Sunday, October 6, 2019

‘Code yellow: Trauma in the emergency room’

Mount Sinai medical personnel treat a stabbing victim (Photo for the Sun-Times by Ashlee Rezin Garcia)
     In July, I read a story in the Sun-Times mentioning that the emergency department at Mount Sinai was "on bypass," meaning that trauma cases had to go to other hospitals. "They must be really busy," I thought, phoning the hospital and inviting myself to visit the ER. At first Mount Sinai's spokesman balked, citing patient privacy, HIPAA laws, the usual reasons. "That's a shame..." I mused, or words to that effect, "because what you do is important. And wouldn't it be nice if more people knew about it..." That started an email  conversation that led to this story. Kudos to Mount Sinai's Dan Regan, who eventually said "yes," trusted us, and stood uncomplaining for eight hours while Ashlee Rezin Garcia and myself collected the words and photographs for this story. Thanks to all the professionals at Mount Sinai who opened up to us or at least tolerated our presence, particularly to Raquel Prendkowski, whose candor and leadership made this more than a description of medical procedures. Thanks to Ashlee—a true professional and a pleasure to work with. Thanks as well to John O'Neill, Paul Saltzman and everyone else at the paper who helped make this pop on the Sun-Times site—wait until you see it.

     “What is your name? Can you tell me your name?”
     The first question that people are asked as they are rushed into the emergency room at Mount Sinai Hospital is a ploy. The nurses and doctors hovering alongside the rolling gurney aren’t really interested in that. Not now, with life potentially hanging in the balance. Besides, they probably could get the person’s name from a wallet in the bloody clothes being stripped or cut away.  

     What they really want is to prompt the patient to speak, or try to.
     If they can, “That tells us they’re breathing fine and their lung sounds are clear because they can talk to us,” said Raquel Prendkowski, emergency department director for Sinai Health System. “We want to see if they’re audible.”
     Marco Munoz, brought in on a recent warm Tuesday night, can mumble his name. But his left lung is not clear thanks to the knife plunged into his chest 15 minutes earlier in K-Town.

To continue reading, click here.


  1. This column is one of the best articles I've read anywhere in a long time. Visiting Mount Sinai is almost like going home, in that my siblings and I were all born at nearby St. Anthony Hospital, just across Douglas Park. My parent's primary care physician was Dr. Christine Veres, who became head of the Geriatrics Department at Mt. Sinai Hospital. I took my Dad there once and Mom twice, each time passing through the ER. Neil describes perfectly what it is like there. Code yellow, lockdowns, now I know what the chimes are about. For my Mom's second trip at a family get together at a restaurant, lifting my Mom I carelessly managed to put a nasty gash in her forearm. A neat thing about driving a Mercedes is it has medkit as standard equipment. I patched her up and everyone met at the Mt. Sinai ER. Only one visitor at a time is permitted to be with a patient. Just beyond triage is the ER waiting room. We did our part to be helpful. Letting someone else visit Mom, find my sister who worked at UCLA Med Lab, had organized games for the children there to help them pass the time. Back with my Mom a doctor unraveling the bandages gave me a quizzical look, and asked if someone in the ER bandaged the wound? Later a nurse bandaged my Mom, and only had tiny pieces of gauze to place on the wound. Did they run out of the good sized Vaseline impregnated gauze? A few years later in the Jewel parking lot I was doubled over with excruciating abdominal pain. Didn't want to risk losing consciousness while driving so called a cab, out of habit requested Mt. Sinai ER. I think it was bay 15, pain was receding, and looking around saw blood spots here and there. Flagged an orderly over and told him I don't mind, but there are people who freak out at the sight of blood. He mopped them up. The diagnosis was kidney stones, they eventually passed. Stopped eating Tums like candy for stress, hasn't happened since.

    1. When I had my stones, blood stains were the farthest thing from my mind. Had I known I would spend 4 hours alternately feeling like I was stabbed in the back or dry heaving from the nausea, I would have cut myself to speed up my treatment. Not Mt. Sinai, but St. A in Hoffman Estates. They ignored me while suffering but wouldn't let me drive home in the morning after the crisis resolved. Still haven't forgiven them.

  2. Very good insight as to what goes on in ER’s and the people who work there. It is true that the ones who can deal with the daily stress tend to stay a long time. It is not because they become “hardened” to what they see. In fact, I believe they become more sensitive. The stress then dissipates. Only the challenge remains.
    What happens to those who stay is that they learn that this is life. This is what goes on every (goddamn) day but only those who treat the sick or injured are the ones who see it. The rest of society stays in the dark. It’s why violence is so shocking to those who remain unaware.
    Having worked as a paramedic, I saw those in the ER do their thing. As with the fire department, it seems that most of the best like to work the busy places.


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