Not being a girl, and thus expendable in the taxonomy of the charge nurse du nuit, I'm rather uncomplainingly floated to cover the jail ward with one of the ER docs in training.
The potential's always there for danger, but it really isn't that bad, because the inmates are usually hoping to stay, for better food and less chance of getting knifed, plus cable TV. Acting up would interfere, so they're usually model citizens in our house, right in the middle of 2 dozen deputies, and random transient police from a dozen agencies bringing in the folks we need to screen before they can be booked, or admit them because they're too jacked up to go to jail.
So after being buzzed into Mordor, and given the 5 cent tour, we settle in to see if the night will bring us business, or a chance to catch up on our reading.
Around 11 PM we get our answer, as deputies deposit on our doorstep an unfortunate lad with a face looking something like steak and eggplant casserole.
So after I get vitals, Doctor Bambi ascertains from our somewhat the worse for wear patient that the mechanism of injury was falling out of his bunk.
Physical exam and x-rays determine all of his teeth are intact, he has a skull of iron, flawlessly uncracked anywhere, but apparently poor luck with the laws of gravity, in this case, the gravity of standing too close to someone who didn't like him.
Doctor Bambi sends him back, with an order for the nurse actually at the jail to give him Tylenol for pain as needed, and we hand him back to the gentle care of the county's custodians of the criminally stupid.
Then Doctor Bambi pops up, and asks where the sherrif's officer in charge has his office.
"What for, doc?" I inquire.
"Because," says she, "that's the 5th patient this month I've had who fell out of his bunk. I'm going to let them know that they need to do something about that, put up safety rails, or something. This is just unacceptable, even if they're criminals."
"Uh, Doc, how long have you done Jail Ward?"
"I didn't do any last year, this is my 3rd rotation this year."
"So, just the two shifts, total, besides tonight...?"
"Yeah." Then, "Why do you ask?"
"Doc, NONE of those patients "fell out of their bunk". They pissed off someone bigger, badder, or different colored, or all three, maybe even a gang of them, and so they got their @$$%$ kicked. And they're stupid, but smart enough to know if they rat somebody out, their next run-in might be toothbrush poisoning, when someone stabs them for snitching. So they "fall down" a lot, from the bunks, in the showers, whatever.
Just as a 150-watt bulb snaps on 6 inches over her head, Doctor Bambi does a facepalm, and says "I am so NAIVE! Dohhh!"
So about 1 AM, we get another case of Malignant Bed Syndrome, this one with both a fractured cheekbone, 2 cracked ribs, and a beautiful imprint of a popular shoe as plain as a tattoo right in the middle of his upper back.
Mechanism of Injury: Fell out of bunk.
So, along with a scrip for some Tylenol with codeine for pain, Doc gives him a classic sendoff as I'm getting the papers for our latest winner of the Victim Lottery ready to roll back to his new temporary home with his custodians:
"Mr. Perp, I understand you had a tragic fall from your sleeping area tonight. I don't know what might have caused this unfortunate problem, but as a doctor, I'd advise you to stay away from that bunk, and any of that bunk's friends, unless you can sort out whatever's causing you to fall out of it, because if you keep falling out of that particular bunk, the next time you're liable to end up in the ICU with internal injuries. You understand me?"
I stiffle a snort. Looks like Doctor Bambi's growing some antlers tonight.