We all carry a certain amount of Neanderthal DNA but what if you went to bed tonight and you woke up tomorrow in a cave...with a Neanderthal family...your family?
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Publish Date: 12/20/2022
Sleeping with Neanderthals
This dream is not possible. I am sleeping in a cave with my Neanderthal relatives. That is impossible. I am an emergency room physician and general surgeon at the Kingston General Hospital in Ontario, Canada. I can’t be dreaming. People never question whether they are dreaming when they are dreaming. This is hyper-realistic. I know these people. They are my relatives. They raised me. I am their leader. I know all about them. But if I am a Neanderthal, how can I possibly know about medicine and Kingston? How do I know they are Neanderthals?
I had a fight with my girlfriend, and she left my lakefront home on Lake Ontario. She was over-the-top angry. We aren’t living together but had planned to spend the night together. It was late enough that I went to bed. I fell asleep quickly, but woke up suddenly in this cave with my Neanderthal family. I feel rested but I should be tired. It isn’t a dream. It must be a hallucination. Oh crap! I am going nuts and hallucinating.
It is dark, but I know where I am. I can smell the dry earthy smell of the cave’s floor. I hear the occasional crackle of the smouldering fire and can detect a faint smell of smoke. There is the sound of one of my relatives snoring. We live as an extended family. Stop! This is nonsense.
I try rolling over. There is a woman beside me. Definitely not my girlfriend. This is my wife. But how do I know that? I am not married, but I know Gora is my wife. Now, where did that come from? How do I know her name? She senses my restlessness and cuddles up against my side. I love her. How do I know that?
Take a deep breath. Relax. Breathe regularly. Close your eyes. Go back to sleep. When I wake up, this hallucination will be gone. I am going to have to make an appointment with a shrink. This all seems so real.
I fall into a troubled sleep. Things have not been going well between my girlfriend and I. She wants marriage and kids but I don’t feel ready. No wonder I don’t feel ready. I have a wife. No, this is a hallucination. When I wake up, it will be gone.
I don’t have to open my eyes. I know I am still in the cave. It is time to empty my bladder and get ready. My brothers are coming and we are going hunting today. Wow! How do I know that?
When I open my eyes, there is light coming in the entrance to our cave. I get up and put some wood on the fire. Gora gets up and gives me a hug and starts preparing our breakfast. It is all so routine and family oriented and ridiculous. I can’t be here. I am a doctor in Kingston.
Gora and all the rest of my relatives eat more meat than I do. I don’t feel well when I eat a lot of protein. Now I have the words and the knowledge to understand that I can’t tolerate as much protein as my wife and brothers, but I don’t know why. Gora will make a breakfast for me with a larger amount of vegetation than she will have. She will however not eat 100% meat. None of us does that. Everyone eats some vegetation.
Gora will make what looks like a fat pancake. She pounded the lentils, nuts, grasses, seeds, and mustard into a mash last night and kept it in a skin bag overnight. Now she will cook it. We do not have pots and pans so she will stoke up the fire until the rocks around the fire get hot. Then she will place the pancakes on the hot rocks to cook them. She is quite skilled at turning them over with a bone knife that I made for her.
No one eats raw meat unless they are stuck out on the land with no safe place for a fire. With my newfound knowledge as Dr. Neanderthal, I am very glad to know this is the case. Not as critical, but I am also glad Gora cooks the vegetable portion of our meals. When out hunting, we will eat nuts and berries as we find them.
The smell of Gora’s cooking has my stomach juices flowing and I can’t wait for breakfast.
My name is Goro, not Dr. Joe Brown. Interesting that even tens of thousands of years ago a name ending in the letter a was a female name and one ending in o was a male name. Stop it. This is stupid. I am buying into this hallucination. I am Dr. Joe Brown.
Gora has just called me for my hallucinatory meal. We sit on the ground or squat on our heels. Squatting is the most common way of sitting down. Whatever the hallucinogen that I have accidentally ingested, this breakfast tastes great. It is gritty because Gora does not hull the seeds, but the flavour is stupendous.
After breakfast, Gora will make food for her father, Drako. He is ancient, about 45 years. He has a bad toothache and is weak from years of a very hard life. He is mobile, but we no longer take him hunting with us. It is too dangerous in his weakened condition. He goes out with Gora and helps collect nuts and seeds etc. Gora’s mum died many years ago and we buried her deep inside our cave. We have buried other relatives in the same area.
I go to the cave entrance and gaze out at the water in the distance, shimmering in the morning sun. It will be a good day. Our cave, and the neighbouring caves sit high up a cliff side above the trees that spread out to the sea. I know the water I see is salty because we get seafood from that area. Fresh water we get from small lakes and streams on the plain below our caves.
