What’s In A Name?

I’m sorry I didn’t know your name.

It’s important for me to know who you are, and not simply to fill in the blanks on my run form. Much of what I do for my patients and their families depends upon their rapport I can develop with them during our short time together. To do that, we need to know what to call each other.

I’ve been known by many names. My mother gave me my first two, and insisted on calling me by my middle name all my life. When I was a child, I detested having what I thought was a girl’s name. As I aged, I grew to like it. When she was angry with me, she’d run through a litany of her children’s names: “C’mere Terry… Sheri… Darlene… Kim… Goddamnit you know what your name is! Now get over here!

The only person who has ever called me by all three of my names at once was my third grade teacher, Mrs. Sanders, after having discovered that I drew a life-sized chalk outline of a naked woman on the cafeteria wall. I got caught because I signed my name to my work. My parents were so mad, they couldn’t even speak, much less use my name.

My paramedic instructor still calls me Lugnut, fifteen years after graduation and ten years after I eclipsed his accomplishments in EMS. My co-workers have, at various times, called me Dr. Grayson, EMS Yoda, and The Answer Man. That’s when they aren’t using terms like prick, asshole, and arrogant ass. The readers of my blog call me AD.

And truth be told, at one time or another, all of them have probably been accurate.

Normally, I make it a point to know my patients’ names, and make sure they know mine.

I introduce myself and my partner to every patient. I introduce my patients to the nurse at the ER. It’s just so much more comforting to know the names of the people who will be caring for you.

Chances are, if you had been conscious at the time, I’d have smiled and winked slyly, and introduced myself as the man who’d be poking unnecessary holes in you today. Or the overpaid taxi driver. Or as a proud graduate of the Close Cover Before Striking school of paramedicine. Or as the actor Chris Farley, doing research for my latest role.

And if you had pointed out that Chris Farley is dead, I’d have winked again and pointed out, “See? You’re not quite as fucked up as you thought you were!”

And I’d have learned your name as well. If you were my age or younger, I’d probably have used your first name. If you’re of a certain culture, I’d attempt to learn your proper name, but I’d probably call you by your street name. If you were older than I, I’d never call you buddy, sugar, sweetie or honey. I’d probably call you Mr. or Mrs., Sir or Ma’am, perhaps even after knowing your given name.

I fear that if I did otherwise, my female forebears might rise out of the ground and git me. You show respect to your elders where I’m from.

So forgive me for not knowing your name, but I already know too much about you already.

I know from your clothing that you weren’t homeless. You were well dressed, if not expensively so. You were well groomed.

You weren’t drunk when it happened. Normally, your blood would have reeked of ketoaldehydes if that were so.

I even know how you died, inasmuch as one can surmise such things without an autopsy. Evaluating the mechanism of injury, the kinematics of the trauma you sustained, comes as naturally as breathing to me.

When the SUV struck you, he was already standing on his brakes, the front end and bumper diving toward the pavement. It struck you near your right knee, which explains the open fracture there.

Only that one leg fractured, and all the ribs broken on your right side. You never even turned to face the danger, never even saw it coming.

Your spleen and liver were probably ruptured as well, in that phenomenon we refer to in dry medical prose as tertiary collision. Simple physics, really. Objects at rest tend to stay at rest. Objects in motion tend to stay in motion. That is, until acted upon by an outside force. In this case, those objects were your internal organs, and the outside force was the impact with the walls of your abdominal and chest cavities.

The head injury probably occurred when you bounced off onto the pavement. No abrasions on you; you weren’t dragged. All the blood and brains were concentrated right there on the pavement beneath your ruined skull.

And all that I can forget, because ultimately you will fade into a half-remembered diagnosis, as so many other patients do; The Diabetic Lady, The Code At The Lakefront, The Assault Patient, The Pedestrian MVA On The Interstate…

It’s harder with you, because I also remember the shell-shocked look on the face of the man that hit you. He’ll never be the same again.

And I know what you looked like before the accident, smiling there in that family portrait in your wallet. Your daughter looks like more like you than your wife. And I’m having a hard time forgetting that, too.

And perhaps I feel a little guilty because I didn’t even try to resuscitate you. I didn’t try, because I knew that the effort would be futile. Your injuries were too extensive. But still, a part of me feels guilty, because not even trying wasn’t what I signed on for.

So forgive me if I didn’t dig further than that, and instead merely handed your wallet to the police officer. I knew your driver’s license was in there, but I told myself I didn’t need it because you were never a patient. If you were never a patient, I never needed to know your name.

And knowing your name is more than I can afford right now.

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