to help you. We’re all here to help you. You’ve been in a car accident and you’re in a hospital. Do you understand that?”
With the oxygen mask still covering her mouth, the answer came out sounding like a grunt, but it was affirmative enough for Cogan to continue.
“I’m going to ask you a few questions and give you a quick examination so we can determine your condition. OK?”
She groaned. Then, squirming a little in the restraints, she murmured through the mask, “It hurts so much.”
“I know it hurts,” he said, taking her hand. “And I’d like to make it so it doesn’t hurt. But I can’t give you anything just yet because if we give you something, you might not be able to tell us where it hurts, and we need you to tell us where it hurts so we can make it better.”
He examined her eyes, then said, “Eyes are equal and reactive.”
Lungs were next.
“Kristen,” he said, “I want you to try to take some deep breaths.”
As he listened with his stethoscope, a wave of pain appeared on her face every time she took a breath. But her lungs appeared to be clear. “Breath sounds equal and present bilaterally,” he announced to the team. Then to her: “Does it hurt when you breathe?”
She had trouble answering him so he told her if she didn’t want to speak that she could just squeeze his hand. She could squeeze his hand, couldn’t she?
She could.
Next, with his free hand—his right—he began to examine her chest. Her skin was warm and moist—she was sweating; Cogan noticed sweat building up on her forehead. He worked his way slowly across her chest, pressing gently on her rib cage, feeling for tender spots. Suddenly, she screamed, and Cogan felt one of her fingernails dig into his hand. He quickly let up on the spot.
“OK,” he said. “I’m sorry.”
He pressed down again, this time more gently on the left side of her abdomen. She didn’t scream but groaned instead, then closed her eyes and said, “Please.”
“Tender left upper quadrant with possible crepitance of left lower ribs,” he announced.
Just then Cynthia, the X-ray technician, came back into the room and said, “Film’s ready, Doctor.”
“Thanks. Kristen, can you hear me?”
The girl opened her eyes.
“You’re doing good,” he said. “I have to go away for a minute, but Pam here is going to take care of you while Dr. Kim and I take a look at what’s going on inside of you. But we’ll be right