A few days ago, while out hunting, we saw a herd of bison. We rarely see bison in the treed forest below the caves. This is our winter home. When we are further north during the summer, we see herds of bison and we are quite practiced at capturing one. We have never seen them this far south previously.
In the time since we saw the small herd, we have been preparing for the hunt. Using branches woven between standing trees, we have created a large v-shaped trap. We will drive the animals into the v and slowly let the bigger ones escape. When we have only one animal, we will drive it further into the v. As it comes to the point of the v the walls will come closer and closer together until they are about the width of the animal. The point of the v will be open and the animal will think it can escape, but once it enters the tip of the v it will get squeezed tighter until it can hardly move. We close the trap behind the animal and also in front.
Next is the really dangerous part. Now that I am Dr. Neanderthal, I understand about throwing spears, but we are not good at throwing things. As a doctor I understand that our shoulder anatomy differs from homo sapiens. These are the other humans that we see occasionally up north. Usually these meetings are calm but at a distance. But not always.
Now that we have the bison trapped, we use our stout spears. A few have fashioned rock points, but mostly we have extras that are simply sharpened and hardened in a fire. Cautiously, we approach the enraged beast and with an upward thrust through the branches in the trap; we stab it until it bleeds to death. At that point, one of us will go back to the caves and let the ladies know that we have been successful. They will come with stone and bone knives and help us with the butchering. We do not eat raw meat, so there is no orgy of eating.
We quickly try to get the animal butchered, and while the ladies continue their work, we take turns in pairs, taking the prepared meat back to the caves. We have to hurry. If a predator such as a cave bear or a sabre-toothed cat comes along, they will chase us away and take our prize.
While I am thinking about all of this, my youngest brother arrives. He is older than me but younger than our oldest brother, Drogo. His name is Poro. Both of my brothers are shorter than I but they are much stronger. He has his rock tipped spear and half a dozen other wood tipped spears. He has always been helpful and was my protector when I first came to live with my family. I was too young to remember, but I remember Poro standing between me and other family members who might want to hit me. I love him almost as much as Gora. We hug in greeting.
He is excited to tell me about the progress of his wife, Pora. She is pregnant and near term with their third child, and he is tipsy with delight. He can’t wait for the new baby. I know all his babies have a brilliant father. His family has been unusually successful. About half of our children die within two seasons. I like visiting his cave and playing with my niece and nephew. Gora and I would like to have children, but so far, we have only had miscarriages.
Soon Drogo arrives, and he has his wife Droga with him. Droga and Gora are going out with Drako, Gora’s dad, to hunt for berries and nuts and other vegetation. Pora isn’t going because she is so fat with the new baby. We say goodbye and start the hike down from the caves to the plain.
In the summer, when we are up north, we all live together in large hide covered homes we make. This is better for defence against marauding animals. Someone is always awake and on watch through the night. We take turns. This is the norm with our species, but while south for the winter in the caves, we have never had a problem with large carnivores coming to the caves. I don’t think the cave bears, as Dr. Joe Brown would call them, actually live in caves most of the time.
Now that we have hiked down to the plain, we need to locate the herd of bison. We spread out and walk in a wide line toward the sea. After half an hour, I hear the hoot of an owl. Owls don’t hoot in the daytime, so I know it is Poro, who was walking on my right out of sight. I give a hoot to call in Drogo and when he finds me; we give a bird call to let Poro know that we are coming to him.
As we get close, we see what he has found. The herd has wandered through this area, leaving lots of broken branches and dung. We become excited because the herd is already heading toward our trap. We spread out and start walking up behind them, although we can’t see them yet. The wind is blowing toward us and after an hour, we can smell them. We are close now. They have veered to the left toward the sea, moving away from our trap which is close. My brothers stay where we are and I move toward the sea to turn the herd toward our trap. Unlike American bison, these are European bison, a different species. Not as big as the American species and not as keen to be in a tight herd. The herds are much smaller and the animals maintain a loose association. Incautiously hurrying toward the sea to get the animals turned toward the trap and watching my footing more than where I was going, suddenly there is a snort 50 feet in front of me. It is a cow with a calf, and she did not look happy about my traipsing through the forest. The calf scurried behind her and she bellowed, lowered her head and pawed at the ground.
With no desire to be a Neanderthal matador, I shinnied up the closest tree. When I was out of her reach, I yelled and broke branches. Since there was nothing to charge, she turned and headed away in exactly the direction I wanted her to go. Her bellow at me had alerted the herd, and I soon realized I had wandered into the loose group as a couple of bulls rushed past the tree without seeing me.
