Nurse Sherlock Holmes

So, I'm in triage (which is about like saying "I was breathing"), and it's well after midnight. And for once, things have actually quieted down, like they used to do every night, instead of once every leap year. But tonight wasn't looking like it was going to be too bad.

And then in comes a certified relative of Wile E. Coyote, Supergenius.

Mr. Wiley has a towel around his left forearm, and announces loudly "I been shot."

Okay, we're not a trauma center, so minus 5 points for being not-so-bright. But we're on the barrio border, so it's not like this never happens.

And, with normal vitals, little apparent blood, and after minimal questions and a visual check, it turns out he has, indeed, only been shot in the forearm.

So during the abbreviated triage, it comes out spontaneously that Wiley, quite the party animal, was "looking for a party" in Not-so-nearby City when Sumdood (damn him!) shot our hero in his left forearm, as he drove by just minding his own business with the arm on the windowsill. Trying to get the mechanism of injury down, he's very certain that he was shot from outside the vehicle as he was driving.

So he then apparently had the presence of mind to drive through 6 surrounding cities, and then come to our not-a-trauma-facility for his emergency gunshot injury.

So I quickly get him settled in the back, notify the doc, and make the obligatory police agency notification, to spare the nurse in back another headache. And because I speak fairly fluent cop, and am pretty darn bitchin good at making mandatory calls painless for us and them.

Therefore I know that on an assault with fists and no desire to report on a busy Friday night, they'll only want us to inform the patient that they can always file a complaint report at the station later, if they change their mind; but I know that when a firearm injury is involved, police will drive across several counties to take the report. People getting shot in their jurisdictions tends to get their constituencies rather upset. So I know this guy is getting a visit, even if he doesn't.

With no one else to deal with, I go outside to let the parking minions know not to park, move, touch, or breathe too closely to Wiley's vehicle, because it's now a crime scene until further notice. Pity that he couldn't have shown up at 7PM, it might have chased a few more folks away to see their regular docs in the AM, but oh well.

So I take a quick look at the car from outside and a few feet away, through the open window. I notice after a minute's inspection that there doesn't appear to be any obvious blood inside the vehicle, nor any extra holes in the cabin. And on the outside, I notice there's a whole LOT of blood, up high and behind the driver's window, and sprayed back towards the rear.

Now, I'm not a cop, forensics examiner, or even a huge fan of CSI. But I know a tad bit about guns, and physics. So, as a rule, when a bullet passes into and out of your arm, blood usually spatters in the direction of the projectile. And people shot in the arm, don't, as a rule, wave their arms higher than their heads outside the car, for the 5-10 minutes it would take to create the Jackson Pollock-like canvas evident on the upper outside of Wiley's car. And the odds of them doing that without having a single drop get inside the car, and having a handy towel for the bleeding, and not having a single drop of blood on their clothing, and somehow driving past a dozen ERs before arriving at ours, are approaching Lotto Powerball numbers.

And, because it's slow, and the PD from Not-so-nearby City won't arrive in 2 minutes, it means I have time for a brief confab with the treating ER doc. We don't get into official forensic caliber diagnosis, nor describe entry and exit wounds. That's for the professionals and pathologists. But Wiley, it turns out, has suffered a very small hole consistent with a .22 on the medial side of his top L forearm, and a somewhat larger hole on the lateral side. Not diagnosing, mind you, but that's consistent with a bullet from inside the car going through his arm towards the outside. And Wiley, it turns out, was right-handed.

I file all this away, until about half an hour later, when a sergeant from Not-so-nearby City arrives. He questions me, and I volunteer my observations, and let him conduct his investigation and draw his own conclusions.

He notes the same data points. And during his investigation, recovers the loaded magazine for a .22 caliber semiautomatic pistol shoved inside the passenger seat crack. With one bullet less than a full load in it.

Then, last of all, he has a chat with Victim Wiley. Whereupon it transpires that Wiley can't remember the party he was looking for, any of the names of people who would be at the party, the supposed address (or approximate zip code, area code, time zone, or hemisphere), or where he was driving when he was shot "by Sumdood" closer than about a 10-mile radius. How...curious. He also has no explanation for what a magazine for a pistol got into the car next to his seat, nor where the towel came from, nor for why the car and his clothes are spotless, but the sidepanel looks like a butcher shop.

He isn't charged at the time, but elects to leave AMA after we bandage his wounds. And the police tow his car for further investigation.

So as a word to those with Low Grey Matter Titer, when you're a black guy with a multi-page rap sheet of prior gang-related offenses on your greatest hits list, cruising around an overwhelmingly asian neighborhood at 3AM "looking for a (mythical) party" in an area where you have no known friends or contacts, and you're resting the muzzle of your heater across your outer forearm while trying to set up a nice drive-by, you need to either avoid those "Pulp Fiction" style bumps in the road, or at least keep your booger hook off the bang switch, to avoid shooting yourself through the arm, having to go home, ditch the gun, and change all your clothes,  grab a towel, and drive across town and make up a total horseshit story before you get treated at an ER 30 miles away, hoping the cops won't show, and we'll swallow all that fertilizer like we were born yesterday.

But at least in this case, the stupid, it burns.