Poll of the Day > Got to see a self inflicted GSW patient today in surgery.

(+) Yeah! (+)

GSW is Gun shot wound if it wasn't clear.

Sometimes when work is dragging a little I like to pop in to the control rooms of our procedure areas and look at what the doctor are doing.

Normally, it's like a cerebral angiogram or like a mediport placement for chemo. Random things that take a few minutes to complete and are minimally invasive.

Today, we had a soldier who was in Iraq that tried to kill himself via gunshot. He failed, in possibly the worst way imaginable. He did the maximum amount of damage you possibly could have done without killing himself or being brain dead.

Its was... Man, I don't even have the words for it. Don't shoot yourself in the head, guys.

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Fuck...

hes lost his eyes, hasnt he?

I remember watching some doctor show many many years ago with a patient who did that. It really fucked me up for a while.

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My brother is "medically retired" from the Marines due to severe PTSD from Iraq, and I've begged him not to own any guns for this very reason.

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So far, his lost a good portion of his jaw, his, ability to do almost anything(speak, move, etc) and I think he severed a ocular nerve.

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When I recruited in the army we had a segment in training on various serious injuries we could encounter and the medic response etc. One was of a guy who took serious gsw to the head. Half the guys face was literally gone. Lip, eye, skull etc. There was a giant hole in his head coming out the back. If anybody follows One Piece its exactly like when Whitebeard got half his face blown off by Akainu.

He lost a big chunk of his brain but incredibly he lived. He was in a coma for months and had serious memory loss but I don't think he was paralyzed. He was able to function relatively normally and had tons of reconstruction surgery etc. But it was crazy to see that on screen so I can't imagine actually witnessing that irl.

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I remember in basic they showed us a photo of a guy who bit down on a crimping charge (or something like that) and lived with nothing but basically an air hole.

then I remember responding to a suicide of a guy who basically did what your guy did, but succeeded. Ill never forget walking in on that shit.

Umm I came in expecting something related to the golden state warriors. This is not what I imagined

poor guy

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FatalAccident posted...

Umm I came in expecting something related to the golden state warriors. This is not what I imagined

poor guy

That was my first thought too

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EvilMegas posted...

So far, his lost a good portion of his jaw, his, ability to do almost anything(speak, move, etc) and I think he severed a ocular nerve.

Honestly, at that point, I really have to question whether or not it's ethical (let alone worthwhile) to save his life. Generally speaking, I'm in favour of intervening in suicide attempts because suicide is so rarely a competent decision and the victim will usually be glad to have survived once the corresponding mental illness is treated, but it doesn't sound like this guy's going to have much life left to live even if he does recover from being suicidal. I don't think it's actually unreasonable here to presume that - were the patient competent and conscious - his wish would be to be sedated and allowed to die as painlessly as possible.

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adjl posted...

Honestly, at that point, I really have to question whether or not it's ethical (let alone worthwhile) to save his life. Generally speaking, I'm in favour of intervening in suicide attempts because suicide is so rarely a competent decision and the victim will usually be glad to have survived once the corresponding mental illness is treated, but it doesn't sound like this guy's going to have much life left to live even if he does recover from being suicidal. I don't think it's actually unreasonable here to presume that - were the patient competent and conscious - his wish would be to be sedated and allowed to die as painlessly as possible.

You go from depressed but able to be fixed to an even worse existence that is not treatable. I feel like at that point its not fair to save them.

You have to wonder how much of the person is still there though. People that have dementia have changes in personality that make them unrecognizable from before. I can't imagine a person that suffers an injury that leaves them unable to move or speak wouldn't go through something similar.

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If it were ever me in that situation, do not try and save me. It must be a hell that I couldn't even imagine.

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adjl posted...

Honestly, at that point, I really have to question whether or not it's ethical (let alone worthwhile) to save his life. Generally speaking, I'm in favour of intervening in suicide attempts because suicide is so rarely a competent decision and the victim will usually be glad to have survived once the corresponding mental illness is treated, but it doesn't sound like this guy's going to have much life left to live even if he does recover from being suicidal. I don't think it's actually unreasonable here to presume that - were the patient competent and conscious - his wish would be to be sedated and allowed to die as painlessly as possible.

I remember an old issue of The Incredible Hulk, where Banner refers to suicide as "a permanent solution to a temporary problem."

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Some problems that people face aren't temporary and even some of the temporary ones are insanely difficult to deal with.

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EvilMegas posted...

Some problems that people face aren't temporary and even some of the temporary ones are insanely difficult to deal with.

Fair, it's a generalization, but a fairly common thread in accounts written or told by suicide survivors is some variation of "as soon as I did it, I realized it was a mistake".

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Reminds me of what happened to Herbert Sobel (Band of Brothers)

"In 1970, Sobel shot himself in the head with a small-caliber pistol in an attempted suicide. The bullet entered his left temple, passed behind his eyes, and exited the other side of his head. This severed his optic nerves and left him blind. Soon afterward, he began living at a VA assisted-living facility in Waukegan, Illinois. He died there of malnutrition on 30 September 1987. No memorial services were held for him."

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If that was me, I wouldn't want to be saved. And of they did save me, I'd just try again probably.

I feel bad for the guy. Living in his state must feel like torture.

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Why are they trying to save him? Seems very immoral.

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At that point, it's not really a doctors call whether they should or not, they just do.

Btw the procedure was a "success" and I phrase it that way because Fuck dude.

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Yellow posted...

Why are they trying to save him? Seems very immoral.

The entire profession revolves around rendering aid. The second you start judging whether you should help or not is a slippery slope.

