The High Cost of Living

The High Cost of Living


shutterstock_142567207Dr. David MacDougall was taking a brief, well-earned nap on a couch in the neurosurgery department at Hermann Hospital in Houston when his beeper sounded at 3 A.M. on July 24, 1988. It was the emergency room calling and the conversation was brief, a basic recitation of the facts. The patient was a Latin American male, age 24, who had been shot in a dispute in Madisonville, 85 miles away, at 1:15 A.M. One bullet had grazed his skull, near his left temple, and the other had entered through the back of his neck, penetrating the spinal cord.

The patient had been taken to a local hospital in a private car. It was unclear whether he had been able to breathe on his own during that trip or if any lack of oxygen had affected his brain. When he arrived at the hospital, about six minutes after the shooting, he was given cardiopulmonary resuscitation and put on a ventilator. After he was stabilized, he was transferred by helicopter to Hermann. Officially, Hermann’s emergency room was full that night, closed to incoming trauma patients. But this young man was admitted. The word in the E.R. was that he would probably make a good organ donor.

MacDougall hung up the phone and walked quickly down the five flights of stairs between the neurosurgery floor and the emergency room. The patient, whose name was Armando Dimas, lay on a stretcher in the middle of the gleaming room. He looked small for a grown man, about 125 pounds. Heavily drugged but conscious, he was squinting in the bright overhead lights. A nurse stood beside his stretcher, adjusting the monitors that tracked his heartbeat and respiration rate. His clothes had been cut from his body by the staff in the emergency room, and a hospital-issue sheet was tucked around him from the rib cage down. Numerous and dramatic tattoos were fully visible against his pale brown skin. A snarling tiger crouched along his left arm, a sultry woman vamped down the length of his right arm and a woman, a man and a flower were sketched randomly across his chest. Colorful, MacDougall thought, as he entered the room and saw his patient for the first time. READ MORE