As soon as I got to the ER and saw the amount of blood on the patient, watch person, shirt being used to stop the bleeding and the number of nurses, who weren't assigned to the ER who had come to help, I knew it was bad. I quickly phoned Jim asking him to come and help and then I started holding pressure to his neck to try and stop the bleeding until Jim got there.
Jim, as you know, has been serving here for over 30 years, many times as our only surgeon. He has seen just about everything in his time here, but I have only been here 10 years, and despite seeing lots of chops, have not see a neck chop like this before. As I stood over Jack holding pressure on his neck, I asked him if he wanted to lay down - he said, no, more blood will come out - right, let's just stay seated. I had the nurses start 2 IVs, I had them get gloves and gauze and dressing material ready for Jim when he came, I had them call lab to get us some blood, and then I started praying while we waited for Jim to come.
It only took Jim a few minutes to get to us, but when a guy's neck has been severely chopped, a few seconds seems like hours, much less minutes. While we waited, I started to talk to Jack, asking him where he was from, what happened and if he knew Jesus. I was pretty sure this chop was extensive and involved some big vessels of his neck and I wasn't sure we were going to be able to save him. So while he was still awake and talking, we talked about Jesus. He assured me he goes to church, assured me he would see Jesus if he died, but also wanted us to do all we could, which we were planning to do. We prayed together, asking for God to help us all, and just about that time Jim arrived.
Once Jim was ready, we all took our first look at the large wound and quickly wrapped him up and headed off to the OT. My arms were shaking from the pressure I was holding on his neck, and I had a nurse relieve me to give me a break, while I helped Jim with the orders. In record time it seemed, we had him ready to go back to the OT and then we had to figure out how to intubate him, hold pressure, scrub, and get him prepped and gowned for surgery without losing much blood in the process. I resumed the job of pressure holder on the wound, while Jim and the Surgical Rural Registrar were getting ready for surgery. Sedating him and intubating him were quite difficult, and Jack was right, when he laid down a lot more blood came out - despite my pressure, the floor was a sea of red.
As soon as he was asleep, Jim and Rebecca were scrubbed and gowned and ready to start closing up this large wound. As they were suturing, I was helping our Anesthesia Officer, administering medicines for his blood pressure (which would go down and then up), changing out IV flasks, giving him more sedation, adjusting the gas on the ventilator, checking vitals, getting blood hanging, etc. We didn't have much down time, I certainly wasn't standing there just watching the surgery or taking pictures, it was quite stressful during the surgery, all of us doing all we could to keep Jack alive. Thankfully Jim was quick and was able to stop the bleeding and close within 30 minutes or so of starting the case. Our challenge then was getting him extubated. The swelling from the injury proved challenging, but after about 1 hr of prayers, trying different meds, reintubating him, etc, we got him off the machine and into the recovery room.
I can't say I got a lot of sleep the rest of the night, there was so much adrenaline going through me, that I wasn't really able to sleep. Tending to other patients in the Labor Ward also kept me up, but when I had some time, I would think and pray for Jack, hoping he was going to be okay. The next morning when I came to round, I diverted from the Pediatric Ward and went to see how Jack was doing on Surgical Ward. I was expecting to find him just laying in bed, not really looking much different than how he left the OR the night before. Instead, he was sitting up, reading a newspaper. He told me he felt fine. I couldn't believe it. Praise God for this recovery and for pulling him through the surgery and for Jim's hands in stopping the bleeding. 4 days later Jack went home with his family, very thankful for the care he got and thankful to God that he gave him some more days on this earth.