There was a guy who was a part of my church group when I was a kid that was a handful of years older than me. At some point when he was in his I think mid 20's he tried to off himself by downing a bottle of pills but ended up living. However, he did so much damage to his body that he now is pretty much fully physically disabled. Like, can't talk, can't move, can't walk, really can't do anything. I understand his brain, however, is fully functioning. So now he's supposedly a normally functioning brain trapped inside a completely nonfunctioning body.

Literally my worst fear.

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Smarkil posted...

There was a guy who was a part of my church group when I was a kid that was a handful of years older than me. At some point when he was in his I think mid 20's he tried to off himself by downing a bottle of pills but ended up living. However, he did so much damage to his body that he now is pretty much fully physically disabled. Like, can't talk, can't move, can't walk, really can't do anything. I understand his brain, however, is fully functioning. So now he's supposedly a normally functioning brain trapped inside a completely nonfunctioning body.

Literally my worst fear.

Dude should have done some research. You can't take just any bottle of pills. You uave to pick the right ones. Or that is exactly what is likely to happen. Surviving the attempt but all fucked up.


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Bugmeat posted...

Dude should have done some research. You can't take just any bottle of pills. You uave to pick the right ones. Or that is exactly what is likely to happen. Surviving the attempt but all fucked up.

Yeah, it's like when people try to O.D. on Tylenol. Probably won't kill you, but will permanently fuck up your liver.

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EvilMegas posted...

At that point, it's not really a doctors call whether they should or not, they just do.

Because they can charge him for it after?

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Gruesome.

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EvilMegas posted...

So far, his lost a good portion of his jaw,

that's what I was going to guess :( that's rough

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EvilMegas posted...

GSW is Gun shot wound if it wasn't clear.

Seems pretty clear in context =p

Then again, I'm American.

EvilMegas posted...

Today, we had a soldier who was in Iraq that tried to kill himself via gunshot. He failed, in possibly the worst way imaginable. He did the maximum amount of damage you possibly could have done without killing himself or being brain dead.

Ouch.

EvilMegas posted...

Its was... Man, I don't even have the words for it. Don't shoot yourself in the head, guys.

tbh, that always seemed like a risky way to go.

MeteoricBurst posted...

If anybody follows One Piece its exactly like when Whitebeard got half his face blown off by Akainu.

Uhhhh... that never happened, unless it was something from the manga that didn't make it into the anime. Anime Akainu hurt Whitebeard a few times before Whitebeard broke through and clobbered him, after which Blackbeard and his crew killed him... or really finished him off, because the multiple chest wounds probably did more damage

DiScOrD tHe LuNaTiC posted...

Fair, it's a generalization, but a fairly common thread in accounts written or told by suicide survivors is some variation of "as soon as I did it, I realized it was a mistake".

Pretty much. The second people realize they're actually about to die, their problems can feel pretty damn trivial. Granted, you also have the people who make other attempts, like Jeffrey Epstein who failed to hang himself once but managed to do it the second time.

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Yeah, that's the kinda thing you really wanna "get right" the first time... the only thing worse than wanting to kill yourself is probably trying and failing like that. jfc. just horrible.

Zeus posted...

Uhhhh... that never happened, unless it was something from the manga that didn't make it into the anime. Anime Akainu hurt Whitebeard a few times before Whitebeard broke through and clobbered him, after which Blackbeard and his crew killed him... or really finished him off, because the multiple chest wounds probably did more damage

The anime censored it with Akainu "just" pumping his abdomen full of magma. The manga had half of Whitebeard's head burned off.

As for the topic, that's incredibly rough.

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I wish half the people that say they support the troops actually paid attention to how terribly they are treated and supported and how much damage is done to young people long term when you strip away their identity and send them off to kill

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iirc, the DoD has a separate budget from Veteran's Affairs, with the VA lagging severely behind.

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Hospy posted...

The entire profession revolves around rendering aid. The second you start judging whether you should help or not is a slippery slope.

Yes and no. It's not at all uncommon to take somebody off of life support not because they will never be able to survive, but because they'll never be able to have a quality of life that they would consider worthwhile. Usually, if a patient is unresponsive, it falls to family members to make that choice, but in extreme cases, doctors will base their decisions off of what else they know about the actual patient's wishes. When my dad had his stroke and took a turn for the worse, the resident on call did ask if we wanted to attempt a pretty radical lobotomy (pretty much his whole right temporal lobe and a large chunk of his right occipital lobe) that might have saved his life, but would have caused major memory loss and probably significant permanent paralysis. We ended up deciding not to go with that because he wouldn't have wanted it, but when we called the neurologist to tell him that, it turned out the resident shouldn't even have offered the choice because he would have refused to perform the lobotomy based on what he knew about my dad's wishes (the resident understated how radical the procedure would have been; my dad would have been little more than a vegetable).

The ideal is to act according to the patient's wishes. In cases where the patient can't express their wishes (and has no form of advance directive), the next best thing is to preserve their life until their wishes can be made clear, particularly if the medical system in question offers physician-assisted suicide so there's an option to rectify any unwanted life-saving (once they're assessed to be competent). In a case like this, though, even if the patient survives, they're never going to be able to express their wishes, nor will they ever be able to communicate a desire for assisted suicide or take matters into their own hands (and while his last decision to attempt suicide may not have been a competent one, this one certainly would be). The doctor must therefore make a judgement based on their future quality of life, and act accordingly (or, at the very least, ensure the next of kin understands the implications of keeping the patient alive before inviting them to make a decision).

Yeah, there's potential for a slippery slope there, and in general, doctors should try to avoid making decisions for patients as much as possible (especially major ones like this), but blindly committing to saving every single life regardless of the circumstances can result in doing more harm than good. Sometimes, death is actually the best outcome for the patient.

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