Finding out medical condition ... New Question in #9

inspiredbymusic · Jan 3, 2014

New question in post#9

Hello,
I had a thread on this scene a few months ago and received some very helpful feedback. http://absolutewrite.com/forums/showthread.php?p=8528023#post8528023 Thank you! The feedback also raised more questions and issues. I am slowly working on revisions to my ms, and I am reworking the scene that pertains to my original question. I thought it would be best to start a new thread rather than confuse the original thread.

The situation: After leaving prom, a teen couple are in a car accident. The girl is seriously injured and dies during emergency surgery at the hospital. The boy suffers a concussion and drifts in and out of consciousness at the crash scene (which is very near the hospital). Both are taken to the same hospital.

For the purpose of the story, it is necessary that the boy not only find out or figure out quickly that the girl is dead, but he also needs to learn quickly that emergency surgery to repair the girl’s severed carotid artery was successful, but that she died of blood loss and/or shock during surgery. (It is necessary that her injuries were successfully repaired and that he find this out, in addition to finding out that she died.)

What I would like to do is have him drift in and out of consciousness as emergency personnel work at the crash scene and at the hospital, picking up on actions and snippets of conversation that let him know what’s happened. This boy is highly intelligent and is familiar with a great deal of medical/scientific terminology, so he should be able to pick up on things that others wouldn’t.

What I am looking for is suggestions on what he could plausibly witness and/or overhear that would allow him to become aware of what happened. Any and all input appreciated!

For the record:
. This is in the U.S.
. The girl who is killed was the driver, but not at fault. (They were hit by a drunk running a red light).
. The boy’s only injury is a concussion, and I would like it to be pretty mild. Medical personnel want to keep him for observation but he defies doctor’s orders and sneaks out of the hospital after finding out what happened to the girl. (If a mild concussion and drifting in and out of consciousness isn't plausible, maybe an alternate possibility would be for him just to be stunned and in shock and picking up on things sporadically?)

MagicWriter · Jan 3, 2014

He won't overhear anything. It is against HIPAA for the hospital personnel to be discussing anything about the girl, while in his presence.

However, you could have the parents of both the boy and the girl talking about the accident, and he would be able to overhear that.

ULTRAGOTHA · Jan 3, 2014

You could make his injuries LESS severe and he could find out what happened from the girl's parents.

The more he's unconscious, the worse his injuries are. Prolonged unconsciousness, despite what you see on TV, is really serious.

MagicWriter is correct that HIPAA would forbid the hospital from discussing the girl's condition with him. Plus with the difference in their injuries, the people who work on her probably won't even be the same people who work on him. The ones who work on him probably won't know what happened to her.

(I will note, however, that if she was still in the emergency room, which she wouldn't be because of her injuries, his overhearing is totally possible. I know quite a bit about a baby that came into the emergency room when my wife was there who was evidently abused by her grandmother who was babysitting her. Contusions, bruises, who found her, how they found her, what the police thought at that time. It was all discussed two cubes over. Those cubes only have curtains. But since inspiredbymusic wants him to know what happened during and after her surgery, that scenario won't work.)

But if he's shaken up but goes home that evening with his parents, it's perfectly plausible that he'd want to find out what happened to her. He'd have to find her parents on his own, though. Or encounter them on their way out of the hospital. The medical personnel won't suggest he speak with her parents if she's just died and they won't tell him what happened.

Alternatively, if her parents wanted to talk to HIM to find out what happened that's also plausible.

Don't forget the police will talk to him, too, as a witness to a fatal crash. They might tell him she's dead but they wouldn't discuss the surgery with him.

Dandroid · Jan 3, 2014

I have brought several people from accidents that involved fatalities to hospitals...those that were conscious certainly didn't find out much very soon...

iLion · Jan 3, 2014

On the other hand...
you could reasonably have an ER situation where both teens were in the same room being worked on at the same time. I work at a hospital where the ER beds are side-by-side, and separated by only a sliding curtain and just enough space for the many caregivers to manuever.