Once the activity died down, I climbed down and made lots of noise to keep the herd moving toward our trap. I don’t think I will brag to Poro and Drogo about stumbling into the middle of the herd. After 20 minutes, the herd is entering the v. Poro and Drogo moved in from my right and we now slow down. We didn’t want a stampede. These animals were capable of breaking down our trap. It was important to encourage the larger animals to sneak past us and escape. Our trap at the tip of the v was only suitable for a calf or small cow. The good news is that the bulls are not particularly gentlemanly and would not defend their ladies, but would choose to escape if given the chance.
The cows and bulls behave differently when they come up to one arm of the v. The cows will follow the arm of the v toward the trap but as soon as the bulls sense they are being controlled by the wall they turn 90 degrees away from it and bolt. We knew it would happen and when it did, Drogo was in their way and he had to scurry up a tree. They didn’t care about him, they just wanted away from the wall.
We closed in behind them after they left. Now came the troublesome part. The cows and calves would want to stay together and our trap was only good for one. Our method was to back off and not push them. After an hour, they calm down and gone back to grazing. One of us cautiously crawls along the arm of the v deciding which animal we are going to try for. This is not a fancy decision. The animal closest to the wall is the one that will get selected. When we find the animal closest to the arm of the v the scout crawls away from the wall and gives us an owl hoot to tell us to crawl in. Soon the last crawler is near the wall with the animal toward the point of the v. In this case, Poro was against the wall and Drogo and I had crawled away from the wall, helping to separate the herd from this one animal. In this case, it was a yearling cow. She was the perfect size for our trap.
When everything is right, another owl call and we all slowly stand up. We want them to move gradually. They see us and the herd moves away, trying to get behind us while the lone cow moves toward the tip of the v. When the herd has moved off, we push our cow further into the trap. We want her moving quickly when she gets to the tip of the v so that she becomes jammed between the two sides. Poro sets off at a run, wanting to get to the tip and hidden before she arrives. He makes a big looping run until he hits the other arm and climbs over it, rushing to the tip of the v and gets down so the cow won’t see him.
We have the cow walking at a fast pace but not panicked. She just wants to get away from us. When she sees the tip of the v Drogo and I yell and run towards her. She rushes into the trap and gets stuck as hoped. Sometimes they don’t get stuck and run right through and we have wasted a day and made the animals smarter. But in this case, she was stuck. Before she tries backing up, Drogo and I put the rear gate in place and Poro puts the front gate in place. We can’t take a breather now. She is not happy and can soon break down the trap.
We grab our spears. Poro and I go to one side and Goro the other. Poro is in position first and, using an upper cut, stabs his spear into the cow’s belly. Just as his spear enters her, she lunges forward. The spear acting against one of the trees as a fulcrum slams backward, catching Poro midway up his upper leg. I hear the snap as his femur breaks and see the gush of blood as it pokes through his skin. What flashes through Dr. Brown’s mind is the info that at the beginning of the WW1 compound femur fractures had an 80% fatality rate.
I rush to his side. The bleeding has stopped although the bone is protruding through the skin, but the skin is pulled tight, sealing the wound. This is terrible. My inattention to the spear in the animal meant I got a whack across my back, which knocked the wind out of me and left me laying on the ground beside my brother. Poro looks at me with a pained expression and says,
“Kill the beast. We need the food. Tend to me after.”
Drogo can’t see clearly and is stabbing spears into the cow. I do the same using all of Poro’s spears and mine. Shortly, the beast slowly slumps down into the chute. I yell to Drogo that Poro’s leg is broken and to come to us. He runs around the chute and when he sees his brother, his face becomes ashen. He knows how serious this type of injury is and that very few survive. I tell him,
“We need help. I know what to do for Poro. You run and get the women. Leave Drako with Pora and the children in case she needs help. The other two ladies should come here. Don’t tell Pora about Poro. She will just worry and there is nothing she can do. She will see him when we get him back to the safety of the caves. They should bring their butchering tools. We still need the meat and if we leave it, some scavenger will get it. When you have left from the caves with the ladies, you can tell them about Poro so that they aren’t shocked when they arrive.”
Goro set off at a run toward the cave. I had to call him back and remind him to take a spear for protection, and then he was off again. It would be at least an hour before he got back.
“You may as well start butchering. There is nothing you can do for me. You know this will be fatal.”
“Poro, I need you to trust me today more than any other day. I know what to do for you. You have never seen what I will do. Can you trust me?”
“Of course, brother. I trust you with my life.”
“In this case, that is exactly what I am asking you to do.”
“I am going to make a special splint that you have never seen before. I have to move around here finding the right branches.”
