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FEATURE

TRAUMA

TOURISM

Fred H. Olin, M.D.

When I was in full-time orthopaedic practice I did my part by fractures and was all bruised up. Something about his chest made
taking trauma calls at the private hospitals in the Medical Center. our ED physician nervous, although he couldn’t really define it, so
Most of the calls were, of course, the usual things orthopaedists he called in a thoracic surgeon. An aortagram showed a small tear
see; little old ladies with hip fractures, kids with distal radius frac- in the thoracic aorta where the ductus arteriosus attached, with a
tures, victims of car wrecks, part-time athletes with sprained, contained hematoma in the mediastinum. He was taken to the OR
strained or torn this and that and so on. However, sometimes ge- where his aorta was repaired. I did a closed nailing of the femur
ography made a difference and we would have some international when that was done. The patient did pretty well under the circum-
excitement. stances and was sent to the ICU after recovery. That is, he did well
If you look at a map of Texas and Mexico you’ll see that San An- …until a couple of days later, when his wife came to visit him. The
tonio is the closest U.S. big city with a medical center to almost all nurses said it was an “interesting” interaction. He was ultimately
of the Mexican beach resorts. Flying time from them to S.A. is discharged and we never saw or heard anything more.
shorter than to other cities because the air-ambulance servicers Another time I received a call from Methodist about an air-
didn’t like flying over water, in this case the Gulf of Mexico. Over ambulance coming in, this time from Cozumel. The patient was
the years those facts led to some interesting adventures. I’ll try to an elderly woman with a hip fracture. Her story extended over
remember the details of a few. the better part of a week. As she and her early-20’s granddaugh-
One afternoon I was called and told that a jet air-ambulance was ter were entering their hometown Stavanger (Norway) airport
coming in from Cancun with a 40-ish-year-old man with several for a flight to London, a door had somehow knocked the older
fractures. It would land in a short while, and he would then be trans- lady down. She was able to get up and hobble on. In London
ferred over to what is now Methodist Specialty and Transplant Hos- they stayed at an airport hotel until their flight to Miami the next
pital, where I was on call. day. She was so sore that she needed a wheelchair to get to the
His story was this: The gentleman was an accountant who lived flight. In Miami, they went straight to the cruise ship for the
in the Maryland suburbs of Washington, D.C. He and his girlfriend main event of their trip. She now was unable to even stand, and
were on a motor scooter when they were crushed against a low wall for some reason there wasn’t the usual physician on board, only
by a bus. The woman was killed. He sustained femoral and clavicular a nurse, and the X-ray machine was allegedly non-functional. By

30 San Antonio Medicine • May 2018