I can envision a scene where the two are side-by-side in separate beds (of course) and the boy can get glimpses of the girl as the curtain gets bumped and brushed by her ED crew. Of course, he would also hear pieces of the ER conversations and orders from MD etc, and finally maybe even pronouncement of death. It's chaotic to the outsider though, so you might not get a lot of detail that way.

When the two initially are brought into ER, the extent of injury is unknown, so they could easily be worked on side-by-side simultaneously - and with all the profuse blood from the boy's concussion that involved scalp lacerations (they often beed tons), it can look much worse than it really is - therefore being wheeled directly into ER with the girl.

ULTRAGOTHA · Jan 3, 2014

iLion said:
I can envision a scene where the two are side-by-side in separate beds (of course) and the boy can get glimpses of the girl as the curtain gets bumped and brushed by her ED crew. Of course, he would also hear pieces of the ER conversations and orders from MD etc, and finally maybe even pronouncement of death. It's chaotic to the outsider though, so you might not get a lot of detail that way.

The OP wants:

but he also needs to learn quickly that emergency surgery to repair the girl’s severed carotid artery was successful, but that she died of blood loss and/or shock during surgery.

Can that sort of surgery be done in the ER? I didn't think so. But if so, then it's very possible he would overhear a lot if she's in the same ER.

Dandroid · Jan 3, 2014

Yeah, by the time she dies she's in another part of the hospital

Dandroid · Jan 3, 2014

I'd go with a different injury

inspiredbymusic · Jan 3, 2014

NEW QUESTION + Thanks!

Thank you all so much!

It is important for the sake of my story that the boy find out about the girl's death, etc. before he leaves the hospital, soon (within an hour) after her death.

I guess MAYBE it could work for him to find out from the girl's father. It's important that his parents not be involved at this point. (As I've written it, the hospital is initially unable to contact his family.)

I like the idea of the boy and girl being worked on side by side in the ER, but it wouldn't work as I've currently written it, since she dies during surgery to repair her carotid artery.

Dandroid said:
I'd go with a different injury

Yes, going with a different injury makes sense! It is important for the story that she dies but that whatever injury she has is repaired prior to her death.

So, NEW QUESTION: Does anyone have suggestions for a type of injury from a car accident that could be quickly repaired in the ER but serious enough to still result in death? (It would be a bonus if this injury would leave a neck wound.) (Sorry this is sounding awfully gruesome ...)

melindamusil · Jan 3, 2014

This is probably not what you're looking for, but you can always go with a severe traumatic brain injury. It's not exactly "repaired" in the ER - more like "managed" - but can still easily result in death. When I had a severe TBI (at age 17), I was brought into the ER in a neck collar and on a backboard (and totally unconscious). Mine was a closed brain injury with minimal blood, but you could make it open and have plenty of blood (and/or you could give her plenty of gnarly lacerations). It's possible that she might come into the ER, be put on life support, be sort-of-okay - but then a few hours later, she tanks and dies.

Dandroid · Jan 3, 2014

Liver or spleen lacerations....strong coincidence with mvcs...especially in the"up and over"pathway

NeuroGlide · Jan 3, 2014

inspiredbymusic said:
So, NEW QUESTION: Does anyone have suggestions for a type of injury from a car accident that could be quickly repaired in the ER but serious enough to still result in death? (It would be a bonus if this injury would leave a neck wound.) (Sorry this is sounding awfully gruesome ...)

Yes, lots of them. It's quite easy for an accident victim to have so many injuries that they succumb to secondary injuries after the major injuries are treated. Just to pick one, cerebral edema or swelling of the brain. She wasn't buckled up and her head became a pinball. If there were any sign of head trauma they would worry about it and try to check on it, but neck wounds are so critical they would focus on that.

ArtsyAmy · Jan 4, 2014

This is in response to your first question. Would the following work?

Someone who knows both the boy and the girl is staying with the boy in the hospital. The boy appears to be unconscious, but is actually regaining consciousness when someone else enters the room. The someone else (thinking the boy is unconscious) tells the first someone that the girl just died, that the surgery had been successful, but the girl had lost too much blood, etc.