At the start of WW1 80% of compound femur fractures died. Splints did not work as well as needed. The quadriceps muscles are the strongest muscles in the body. They are on the front of your upper leg. When the femur breaks, the broken bone ends are pulled toward and past each other by this powerful muscle. The sharp ends cut muscle and worse, they cut arteries and veins. A special splint called a Thomas splint was put into service and suddenly the fatality rate dropped to 20%. The Thomas splint saved untold numbers of lives. This splint comprises a hoop that goes over the leg and is pushed up against the crotch and hip bone. There are two long boards that are attached to this loop, one on the inside of the leg and the other on the outside. These boards are longer than the leg. They are attached to a small but strong joiner board about 6 inches to a foot below the bottom of the foot. When the splint is in place, a soft but strong cloth wrapping is wound around the foot and tied to the bottom horizontal board. There is now a loop between the foot and the bottom joiner board. A short board is put through the loop and twisted, tightening the loop and pulling on the foot. This is called a Spanish windlass. As the windlass pulls on the foot, the bones are pulled closer to their normal position. If the bones are compounded (sticking through the skin) they will withdraw back into the skin. What is amazing is that the patient gets immediate relief from the horrid pain. It does not go away, but it is considerably better. The Thomas splint is a simple device which can be easily fashioned. This was my plan for Poro. I did not even want to think about infection now, but I knew that was his greatest threat after controlling his leg with the Thomas splint and getting any bleeding under control.
To start, I needed to find a pliable branch about an inch in diameter to form the loop to go around his leg. The problem was that a branch that thick would break when forced into an oval. I broke half a dozen before I smartened up and started looking for a vine. Once I found a vine, it was easy to form the loop. I didn’t tie it in the loop, but planned to do that after I slid it under Poro’s leg. I had some cord with me which our ladies made for us and we always carried. Two stout dead and dry branches were not a problem, and then I needed a crosspiece for the bottom and another piece to act as a windlass. Shortly, I was kneeling beside Poro. I was going to explain it all to him, but he just said,
“Do what you have to do, Goro. I trust you.”
A moment later, when I slid the vine under him, he may have wanted to take that trust back, as he groaned in pain. I got out my cord and tied the loop together and got his cord out as well. I was going to need every inch. Next, I tied the long splint limbs to the loop. This caused him a great deal more pain. There were tears in my eyes. I had done lots of painful procedures in emerge but never on someone I loved. His pain was hurting me. I wish this hallucination would suddenly end. It is too painful.
The worst was now over. I did not disturb him much more. Soon I was ready to tighten the windlass, but there was something I needed to do first. Right now, I would kill for a piece of metal. If there was a lot of bleeding when I tightened the windlass. I might need to cauterize the wound. The only thing I could think of out here in the forest was a hot knife. While I was debating how to solve this dilemma, Drogo arrived with the women. I told Droga to start a fire and to collect some small rocks to heat in the fire. I was going to use a hot rock for cautery if needed. I hoped no artery was cut. I would not be able to stop an arterial bleed and would need to tourniquet the leg and that would be the end. It would have to come off.
I sent Gora to collect some poplar leaves, yarrow, and chamomile. I tended to Poro while I was getting the women organized and then, when they were doing the assigned chores, I arranged my little rocks near the fire so that they would get blistering hot.
When Gora returned with the poplar leaves, I instructed Poro to chew them to a paste and swallow them. My family were familiar with the pain relieving ability of poplar bark, roots, and leaves. I doubted they understood the antibiotic properties of the mold that grows on poplar. That mold is penicillium, the source of the antibiotic penicillin. When Poro had chewed and swallowed the leaves, I then had him eat all the yarrow and chamomile he could manage. They both have antibiotic and anti-inflammatory properties. My relatives were familiar with this and frequently ate those plants for upset stomachs. But what I did next would not be familiar. I sent Gora to find some dry moss. When she returned, I was ready to save or kill my brother.
I showed Droga how to turn the windlass. I had Gora ready with the moss and a powder she had made of poplar bark, chamomile, and yarrow. Slowly, the bone ends pulled back under the skin. This was the moment. If an artery or large vein was cut, I would need to try to cauterize it with the hot stones. I didn’t think it would work, but I had no other ideas and we needed to get Poro back to the cave. A night out here being immobile would probably be a death sentence. We had seen and heard hyenas prowling around in the recent past. I was ready to grab a hot rock as the bone slid under the skin. There was bleeding which I expected. But there was no spurting indicating an arterial blood and no gushing which would be a large vein. It was just bleeding freely. Phew! I put the moss mixed with our poplar, chamomile, yarrow mix on the wound and pressed down with my hand.
