Fabrice was clinging to the bedrail when the paramedics wheeled him into the emergency department. I watched from down the hall as a portly police officer struggled to keep up and glanced upward at the receiving board to learn the story. Another stabbing victim. In this urban ed, it was a common story, another young male caught up in gang violence and the drug trade. I slipped in quietly as Fabrice answered the doctor's questions. I was a silent shadow, there just to observe and to learn what I could. I watched the nurses move about with well-rehearsed choreography, each sure of his or her task. A resident poked and prodded as his attending arms folded tightly, watched every move. Monitors chimed their familiar tones and interrupted the steady whoosh of the ultrasound. A brand-new student, I hid in the corner, mystified by acronyms and lab values, unable to comprehend the snowy sonar picture. Eventually, all the tests were finished. Luckily for Fabrice, there was no serious injury, just a constellation of cuts that needed more than a few stitches and about an hour of the rushed resident's time.
As we sat down, Fabrice noticed my shirt and tie, glaringly out of place in this department full of scrubs and white coats. My badge, issued by the hospital just hours earlier, gave me away as an interloper. His eyebrow rose suspiciously and my cheeks flushed red. I explained myself as a first year medical student, just starting out and ready to learn. I asked it if was ok if I stayed to watch the resident sew his stitches. Fabrice's face lit up. He was excited to serve as a learning model, and insisted that I lean in closer so that I could see every twist of the needle driver. He presented either arm, proudly displaying the many rows of railroad track scars that bore evidence to no small familiarity with the sharp end of a knife. He insisted that I be allowed to place the last stitch, an unnecessary knot at the periphery of the wound, but a tiny indent that he'd be able to show as proof of his night as a professor. Fabrice walked out of the front door of the hospital and into the dark early morning. There was no great life lesson learned, no moment of realization or epiphany. Fabrice represented the constant story of the recurrent inner city trauma patient, and the tired resident sighed as he pulled off his gloves. And we were done.