Free Emergency! by MD Mark Brown Page A

bringing in a snake expert from the local zoo. If he could identify the snake, then maybe the doctors could find out how to treat the injury.
    The expert arrived at last, appearing somewhat shaken after his Code 3 ride in the patrol car. After taking a few moments to examine the remains of the snake, he rose to face the expectant crowd. In a calm voice he announced, “This is a Golden
False
cobra.” He went on to explain that the unfortunate animal was only minimally venomous, and that his bite was so unlikely to cause any harm that no treatment was necessary.
    All the tension went out of the place like air out of a balloon. The tourniquet and IV were removed. The patient was given a tetanus vaccination and discharged. The physicians and nurses returned to the more usual calamities of an urban ER, and the police took charge. The city had an ordinance outlawing exotic pets. Though the snake had been purchased in the suburbs, when the patient had brought it inside the city limits he had broken the law. No longer a victim in need of dramatic emergency assistance, he was now just another small-time criminal. A citation was issued, and the police left.
    Finally, only the two of us remained. The patient sat on the gurney, the purple hue slowly fading from his forearm, the policeman’s ticket in his other hand, a dazed look on his face. I wondered what he was thinking. Was he angry that the pet shop had sold him something less than he thought he’d paid for? Relieved that he was safe? Sad about losing his pet? Perhaps he was adding up his financial losses: the snake, the fine, the hospital, the ambulance, the repairs to his kitchen. Maybe he was just trying to solve the problem of getting home. The last time I saw him he was headed for the hospital lobby in search of a pay phone. He’d had his Warholian fifteenminutes of fame, and a little more, but he didn’t seem to have enjoyed it much.
    PAUL L. SNODDERLY, M.D.
    Fort Collins, Colorado
   

THE FIRES OF HELL
    â€œD oc,” the nurse told me, “the paramedics are coming in. They have a fifty-eight-year-old seizure patient. The paramedics know him. His seizures are fairly frequent. He’s still confused, but has good vital signs and no obvious trauma. ETA is seven minutes.”
    The patient’s name was Carl Long. He arrived groggy and not very communicative. He’d had a grand mal seizure at work. His frequent episodes had always been full-blown epileptic events that appeared to be violent, occurred without warning, and were poorly managed by medication. They were followed by the classic period of coma gradually transformed to lethargy, confusion, and, finally, understanding.
    The passage from preseizure to the postseizure confusion was a Rip Van Winkle nightmare for Carl. He would be going about his business, then would awaken with crowds all around, on the ground alone, or in the confines of an emergency room. He would have no memory of the events in-between.
    The last thing that Carl remembered today was being at work in the mall arcade. Years of poorly controlled seizures had limited what he could do for a living. Carl had lost many jobs when bosses, afraid of his frequent seizures, had fired him. Carl really didn’t have mucheducation. What little he possessed had been picked up here and there. He had also learned how to keep alive in a cruel, unforgiving world. At the mall, Carl got along with the kids fairly well, kept the peace in the arcade, and counseled and helped when he could. He seemed to ignore the teenage jibes of “The Dancin’ Man” given to him by some.
    Now, as Carl was awakening from the fog, his mind told him not to panic. He had been here many times. I began to examine him to see what, if anything, was to be done. I requested blood tests to check medication levels. Pulling aside the gown to listen to Carl’s heart, I saw the waxy smooth, rippled scars of an old third-degree burn. They