Poro groaned loudly. I had no choice. I needed to keep pressure on the wound to help nature stop the bleeding. Everyone was watching expectantly, but there was no time to rest. I told the ladies to butcher, and Drogo to get the skin containers ready to be filled with meat to be carried back to the caves. They went silently to work. I waited 5 minutes eased back on the pressure. There was some slight oozing but no flow. I reapplied the pressure to Poro’s discomfort and waited another 5 minutes. When I eased my hand off the moss dressing, it sat perfectly still on the wound and did not bleed. I needed to cut off some of my skin clothing to make a dressing to hold the moss in place. I wasn’t worried about more bleeding as much as I wanted the antibiotic materials in the dressing to remain in contact with the wound.
There were enough large chunks of meat butchered now for Drogo to make a trip to the caves. I didn’t enjoy sending him alone, but I needed to stay with Poro, and the women needed to continue butchering. It would be a long while before we would be able to hunt a large animal, now that Poro could not hunt with us. Drogo took off at a slow trot. He was carrying a lot of meat. I instructed him to drop the meat if he met any hungry animal. He mustn’t get killed. I needed his help.
While Drogo was gone and the women continued their chore, I searched around for limbs to use in making a litter. Normally I would have made a travois, but that was going to be too bumpy a ride for Poro, and I feared the jostling might get his leg bleeding.
Drogo returned after a successful trip. Drako, Gora’s elder father, had given Drogo a questioning look. He knew something was off because of Drogo coming alone, but Drogo didn’t take the time to explain. Now I had to make another hard choice. I was going to leave the ladies butchering, while Drogo and I carried Poro back to the cave. The ladies knew how to use a spear and had been in on the kill of smaller animals like goats. Poro had gotten some relief from the Thomas splint and the poplar aspirin and was resting quietly. While Drogo was gone, I had fashioned a litter using two heavy limbs and my top, which I had lashed to the limbs. Thank goodness the ladies always carried bags full of things and lots of cord was one of the things. My over worked mind laughed, realizing ladies had been carrying purses for tens of thousands of years.
Drogo quickly saw the need and gave up his top and helped me complete the litter. When we put Poro onto the litter, he groaned. His pain must have been terrible. A quick goodbye to the ladies and we started our slow walk to the caves. It was only nearing noon, so we still had lots of daylight. We were going to need it. Although we were as careful as we could be, we still tripped several times, dropping poor Poro to the ground. He was brave and cracked a joke about it wouldn’t hurt as much if he walked and carried us. However, the pain eventually got to him and he passed out.
When we approached the caves, we found Drako outside with a spear at the ready. He knew something was off and he was prepared to give his life to protect Pora and the 2 children. We quietly went into my cave and then went to tell Pora and bring her to see her husband. She was very brave. We all knew without discussing that we would all move into one cave now. Drogo and I needed to protect 3 wives, 2 children, one elder and Poro. We could not afford to be spread out.
As quickly as possible, I gave instruction for Poro’s care. The biggest was to watch for bleeding and apply pressure until I returned. They needed to make a tea with poplar bark and get him to drink all he could while awake. Drogo and I headed back to the kill site.
The trip went much faster, not having to carry Poro. We both drew a sigh of relief when we reached the site and the ladies were busily cutting up bison. They had more ready than we could carry in one trip and we were quickly under way again. When we arrived back at the cave, Poro was sleeping fitfully, with Pora by his side holding his hand. His 2 children were laying on each side of him. Drako helped us unload the meat. Since everything was good, we hurried back to the lady butchers. We spent the rest of the day going back and forth without incident. On the last trip, the ladies carried a big share of meat and we were all happy to get into the cave and sit down to rest.
Dusk was coming on quickly. I did a check of Poro’s dressing and all was good, but his leg felt warm. I expected it to be inflamed despite the chamomile and yarrow. What I hoped was that his body could fight off any infection. I would know in the morning how well that was happening.
Meanwhile, Gora and Droga had cooked some of the fresh meat and the vegetables they already had in stock and we all ate a quiet meal. After dinner, the 3 ladies all set to work slicing the meat into thin slices in preparation for drying and/or smoking. Those are our 2 methods of preserving meat. They told Pora she didn’t have to help, but she knew there was a lot of meat and it needed to be tended to. Poro was sleeping with the kids by his sides, so she wanted to help. She had seen wounds like this in the past and knew they rarely came out well. Pregnant, 2 kids, and no husband would be a real problem, although we would all do our best to help her.
Much later I lay down beside Gora, put my arm around her, and fell asleep wondering if this very real hallucination would be over when I woke.
I awoke to a bee buzzing. I opened my eyes to a dreadful, strobing light in the cave. Not a bee, but my alarm clock with the optional strobe feature, which I now hated. I felt like I had just put my arm around Gora and fallen asleep, but now, moments later, I was awake in my bed in Kingston. I hammered the alarm and laid back in bed. It had all been a dream. But it seemed so real. Nothing but a wild dream. But I had questioned while I was dreaming if it was a dream. People don’t do that. Could it have been a hallucination while I slept? I’ve never heard of that. A hallucination while you sleep is a dream. I needed to talk to one of the shrinks at work.
