Op Note XXIII
The child rolled into the OR clinging to life. We opened him up. There was a warm gun steaming right there in the middle of the carnage. Bullets caterwauling. A liver shredded A spleen like beef tossed into an animal's cage. I took off my gloves. I tore my mask. I breathed in the sulfurous fumes of the almost dead. It was a Beretta, a SIG Sauer, a Glock 19. AR 15. I remembered that AR doesn’t stand for automatic rifle or assault rifle. It means ArmaLite. Which is just a brand. Like Whirlpool. Like Frito Lay. It’s important you don’t attack straw men. That you use the correct terms. Because you look dumb if you call things by the wrong name. It means you are an unserious person. Who doesn’t understand guns. Who isn’t a real man. The term for what I am seeing is grade IV liver laceration. The term for this is ureteral transection. The term for that is an expanding zone I retroperitoneal hematoma. The term for this is extraperitoneal rectal injury. This up here is a massive hemothorax. Cardiac tamponade. Tension pneumothorax. Duodeno-pancreatic disruption. The term for what I am doing is Mattox maneuver. This is a Cattell-Braasch. We’re clamping and tying. We’re whip stitching. Packing all four quadrants. This is called a Pringle maneuver. I’m holding on for dear life. I am a good guy without a gun. Smoke still wisps from the barrel of the rifle in slow spiral staircases like a cigar briefly abandoned by the man who always comes back.