On August 1, 2012,Reagan County Sheriff's Deputy Josh Mitchell died under my care.

He had been shot with a rifle by a chronic meth-head here in my little West Texas town about 90 minutes before I finally gave him up to the Lord and admitted there was nothing more I can do. I, and my entire trauma team, worked our ass off trying to save Josh's life. I spent 20+ hours from the time Josh got shot to the time the perp tried to eat his gun (typically for him, a botched job) trying to marshal our small hospital's resources to be as prepared as we could be to meet the needs of whatever might have come down the pike. I was deathly afraid that I was goiing to have two or three wounded cops in my ER in the next few hours. I can't begin to describe what I, and key hospital staff, had to do in the hours after Josh's death to be prepared for the deaths and injuries we were obligated to be prepared for.

I am a damned good trauma doc. I have saved lives more than a few times, but I've lost a lot more than I've saved. I have enormous resources at my command in virtually any ER I work here in America, but resources and skill can't save the life of someone whose injuries are beyond repair. 

Josh's GSW was not survivable. If he'd been shot in the lobby of Odessa General, our closest Level I trauma center, he'd have died. But knowing that doesn't kill the sadness I feel for not being able to save him. 

I feel surrounded by loss and doubt at this time. We have had our debriefings, our group counselling session that did an enormous amount of good for the folk who do what they do in our little rural county. These folk have been overwhelmed by this situation, and I think we've accomplished the first steps in the healing for them. 

But for me, there's no one. I'm not saying this as an expectation of a pity party. But really, there's no one who can feel what I feel, other than a handful of smalltown ER docs scattered around the country. I only know a few, and tomorrow (today, really, as I type this.... it's 4 am) I will be calling the 3 or 4 guys who, like me, are small town ER docs with Big  City ER experience and attitudes to bounce this stuff off of. 

As my good friend Gail Pepin, an ER nurse, says: "If they die, they die."

She's right.

But here in Small Town America, it hurts to know she's right.

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January  2018
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Screen shot of Dr. Williams being interviewed by Police One TV