Deep Wounds
by Mike Litrel, M.D.

How in the world do you get a stranger fresh out of a knife fight to trust anyone? Then I remembered the knife fight I once got into. I was four years old.

It was my second day of nursery school. On the first day, the other children had laughed at me. My mother is Chinese, and my Asian appearance made me an obvious target for ridicule. I was confused and frightened by the teasing of the other children. I was also infuriated.

The next day I sneaked a butter knife to school. When the children started in again, I pulled out my knife. My fellow pre-schoolers screamed in terror. An exhilarating sense of power filled my entire being. For five seconds. Then the teacher arrived. My mother was called, I was taken home, and my bottom was spanked. That is the sum total of my experience with knife fights.

But the incident actually left a wound. After that I never looked in the mirror the same way again. I didn't want to look different.

Later, those feelings would play into my desire to become a physician. In my childhood dreams, the hospital existed as a place free of prejudice, where strangers helped each other no matter what, and where love and trust flourished.

Unfortunately, Grady proved me wrong. The minute I walked through its doors, I was assaulted again by the full forces of racism. Only this time it wasn't for my Chinese heritage. I was surrounded by an African American staff and patient population. Suddenly, I was white.

At Grady, the presence of the mostly white physician staff created an atmosphere of racial tension. By and large it wasn't the patients — it was the staff. You can't prove you aren't racist, and it's hard to work with people who think you are. So I understood Mr. Stanton's mistrust. This inebriated African American fresh from a knife fight was not about to sign a consent form allowing white doctors to make some more cuts.

I showed Mr. Stanton the CAT scan confirming the life-threatening bleeding. He just scowled at me. As I pushed his stretcher back to the emergency room, a sense of sadness and futility engulfed me. A tragic death was about to occur unnecessarily — all for lack of trust and understanding.

On the other hand, it was three in the morning. I was dead tired. Mr. Stanton had cursed me so many times that even the compassionate part of me was starting to hate his guts. And that's when inspiration struck.

"Look, Mr. Stanton," I said. "This is your last chance to sign this stupid consent form. To tell you the truth, I don't care anymore, one way or the other. If you die tonight, all it means to me..." I paused for effect. "All it means to me, is that I get more sleep."

This time his glare was murderous. But he grabbed the pen from my hand and signed the dotted line.

Back in trauma, the Chief was amazed. "How'd you get him to do it?" I hesitated. Frankly, I was afraid if the truth came out, I'd be reprimanded, or fail my rotation, or maybe even get kicked out of medical school. "Let's hear it!" barked the Chief. I told him. The silence that followed was awkward. The Chief and the other surgeons exchanged glances. I couldn't breathe, waiting for the consequences.

Then the laughing began. "You told him you didn't care if he died because you'd get more sleep," the Chief repeated. "Whoo! Ha, ha! That's the best one I've heard in a while." The general laughter continued for long minutes and spirits were very high by the time Mr. Stanton's surgery began. "Okay, Litrel, you saved a life — you get a reward." I got to drain the blood from Mr. Stanton's chest.

Placing a chest tube wasn't all I learned that day. Many of us share wounds not so obvious as those from a knife. For me, it was the childhood pain of racial rejection. But I was reminded that day that the experience of pain is not necessarily a bad thing. I believe God can transform our pain into a window for understanding. For only when we understand can healing begin — for ourselves, and for others.

Incidentally, I got an "A" in trauma surgery.

Dr. Litrel is in practice at Cherokee Women's OB/GYN in Woodstock and Canton and is a Clinical Assistant Professor at Emory University School of Medicine. He lives in Towne Lake with his wife Ann and their two sons Tyler and Joseph. (Atlantalitrels@CS.com)

After two years of medical school, it was tempting to feel smart. Immersed in the study of disease and the human body, my classmates and I studied seventy hours a week. Then we took Part I of the National Medical Boards, a twelve hour test. Sure enough, my scores confirmed it: I was, officially, smart.

Armed with my vast array of knowledge, I was eager to proceed to the next step — clinical training at Grady Memorial Hospital in downtown Atlanta. On this holy ground of the teaching hospital, I would heal the sick, save lives, and stamp out disease and suffering.

But I quickly discovered that like all my fellow students, I had no idea what I was doing. I didn't just feel like an idiot — I was an idiot. Forget about stamping out disease. I couldn't even draw blood.

Nowhere was I more stupid than on Trauma Surgery. My job was to shadow the third year Surgery Resident. This was a harried physician in his third year of surgical training after med school. One Saturday night a Mr. Stanton became our biggest problem — a thin, inebriated African American on the losing end of a knife fight.

Mr. Stanton had multiple stab wounds on his chest and abdomen. The stretcher and sheets were covered with his blood. Mr. Stanton thrashed around so much he had to be tied down. He cursed the nurse when she stuck his arm to place another IV. A seasoned veteran, she casually moved aside to avoid his bite.

Still the idealistic rookie, I was stunned. The surgery resident shrugged. "Just another member of the Grady Gun and Knife Club," he remarked.

Mr. Stanton needed surgery. But he wouldn't consent to the operation. Each time the third year Resident attempted to explain the reasons for surgery, Mr. Stanton cut him off with violent cursing and a hard glare. Precious minutes passed, and finally the resident gave up. He called his Chief.

The Chief was annoyed to be awakened. As the Chief Resident in his final year of training, his goal was to stay asleep in the call room until the lower residents had the patient prepped and in the operating room. On the other hand, like every good surgeon, he enjoyed surgery and Mr. Stanton was "a good case." The maxim of surgery is, "A chance to cut is a chance to cure."

So the Chief made an attempt to convince Mr. Stanton himself. "What do you mean you won't sign the consent? If you don't have this operation you will DIE. You're bleeding inside — you'll be dead tonight!" Mr. Stanton showered the Chief Resident with another barrage of profanity.

The Chief looked at me. "You! Mr. Medical Student," he said, not bothering to read my name tag, "take this gentleman to Radiology and get a CAT scan." He handed me a consent form. "And try to get him to sign this. If you do, you save his life."

Alone on the elevator with Mr. Stanton, I became the next victim of his profanity. He glared at me, his eyes filled with anger — and something else, too... I pondered for a long minute and it came to me. Mistrust. His eyes were filled with mistrust.