A figure glides silent with muted rubber-soled footfalls down a long, darkened corridor. Head slightly forward and intent, there is no notice paid either way between the two hunched forms seated in a cocoon of cool white lamplight at the desk to the right and the institutionally uniformed character passing rapidly by in the near darkness. It’s just past 3 a.m. The only light now in the broad hall of battleship linoleum is provided by the red ‘Exit’ lamp beyond. Without hesitation a swerve to the left and then a purposeful push with fingertips on the stainless press-plate of a door labeled simply, ‘603’. A slight resistance on the hydraulic hinge slows the progress into the room only a fraction of a second and then fully into the room there is a sudden halt.
Eyes adjust now to a deeper purple darkness. Tiny red and white lights and pale green digits on various boxes and panels mark four different stations about the perimeter of the room. A plethora of lines, tubes and wires connect the various whirring, clicking and silent devices to four prone figures, draped unmoving in white linens; silent, sleeping and unaware.
Not enough light for the mission at hand, a flick of a switch to the left and light leaps into the room. A small pull of the adjacent door handle collapses the light from the washroom back to a level just adequate for the purpose.
Stepping forward again, virtually imperceptible glances pass over three of the sleepers. Only enough notice to ascertain their full quiet is necessary. Intention on only one sleeper is required now.
A practiced glance at the order and array of tubes and lines, position of switches and their little lights and the story of the digits confirm the integrity and placement of the various bedside tenders. There will be effort not to disturb their function or rouse their alarms. Hands working in concert deftly lower the chromed steel rail adjacent our sleeper and muffle the click as it drops to the side.
Both hands slide under the coverings and feel about the length of a particular tube, searching the terminus. It disappears, unseen, only felt under long layers of gauze taped loose to the abdomen. At the intersection of vessel and skin fingers find a warm treacle of unknown oozing, startling the touch. The clock of this sleeper’s life begins a terminal countdown.
By conventional wisdom of those who have mastered the arts of unarmed combat, it is acknowledged to be very difficult to kill someone without the benefit of a weapon. To generate a single killing blow by force of muscle, bone and sinew requires years of dedicated practice and training. A lethal ‘karate chop’ is no simple matter. Precise delivery of a large amount of prescribed force to one of a small number of defined targets is necessary and likely only after years of training. The resistance offered by the victim to any number of attacks makes a deadly blow much more a matter of chance than design. Even introducing weapons to the task will not make certain the result. The outcome of various wounds delivered by gunshot, stabbing or blunt-force trauma seem a matter of caprice to experienced emergency department practitioners.
There are many ways to kill with one’s hands, wielding a weapon or without, but it is nature herself over millions of years of evolution that has created the most impressive arsenal of “empty-hand” weapons; unseen, insidious and deadly. And all at your fingertips.
Hospital acquired infections are the fourth leading cause of death for Canadians. 220-250,000 infections each year result in 8-12,000 deaths. The majority of these are entirely preventable, depending entirely on our level of intention. The stars on nature’s starting team; MRSA, VRE, C Difficile and the rookie sensation, CRE, heavy hitters all.
Trace if you will, the path of the providers hands that night in the hospital and all the vectors that come in contact with the fingertips on the journey to the bedside. The stunning fact is a single interruption in the journey at a hand-sanitizing station, prior to patient contact, would have prevented a protracted, painful death and produced a victory for patient safety with a twenty second investment of effort.
Ultimately it will be up to you how you answer “Ever kill somebody with your bare hands?”
Darrell Horn, June 28, 2019