The story of an unconscious teenager with his calf hanging loose
“Whoa…” I heard my dad exclaimfrom the kitchen.
“You okay?” Alarmed, I raised my head from my pillow.
“I’m fine, but this guy isn’t,” came his reply.
Curious, I made the effort to get up and join him. My sister, having caught our conversation, did the same. The two of us saw our dad looking out the kitchen window.
We could see three guys standing on the opposite side of the street. Tall and gangly, they looked no older than 16 years old. Two were helping the third one onto a bench in front of the apartment block – he’d clearly injured his leg. The thing that caught our eye was the puddle of blood quickly forming under the bench. My sister gasped.
“That much blood, it must have affected an artery,” my dad murmured. I did not question his conclusion. The puddle steadily kept growing bigger. It was not the bright red people would expect; rather it was an intense, dark red streaming from his calf. One of the boys was already on the phone, his voice rising with panic. The other one was pacing around looking at his injured friend, hands on his head in the typical “what just happened” position.
“I think I need to go help,” I said. If it were a trivial injury, I would not bother interfering. However, this looked serious. As a third-year medical student, I felt it necessary to go and offer help. It was not the first time I had to deal with emergencies outside of medical school – I had worked as a lifeguard on one of the busiest beaches in Malta – but I had never dealt with proper arterial bleeding before. I paused at the realisation, wondering what to do.
“Take this,” my dad said, passing me a clean towel. “I’ll join you outside. Avoid getting in direct contact with blood if you can,” he added, clearly thinking about blood-borne diseases. I nodded and raced off.
I fought my way through a small group of curious neighbours to get to the bench. The three guys turned out to be Ukrainian and spoke no other languages. I tried to reach the injured boy, to wrap the towel around his leg, but his two friends barricaded the way.
“He needs to apply pressure to stop the bleeding,” I said in Bulgarian. I demonstrated by throwing around my hands, hoping they would understand what I mean. They took the towel I offered but did not let me come any closer. They were naturally cautious of me. As they turned to their friend to wrap the towel around the wound, I grasped the full severity of the situation. My eyes widened at the sight – half the calf was hanging loose, the muscle torn deeply, bathed in red. I thought I could see bone.
The injured boy, in an initial attempt to shrug off what had happened, had been sitting on the bench. By now, he was laying, his leg raised. He was trying so hard not to cry, but you could see wild panic in his eyes. The cigarette between his lips seemed almost ironic combined with the childish fear on his face; the futile hope that the nicotine would calm his nerves was written across his face. His friends wrapped the towel too loosely. Red flowers immediately bloomed on the white and yellow fabric.
I could hear my pleas growing desperate — they needed to apply pressure to minimise the blood loss. His two friends looked lost, their teenage minds fogged with the shock of their current reality, but they remained stoic in their roles as bodyguards. They would not let anyone close by. In a way, I could understand them – why take advice from nosy strangers who probably knew no better than them?
I remembered seeing one of the boys talking on the phone from our kitchen window. I asked when we expected the ambulance to come. A woman from the circling group of locals informed me that it would take an entire hour to get here. The peak of the summer season, a foreigner who spoke no Bulgarian, and who could not articulate the gravity of the situation — it was assumed the call was not a priority. There was only one ambulance available to the small town, and the majority of foreigners calling were tourists who simply drank too much the night before.
The atmosphere of the scene grew heavy – the sheer anxiety sprawled across people’s faces was infectious. Even worse, the injured boy was starting to drift in and out of consciousness — he was losing too much blood. I dialled the emergency services again. With the corner of my eye, I saw his friends making a do-it yourself tourniquet using a shoelace. As the operator answered, I could see my dad crossing the street, carrying something in his hand.
“What is your emergency?” a female voice inquired.
I tried to remember the SBAR format as much as possible. SBAR is a quick handover tool used by medics — Situation, Background, Assessment, Recommendation. “There is a 16-year-old boy with a serious injury to his calf. I am a medical student, and I suspect an artery is ruptured by the amount of blood lost. I did not see what happened. His friend phoned for help already; he was told that the ambulance would arrive in an hour. We need help immediately— the boy is losing consciousness.” Wow. So much for medical school— that was probably the worst hand-over ever. My brain was not working properly —I could not stop replaying the dreadful sight of the wound in my head.
“We received the signal, but there was no mention of severe arterial bleeding. The ambulance will be onits way. Please wait while I connect you to a dispatcher over what actions you need to take next.” A happy-go-lucky tune started ringing in my ear, completely inappropriate to the situation. I scolded myself. A now unconscious teenager with a pool of blood beneath him, on the front of an upbeat melody – this is the type of material horror movies are made of. I glanced at the time —it was 17:52. At least 10 minutes had passed since the original incident. Ten more minutes until the ambulance would arrive, they had said. Each minute became more and more drawn out.
Within my peripheral vision, I could see the object my dad was carrying turned out to be a corkscrew. It took me a moment to understand. He must have seen the amateur tourniquet from the kitchen window. He had approached the “bodyguards” and politely but assuredly pushed them away to get to the injured guy. Before the other two had realised what was happening, he had placed the corkscrew in the knot of the shoelace, and by turning the corkscrew, tightened the tourniquet.The flow of blood slowed a little.
The dispatcher started talking in my ear, telling me to apply constant pressure to the wound. I kept talking to the Ukrainians, gesticulating wildly, repeating in every language I knew what they needed to do. They tried to tighten the soaked towel, but not merely enough. Maybe it is because they didn’t understand me—or, more likely, because they were scared to touch the wound.
It was a delicate moment — I did not want to overstep any personal boundaries. For all they knew, I was yet another good Samaritan with intentions to help, but with little knowledge to do so. I was only a little older than them; what experience could I possibly have? I could understand they felt obliged to help their friend by fending off nosy people. The language barrier did not help either. They had demonstrated they wanted my dad to back away too, and so he did.
The ambulance really did arrive 10 minutes later, at 18:02 on point, and placed the unconscious boy on a stretcher. Over the course of the evening, we made sense of what happened. Before then we were too busy to even consider trying to piece together events. Instead of opening the door of the apartment block using his hands, the boy had kicked it. But it was an old door, and the glass ornaments had shattered where the boy had kicked it powerfully. Upon withdrawing his leg, jagged pieces of glass had cut through his calf, tearing through it.
It all happened so quickly. I hoped I helped, but I wondered whether I had reacted to the best of my abilities. I found solace in the fact that my call made the ambulance come 50 minutes earlier.
My family reassured me I had done all in my power under the circumstances of the situation, but I could not help but feel guilty. Every couple of hours, I checked the local news for any word of the accident. I had never really believed the phrase, “no news is good news”, but I tried to stay positive. No news appeared.