I shaved and hopped into the shower. Wow, the hot water was stinging my back. I turned it to tepid, and that didn’t feel any better. I closed the taps and dried myself. Damn! There was blood on the towel. I trotted into the kitchen and put the towel into the sink with water and poured some salt onto the blood. Then I went to the bathroom mirror to see where I had cut myself shaving but could not find any bleeding. I gave up, had a quick breakfast and headed to emerge for my shift.
The moment I stepped into the emergency department, I was inundated by the nurses having patients that needed attention. We have been operating at 50% over capacity for months now while the politicians talk. They talk and people die and they talk some more. The most urgent was a patient in room 2. The paramedics and nurses had been doing CPR for twenty minutes. What they needed was a doctor to say the obvious. I went in and did a couple of tests. The ECG was flat, and the vitals non existent. I pronounced the gentleman dead. I am sure the family would have wanted us to continue CPR for hours and to create a miracle, but the cold hard reality is that he was dead and there was someone in room 1 who I might be able to keep alive. Now the paramedics were free to get back to their actual job instead of behaving like unpaid hospital help.
In room 1 was a patient who had just collapsed in the waiting room. He didn’t seem to have anyone with him, and his triaged complaint was that he felt sick. Nothing more specific, and the triage nurse had probably thought he had the flu. Now he was unconscious on the gurney. I ordered a bolus of 50% glucose and water. His colour was good, so unlikely a heart attack. Possible stroke. Not a grand mal. Possible insulin shock or hyperglycemia. It is interesting that with an unconscious patient with an unknown history, the first treatment is the bolus of sugar water. If you are dealing with an undiagnosed diabetic, his blood will be so full of sugar already that the extra in the bolus won't matter. But if it is insulin shock, brain cells are dying for lack of sugar and that bolus is critical. A quick finger prick and test with a glucometer showed a blood sugar level of 3 mg/dL. He was in insulin shock, so I ordered another bolus and an IV of D5W and finger pricks every ten minutes until we got his blood sugar up to 5 mg/dL. Watching an unconscious patient in insulin shock recover is one of the wonderful miracles that we get to see in medicine. Soon, this unconscious man would be sitting up and talking as though nothing had happened. But the status of medicine today meant that the nurses would be witnessing his recovery. I had to try to save the next life.
The next life was in room 3. When I entered, there were two cops and the patient was handcuffed to the gurney. The cop explained that he had been beating up his live-in girlfriend, who took offence to the beating. She was the first one to get hold of the baseball bat and he had a split on his scalp that was making a mess of our sheets. Head wounds bleed profusely. As I approached the patient, he loosed a string of foul-mouthed threats in my direction, threating to kill me if I touched him.
“Are you refusing medical care?” I asked.
Another string of profanity. Not the brightest light on the Christmas tree. His pronunciation of some of the swear words seemed off, and I wondered about a brain injury. Also potential for a personality change, although I doubt he was originally a choir boy.
“Will you sign a form refusing treatment?”
“You have a serious head wound. It may very well kill you shortly. Are you refusing medical care? Please let me help you.”
More foul mouth.
I turned to one cop.
“You have heard him refuse medical treatment twice. I need you to sign that you saw him refuse and then you can take him off to jail. You won’t have to care for him long. He will be dead by morning without treatment.”
Suddenly, the swearing stopped. There was a long hesitation.
“OK, you can look at it.”
This was my chance. I moved in with a cotton swab and took a swipe at the blood to try to see what was underneath. Crap, this one really was serious. There was a depression under the blood. He had a depressed skull fracture. This kid might really end up dead and long before morning. If he was bleeding under that fracture, he might only have minutes to live. I needed a stat x-ray and the on duty neurologist to see him now. I told the kid it was serious, and he needed to behave while we tried to save his life. The nurses would watch him until the neurologist took over, and I was on to the next patient.
A pregnant lady of 7 months who said she was spotting. When I looked, she was well beyond spotting and needed to go to labour and delivery now. She was determined to climb down from the exam table and she slipped. I grabbed her, but her weight took us both to the ground. I ended up banging my back on the handrail as we went down. Damn, that hurt. The attending nurse got us both straightened away. It is not efficient, but in this day and age, I always have a nurse with me when examining a female. Better safe than sued or called a pervert.
I left the room headed for my next patient when a nurse I knew grabbed me by the arm.
“Joe, you have blood all over your back.”
“You are bleeding under you tunic. Come on in the linen closet and let me look. What happened?”
“Nothing. I just banged my back on a hand rail falling down with a patient.”