Perhaps the "someones" could be people who also were at prom and witnessed the accident (perhaps adults who had been chaperones at the prom). This scenario gets you around HIPAA requirements that the hospital staff would be aware of, and the issue of where in the hospital the patients would be so the boy could overhear.

inspiredbymusic · Jan 4, 2014

Thanks again for the responses!

It's important that her injury or injuries are repaired before she dies (so that her body and brain are in functional condition even though she's dead), so it wouldn't work for her to have multiple serious injuries or severe brain injury.

Dandroid said:
Liver or spleen lacerations....strong coincidence with mvcs...especially in the"up and over"pathway

Would it be possible for liver or spleen lacerations to be quickly repaired in ER? (Also, what is mvcs? And by "up and over" do you mean that the victim goes through the front windsheild of the car? Thanks!)

What I am looking for is an injury that could plausibly be quickly repaired in the ER, but that could result in death (maybe from blood loss or shock?). What I need is for her body to be in working order even though she has died.

ArtsyAmy said:
This is in response to your first question. Would the following work?

Someone who knows both the boy and the girl is staying with the boy in the hospital. The boy appears to be unconscious, but is actually regaining consciousness when someone else enters the room. The someone else (thinking the boy is unconscious) tells the first someone that the girl just died, that the surgery had been successful, but the girl had lost too much blood, etc.

Perhaps the "someones" could be people who also were at prom and witnessed the accident (perhaps adults who had been chaperones at the prom). This scenario gets you around HIPAA requirements that the hospital staff would be aware of, and the issue of where in the hospital the patients would be so the boy could overhear.

I like this suggestion too. However it is necessary for my story that everything happen very quickly. Maybe this would make sense if it were someone else at the prom who witnessed the accident (or even another prom couple in the back seat, who escaped injuries?) But then how would they know what happened to the girl since HIPAA would prevent staff from telling them either, right? Hmmm ...

Still open to any and all ideas!

BrightSera · Jan 4, 2014

inspiredbymusic said:
Thanks again for the responses!

It's important that her injury or injuries are repaired before she dies (so that her body and brain are in functional condition even though she's dead), so it wouldn't work for her to have multiple serious injuries or severe brain injury.

Would it be possible for liver or spleen lacerations to be quickly repaired in ER? (Also, what is mvcs? And by "up and over" do you mean that the victim goes through the front windsheild of the car? Thanks!)

What I am looking for is an injury that could plausibly be quickly repaired in the ER, but that could result in death (maybe from blood loss or shock?). What I need is for her body to be in working order even though she has died.

I like this suggestion too. However it is necessary for my story that everything happen very quickly. Maybe this would make sense if it were someone else at the prom who witnessed the accident (or even another prom couple in the back seat, who escaped injuries?) But then how would they know what happened to the girl since HIPAA would prevent staff from telling them either, right? Hmmm ...

Still open to any and all ideas!

Hmmm. You may have written yourself into a corner if you want to preserve her body and brain with this scenario. An accident bad enough to kill a young, healthy woman will involve usually involve complex multi-system trauma, and any singular piece, like a severed carotid artery, will be fatal within minutes.

The only thing I can think of is a slower arterial bleed managed by EMS, gets her to the ER, she's showing signs of blood loss, the high heartrate masks an arrhythmia of the heart (not sure if this works either, wouldn't someone notice?) she goes up for a surgical repair and codes because of the v-fib, an undetected heart defect, the combined blood loss makes saving her difficult, etc. But that's not straightforward either, since she's young and healthy, and trauma hospital personnel usually know what the hell they're doing on complex cases. It's like they love to be surprised, at times.

melindamusil · Jan 4, 2014

inspiredbymusic said:
I like this suggestion too. However it is necessary for my story that everything happen very quickly. Maybe this would make sense if it were someone else at the prom who witnessed the accident (or even another prom couple in the back seat, who escaped injuries?) But then how would they know what happened to the girl since HIPAA would prevent staff from telling them either, right? Hmmm ...

Her parents tell them, or her parents tell someone else who tells them (you know how teenagers love their rumors). Does the dead girl have a sibling? Dead girl's sibling tells his/her friends that his/her sister is dead.

