serendipity.

Awhile back I had a patient who was young, in his mid twenties, which was memorable because I hadn't spent much time on units that get patients younger than 50 very often. I remember he proudly announced it was his birthday when we came in at 7am to introduce ourselves, a trait you don't normally see in twenty somethings - this much pride, in fact, gave him the air of someone four times his age. He asked if it would be okay if some friends and family came during "patient siesta time"(quiet time enforced from 2-4 to ensure patients get some rest despite the commotion of the nursing station) because it was the only time they could make it. We told him it would be fine.

As we brought him in a piece of cake (you see he was going NPO in just a few hours for surgery the next day) and clapped and sang in a makeshift choir of nurses, he grinned (and you could tell this was unusual, it was easy to see he was "too cool for school" on the outside). But he and his family were celebrating. What were they celebrating? His car accident.

An unusual thing to celebrate... a car accident. But you see, it was perfect, because he sustained no visible injuries and claimed upon regaining consciousness not to be in any pain. Protocol requires tests to rule out insidious injuries, so they performed a battery of tests not otherwise indicated. When doing an abdominal CT, they did indeed find damage. It wasn't from the car accident however, no, it was a tumor. This tumor was quite large (8cm), and was at just the right point to be taken out before it started to wreak havoc on his organs. What could have been fatal in just a few years was found because of serendipitous bad luck, and that birthday which could have been one of his last will hopefully be one of many, many more.