By now, we were in the large closet with the light on. She hoisted my shirt up part way.
“Shirt off. Something bad is going on back here.”
I undid the top buttons and pulled the tunic over my head. I saw what she meant. The back of the shirt was red.
“Joe, you have a gash angled across your back from one side to the other. It is open and oozing and will need at least half a dozen stitches. I am going to put a dressing on it for now and call somebody to get over here to stitch you up. Are you OK to see patients until I can get someone here?”
I said I was OK and then it hit me like a hammer. This was not a scratch from a handrail. This was a gouge from a spear sticking into a bison. It was not a dream. It was not a hallucination. My other life was real. I sank to the floor in shock.
“That’s it. No more doctoring. You are now a patient. The bruising around the cut is 3 to 5 inches across. That was a vicious bedrail. You don’t have to tell me the truth, but consider telling the truth to whoever the doctor is that I can round up. Stay there on the floor. Don’t get up, you dumbass hero.”
She opened the door and yelled,
“Nurse needs help now.”
In the blink of an eye, an orderly and an RN appeared. They got me onto a gurney and into an exam room where there was already another a patient. I laid on my side, not knowing what to think. Gora, my family. How could I get back to them? They needed me.
After a brief period, a doctor entered the exam room and pulled the surrounding curtain. It was the neurologist I had sent the profane kid to.
“Hi Joe. You really aren’t helping by becoming a patient.”
“Hi Bob. It wasn’t on my plan for today. I think I will be OK to go back to work after you put in some stitches and the ladies add a dressing.”
“Not what I heard. You went down for the count. You are in the penalty box for the rest of the game. Let me look.”
I sat up. I was in a patient gown open at the back.
“What sort of shit are you feeding the girls? They said it was an injury from a bedrail. Were you in a bar fight?”
To distract him while he put in the sutures, I said,
“How did that kid I sent to you work out?”
“Not good. He’s dead.”
“Sorry, you don’t want to hear this now but, you know how we say they will forget the million cases you did right and fire you for the one you got wrong. This might be our one in a million. He was taken to x-ray with the 2 cops in tow and I was notified. But I had my hands were busy inside someone’s skull and I couldn’t leave. I knew if the stat x-ray showed anything that the radiologist would call me. Of course, we were all concerned about an intracranial bleed.”
A bleed inside the skull is very dangerous. There is no place for the blood to go and the pressure eventually starts squeezing the brain out of the large hole in the skull's bottom. This is called coning, and it is fatal and can happen quickly.
“Somehow, the stat part of the x-ray order never made it to the x-ray department. So they put him in the line of patients needing x-rays but with no urgency. An hour later, when his turn came, the x-ray tech found him dead on the gurney between the two cops who were busy chit-chatting about their plans for the weekend. The tech called a code, but he was already cold.”
I started second guessing my care and what I had done, but he had not shown any signs of an intracranial bleed, such as ipsilateral dilatation of the pupils meaning the pupils would not be the same size. I had looked into his eyes in the area of the cranial nerve looking for bulging and there was none. I had done some other things but there had been nothing to make me think he had a bleed. I had sent him for the stat x-ray just to be sure and asked for the neurological consult again just to be sure.
“Now you have gone over everything you did and know you could not have done more based on the signs you saw. You still better give your lawyer and your malpractice insurance company a heads-up. You, I, the x-ray techs, the cops, and even the poor radiologist who knew nothing and saw nothing are probably going to end up in court over this one. OK you are sewed up. I’ll ask one of the nurses to put a dressing on it. It may be a while, as you know.”
Bob left to return to the neurology department, and I sat on the bed waiting for one of the overworked nurses to come and patch me up. I felt guilty because I knew I would be moved to the front of the line behind imminent death patients. Our free health care system. What a mess. My mind was just drifting back to Gora when an eager beaver student nurse came in.
“Hi, I am supposed to put a dressing on your back. I am a student nurse and I know you are a doctor. Please don’t yell at me I am trying my best.”
“I know you are and the only thing that I will say is thank you. Good news. It is on my back and I can’t see if you screw up. Try to relax and enjoy the learning process.”
“Oh thank you Dr. Brown. I heard you were a nice doctor.”
She slowly got the job done, struggling with her sterile procedure. She would not have worried about sterility if she knew the true story about my back. Before Bob had left, I had gotten a prescription for a potent antibiotic. He questioned my request, and I told him if he knew the truth, he would understand. He let it go at that. My plan was to take the antibiotics to Neanderthalland for Poro. If I could get back there. I sat on the bed puzzling over what was happening with my two lives and how it was occurring. Before going into medicine, I had done a masters in physics and knew about the theory of parallel universes but had not really bought into it. Now I was wondering.