BrightSera said:
Hmmm. You may have written yourself into a corner if you want to preserve her body and brain with this scenario. An accident bad enough to kill a young, healthy woman will involve usually involve complex multi-system trauma, and any singular piece, like a severed carotid artery, will be fatal within minutes.

I'm with BrightSera on this. Why does her body and brain need to be in functional condition? Maybe if you share a little bit more, we can help you find injuries to fit your scenario. Is the survivor of the accident planning to steal her body and Frankenstein her back to life?

If she dies from blood loss, that usually implies that blood is leaving the body faster than the doctors can put it back into the body - which in turn implies that something (artery? liver/spleen?) is still bleeding and hasn't been repaired.

"Shock" usually refers to hypervolemic shock, which occurs when the blood volume drops too low. As I understand it, dying from shock is akin to dying from massive blood loss or massive plasma loss (as in severe burns). (Medical people are welcome to correct me.)

Now, I suppose it's possible that she loses massive amounts of blood and suffers additional trauma due to the loss of oxygen that is not immediately apparent - but that would not work under your desire to leave the body and brain in functional condition.

CoolBlue · Jan 4, 2014

inspiredbymusic said:
What I need is for her body to be in working order even though she has died.

This is belaboring the point, perhaps, but: The reason we die is because a part of our body is not working.

The things that kill us suddenly with a working body are things that are easily fixed in a hospital setting. Sudden arrhythmia, perhaps caused by an elecrolyte imblance that should have been noted before. Congenital error of cardiac conduction, such as Wolf Parkinson White.

You don't die with a healthy body!

HTH
CB

ULTRAGOTHA · Jan 4, 2014

Maybe she could be patched up and surgery over and then she dies later from complications.

It sounds like the OP wants a body that, if re-animated, isn't going to die again immediately because there are leaks in the plumbing or somesuch. That's tricky but it sounds like it's SF/F so we can roll with it.

Is this zombies? Am I helping with a zombie story?!? OMG, zombies.
:chair

NeuroGlide · Jan 4, 2014

CoolBlue said:
You don't die with a healthy body!

I'll grant you it's atypical, but there are always the oddball cases that haunt the doctors involved where the patient was successfully treated, but still died.

A far more common situation, however, is hypothermia. Rule for hypothermia is you're not dead until you're warm and dead. They'll treat injuries as they warm her up hoping to get her heart restarted.

CoolBlue · Jan 4, 2014

NeuroGlide said:
I'll grant you it's atypical, but there are always the oddball cases that haunt the doctors involved where the patient was successfully treated, but still died.

A far more common situation, however, is hypothermia. Rule for hypothermia is you're not dead until you're warm and dead. They'll treat injuries as they warm her up hoping to get her heart restarted.

Hypothermia does not kill directly, if you are to survive at all. If her body is "in working order" after being resuscitated, and she dies later, it still isn't working when she dies! She died from what caused the hypothermia, perhaps, such as a stroke causing her to lay outside. She develops pneumonia.

Remember, the OP said she survives. You don't die with a functioning body in a hospital. Even if you get shocked by a power cord, let's say, and aren't found soon enough, you die from brain anoxia.

HTH
CB

NeuroGlide · Jan 4, 2014

CoolBlue said:
Hypothermia does not kill directly, if you are to survive at all. If her body is "in working order" after being resuscitated, and she dies later, it still isn't working when she dies! She died from what caused the hypothermia, perhaps, such as a stroke causing her to lay outside. She develops pneumonia.

Remember, the OP said she survives. You don't die with a functioning body in a hospital. Even if you get shocked by a power cord, let's say, and aren't found soon enough, you die from brain anoxia.

Like you said, a dead body in working order is nonsensical. If it were working, it wouldn't be dead, but his original request was for a person how died despite the injuries being repaired. A person who was hypothermic (is that a word?) can fit that bill as they can't be sure that she's dead until they get her warm, but they will repair any life threatening injuries on the hope that the cold preserved her. Since this is a car accident that someone else (the MC) was pulled alive from, they have good reason to hope.

