On the other side (or 2 days since Step One)

On Thursday, I slept in Philadelphia with my partner at a small Airbnb near the testing center. On Friday, we sat for Step One and drove home to Coopersburg in a post-test daze. On Saturday, we started our morning to gunfire, a wounded man, and chaos.

Step One felt like a grinder of a day and entirely anti-climactic at the same time. The week before, I completed a full-length practice test and the real-deal felt much the same. A very difficult exam, but now the results are weeks away from reporting. So, I’ll just relax and breathe a bit of relief knowing that I don’t need to stare at a computer screen for quite some time. It feels so odd to be done. I have all of this anxious energy that does not know where to go. The eight-plus hours a day devoted to review and to practice questions vanished in an instant.

And so we awoke on Saturday, a bit slowly and with so many plans for the day. I will intentionally leave out many details, as this is an on-going criminal investigation.

Earlier in the morning, we heard shouting and arguments coming from the home across the street. There, our landlord and his uncle live together. We have met and talked with them both a dozen or so times since we have moved in at the beginning of the month. We thought nothing of it, deciding to close the windows and continue on with our morning.

A few hours later, around 1120a, we heard noises that sounded too loud to be fireworks and too close to be deer hunters on the far end of the property. We perked up and saw a woman fleeing the house across the street, one we haven’t seen before, saying “he’s shooting a gun” as she fled further up the road. I promptly began a call to emergency services and the following hour felt like a blur that happened to someone else.

Another volley of shots from across the street. Then, we saw our landlord exit his house, limping and visibly bloody, escaping into the woods and away from the house. We saw the uncle search outside, once by himself and then a second time with a shotgun. At one point, he began to walk up the road, to our new home, and we had to briefly consider defending ourselves with deadly force.

Thankfully, the situation did not escalate to that point. Instead, the uncle started up his golf cart, the same one he used three days before to cut down the branches of an apple tree in our backyard, just as the armed police response arrived. With a bit of guidance, they were able to locate and subdue the uncle without any shots fired or any loss of life.

His nephew, our landlord, left the safety of the woods and laid in the middle of road as the police arrived. Myself, my partner, and new roommate all came to his side to provide initial triage and support to him before the Emergency Medical Services were cleared to enter the scene. Now, we know that he was shot five times in total. Then, we just saw a man in deep shock without any major bleeds. He had a grazing bullet wound on his skull, a near miss if I have ever seen one. We gave him some water, some words of comfort, and gentle pressure on wounds as the ambulance arrived.

In some ways, I am thankful for this experience. If this had to happen, then I am glad it happened the way that it did. No one died, we did not have to hurt anyone, and we were able to soothe, even briefly, a suffering man.

In retrospect, I know that I need to work on my initial assessment skills. The first questions they asked were the same ones that I should have completed. Any allergies to medications, any medications you are taking right now? I checked for a patent airway, peripheral pulses, and completed a quick scan for major bleeds, but that was where my training ended and the adrenaline dump began.

The Step Cave has been my life for the past two months. My day began with a qbank and ended with review videos. In one week, we will begin Intro to Clerkships and then shortly afterward, I will begin my Internal Medicine rotation.

This experience woke me up. I am no longer in the realm of multiple-choice questions or obscure genetic diseases. I am about to enter the world of bleeding children, dying mothers, and crying men. I provided the initial medical response to a victim of multiple gunshot wounds.

This rite of passage, away from the powerpoint slides and toward a pair of bloody hands that clean a man’s face, has marked the beginning of my true medical education more than anything else can. Before, I had always wondered how I would react to a life or death situation where my decisions affect the outcome. Now, I know that I can act in the face of violence and that my current level of training is insufficient for the realities ahead.

I look forward to the growth and the challenges of Third Year, knowing that I have survived the first dip into the crucible.



Long Form Sundays

On Death Podcast

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