I heard a doctor come in and deal with my roommate, but I didn’t recognize her voice. The guy had diarrhea, so he got a prescription and was soon gone. Suddenly, there was a lot of activity. I could hear the paramedics giving a report. 46-year-old male collapsed in a mall. VSA (vital signs absent) CPR started immediately by 2 trained security guards and then continued by the paramedics. No history available. He has not responded to multiple tries with the defibrillator on the way in. That was enough for me. I threw back the curtain and said,
“Screw this. I just signed myself out as a patient and back in as an emerge doc. Give me a needle with epinephrine for a cardiac puncture.”
It must have looked ridiculous with a guy in a patient’s gown running a code, but we were successful in bringing the patient back to life. This was my reason for going into medicine. The mess that was our health care system was not why I was here.
The balance of the shift was hectic. Eventually, I got out of my gown and into some scrubs, which probably made the patients more comfortable. I was glad to see the end of the shift. The prescription for the antibiotics was ready, and I picked it up before heading for home.
When I got home, my girlfriend was sitting on the porch. I asked her why she hadn’t gone inside since she had a key.
“I am here to return your key. I love you, but we are going in different directions and eventually we will hate each other. It is time to call it quits while we can still be friends.”
“Do you want to stay for dinner?”
“No. I am too upset to eat. Here is the key. Goodbye.”
And she was gone. I didn’t stop her. She was right. Obviously our relationship was not strong because the first thought that went through my head was, heck, I have to find a lawyer now that the free one just walked out of my life. She was a crown attorney and couldn’t really take my case if the death today turned into a court battle. I went inside and heated a can of beans.
After I ate, I sat down at my computer to learn everything I could about Neanderthals. I found out the archeologists had gotten it right about my family knowing about salicylic acid and poplar trees. Also, the scientists knew about chamomile and yarrow. It was interesting how they discovered that Neanderthals were using these natural medicines. The Neanderthals did not know anything about dental care, so there were big build-ups of plaque on the teeth of the skulls that had been found. They removed this plaque and ground it up. Then, through some of the miracles of chemistry and DNA they were able to discover that my relatives had been eating poplar, chamomile, and yarrow. These plants and that tree are nutritional zeroes. You would not eat them as a food source. They concluded they were being used as medicine. They had gotten it right.
I discovered something I didn’t know that could be used as an antibiotic and it was something I had never seen used by my Neanderthal relatives. and there had been lots of opportunities because injuries are very common. My plan was to make up a kit of the most important things that would help save Poro and improve Neanderthal life. I did not know how the… what will I call it? The sleep transfer to another… What is it? Another dimension? I need words to describe what has happened. I will use the best fit words that I can come up with and worry about technical accuracy another time.
I am preparing a kit to take with me in the sleep transfer to the Neanderthal dimension. I have the antibiotic prescription. Also, I am taking some restaurant packets of honey. I swiped some sterile dressings from work. Normally I am not a thief but this time I set my morals aside. There are a bunch of other little things. I am going to adhesive tape my package to my chest. I am ready with new knowledge and a package that I will call the rescue kit.
I have debated taking a sleeping pill. I am keyed up with excitment, but I fear that changing things, particularly put chemicals in my body, might bugger up whatever happened. So now I lay in bed wide awake trying to go to sleep. It just isn’t happening. I get up and have a bowl of cereal with milk. Milk contains tryptophan, which helps some people nod off. Back to bed. Wait. Wait. Wait. Still awake.
Opening a book I try reading, but an hour later I am still awake. The adhesive tape I have used to attach my rescue kit is pulling my chest hairs as I move around and it is one more irritant keeping me awake. Finally, I give up trying things and just roll onto my side and think about Gora and the good times we have had together. Yes, there have been tough times, but I remember the first time I saw her. I was with my adoptive family when we met another group of Neanderthals with Gora, their daughter of about six years. We were about the same age. She didn’t say a word, but just walked over and took my hand and held it. Years later, when we were at our summer hunting ground up north. We went to the camp of Gora’s family. It was silent as we approached. Too quiet. Drako was instantly on the alert. He did a silent pushing motion at us, showing we should slip back into the forest. We watched him silently approach and enter their hide home. He came out and walked carefully around the area. He stopped several times after entering the edge of the forest. Then he gave a loud owl hoot. Then again. Finally, we heard a tiny hoot. The calls went back and forth as he moved into the forest. Finally, he returned holding hands with Gora. When he returned, he told us that Gora’s family had been massacred by a band of young male homo sapiens. The new people. Sometimes friendly. Sometimes deadly. Gora was going to come and live with us. I wanted to hug her, but she reacted badly as I approached her and I stopped. Something had changed other than her family dying and I didn’t know what it was.
I feel myself falling and let myself go. Where will I wake up?
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