Rawhide Down_ The Near Assassination of Ronald Reagan - Del Quentin Wilber [55]
When Gens arrived at the president’s side, he found Wesley Price standing to Reagan’s left. At the foot of the bed was William O’Neill, holding medical instruments. Another surgical resident who had arrived in the ER a minute or two earlier was standing nearby.
By virtue of his seniority as a chief surgical resident, Gens was now in charge of the president’s care.
“What do you have?” asked Gens.
“It’s the president of the United States,” one of the residents answered. “Looks like he’s been shot.”
“What’s his blood pressure?”
“It’s 110,” the resident replied. This was already a major improvement.
“Keep the fluids going until we get the blood,” Gens said, before turning to Price. “Did you hear any breath sounds?”
“No.”
“Go ahead with the chest tube,” Gens told Price, confirming that they would be following standard protocol for such a wound. With any luck, the lung would soon reinflate and clamp down on nearby blood vessels, thus stanching most of the bleeding. Whatever the problem, chest tubes usually took care of it: 85 percent of the time, surgery was not required after this type of trauma.
Price scrubbed Reagan’s lower left chest with Betadine, an antibacterial solution, and covered the surrounding area with sterile towels. He injected Xylocaine, an anesthetic, near the president’s fifth rib. Next he would slice open the skin and underlying tissue, after which he would burrow a hole large enough to allow him to insert a No. 36 tube, which was about half an inch in diameter. Then he would push the tube deep into Reagan’s chest cavity and begin to drain the accumulating blood.
Approximately seven minutes had passed since the president had walked through the emergency room doors.
CHAPTER 9
STAT TO THE ER
Dr. Joseph Giordano leaned against the wall of the hospital’s sixth-floor vascular laboratory, watching a nurse strap a blood pressure cuff around a patient’s penis. The nurse hadn’t wanted to work alone with the man, so she’d asked Giordano to attend the procedure. Giordano was a new breed of surgeon—a bit softer around the edges, he was kind to nurses and considered this sort of professional babysitting just another duty among many. He was the type of surgeon who learned his patients’ names and was obsessed with their outcomes. On many nights, the surgeries and patients invaded his dreams, startling him awake, sending his hand flashing reflexively for the phone on the nightstand. “How was the blood pressure?” he would ask the nurse on duty. “Any bleeding?”
He practiced vascular surgery, a demanding specialty that focused on repairing damaged blood vessels. That morning, he had removed a gallbladder, and he would perform another half dozen operations before the week was over. His vascular work was enough to keep him more than busy, but it wasn’t his only job at GW.
Giordano joined the hospital’s staff in 1976 after a stint in the U.S. Army. A few weeks before his arrival, GW’s brusque chief of surgery called Giordano into his office and told him that the director of the emergency room had quit. He needed his new vascular surgeon to take over management of the ER.
“By the way,” the chief of surgery said, “the handling of trauma patients down there is a real mess. See if you can fix it.”
Giordano was stunned—he knew next to nothing about emergency medicine. Soon he was reading everything he could in medical journals and newspaper stories, seeking to learn more about a specialty that was still considered a backwater by the medical establishment. In the 1960s and 1970s, internists, gynecologists, even psychiatrists shared ER duty at most hospitals. The emergency room is one of the most intense and chaotic units in any hospital, but in those days it was often run by an intern or a nurse. Few civilian doctors had extensive training in trauma