CoolBlue · Jan 4, 2014

NeuroGlide said:
A person who was hypothermic (is that a word?) can fit that bill as they can't be sure that she's dead until they get her warm, but they will repair any life threatening injuries on the hope that the cold preserved her. Since this is a car accident that someone else (the MC) was pulled alive from, they have good reason to hope.

Yes, it is a word. Your scenario does not really make much sense, in that you are describing that one person does not become hypothermic, yet the other does.

They are also, according to the first question, quite close to a hospital. So, I suppose you are suggesting that perhaps the one person was thrown from the vehicle, into a snowbank, and that it was cold enough for this person to become so hypothermic that they would be protected from a severe injury (but also not suffering any frostbite), while the other remained in the vehicle did not? Perhaps the engine remained running, and kept the vehicle warm after the accident.

If the setting is a very cold climate, perhaps. On the other hand, you would need a ton of 'splainin to make it work, and not seem contrived. I suppose if the hypothermic person fell into water that was liquid, yet did not drown, it would happen fast enough without causing frostbite. (Think "The Abyss").

Interesting hypothesis, nevertheless.

CB

NeuroGlide · Jan 5, 2014

CoolBlue said:
Yes, it is a word. Your scenario does not really make much sense, in that you are describing that one person does not become hypothermic, yet the other does.

They are also, according to the first question, quite close to a hospital. So, I suppose you are suggesting that perhaps the one person was thrown from the vehicle, into a snowbank, and that it was cold enough for this person to become so hypothermic that they would be protected from a severe injury (but also not suffering any frostbite), while the other remained in the vehicle did not? Perhaps the engine remained running, and kept the vehicle warm after the accident.

If the setting is a very cold climate, perhaps. On the other hand, you would need a ton of 'splainin to make it work, and not seem contrived. I suppose if the hypothermic person fell into water that was liquid, yet did not drown, it would happen fast enough without causing frostbite. (Think "The Abyss").

Interesting hypothesis, nevertheless.

CB

Yes, I'm thinking near freezing weather, car rolls into marsh and is partly submerged, survivor climbs out before passing out, passers by drag him to safety/warmth, but can't get to her. That is as far as I can bend reality to fit the author's requirements.

ULTRAGOTHA · Jan 5, 2014

Or even that the EMTs get him out and off to hospital before they can get her untangeled from the wreck. That precludes a bleed as she'd die from a major bleed before they could get her out but would fit hypothermia.

inspiredbymusic · Jan 5, 2014

Thanks you all so much for the input! It really is amazing to have others thinking about this and willing to try to help.

BrightSera said:
Hmmm. You may have written yourself into a corner if you want to preserve her body and brain with this scenario. An accident bad enough to kill a young, healthy woman will involve usually involve complex multi-system trauma, and any singular piece, like a severed carotid artery, will be fatal within minutes.

Yes, and it seems that solving one issue opens up another can of worms!

I get the point that a healthy functioning body does not result in death, but would it be at all possible for someone to die (of blood loss ?) during surgery and that staff could be unable to resuscitate the victim even though surgery successfully repaired the injury?

. Hypothermia will not work. The setting is Phoenix, AZ. (I appreciate the creative suggestion though!)

. And, yes, as most of you have guessed, this is a Frankenstein(ish) story.

I originally based my idea for what happened to the girl on information I read about a freak hockey accident in which the goalie’s carotid was severed, but he was saved by emergency surgery. So the way I wrote it, the girl’s carotid is severed (or partially severed) in the accident, she’s rushed into emergency surgery and the surgery is a success, but she flatlines due to blood loss near the end of surgery and they’re unable to resuscitate her.

As I wrote it initially, the hospital staff won’t tell the boy anything, but he becomes extremely agitated and pressures them into telling him.

Does any of this make any sense whatsoever??

At this point I am leaning toward keeping it pretty much as I originally wrote it, but changing the way the MC finds out to a combination of picking up on clues and then talking to the girl’s father.

Thanks again, everyone, for all the information and suggestions!

Finding out medical condition ... New Question in #9

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