Some people expect that ER doctors will believe anything you tell them. Not quite. While non-ER physicians might find this hard to believe (or, they may simply be unaware of the statistics), gaining acceptance to an ER residency program is the most competitive venture in postgraduate medical education. Think it's difficult getting into a residency for orthopedic surgery or neurosurgery? It's a piece of cake compared to getting into an ER program. Having worked for years as an ER doctor, I have to wonder about the intelligence of anyone who actually wants to abuse themselves—I mean, be an ER doc. Kidding aside, ER doctors are anything but stupid. Mary didn't believe that, though. Want to hear a wild story? Good.

Joe went over to Jim's home. Jim, a friend of Joe, was making love to his girlfriend, Mary. Without being too graphic, Jim could not satisfy Mary, so he got up and left the home. But not Joe. He decided to give it the old college try, seeing if he could satisfy Mary. Joe and Mary were thoroughly enjoying themselves when Jim returned. Jim asked Joe to get off his girlfriend. Joe had something else on his mind, however, and continued on his merry way. Jim then tried pulling Joe off. No go. Jim then got his pistol and shot Joe in the back of the head. What a way to end a friendship, huh?

The paramedics brought what was left of Joe into the ER. The gauze wrapped around his head wasn't doing a good job of keeping the blood inside, which spilled out so profusely that it cascaded off his gurney onto the floor, creating the largest blood trail I've ever seen. As I followed the patient from the ER entrance to the Trauma Room 120 feet away, I found it difficult to believe that so much blood could flow from one body.

Trauma resuscitations begin with the ABCs: airway, breathing, and circulation. Once those basics were taken care of, the next logical step in this case was to take a gander at his wound, thus giving us an idea if this patient was salvageable. The second the nurse removed the blood-soaked gauze, I knew the patient was a goner. I estimated that at least half of his brains were missing, undoubtedly spattered over his friend's bedroom. From the gruesome way in which his skull was blown open, I knew that he must have been shot with a large-caliber handgun. My guess was a .44 Magnum—definitely not something wimpy like a .22 or .25 Auto. A large exit wound and X-rays showed that the bullet had left his brain. From the path it took thereafter—through a wall, floor, and who-knows-what-else—the CSI team could glean useful information for the prosecution. Mary claimed that after Joe finished making love (well, having sex is a more apt description), he got Jim's gun and shot himself.

Oh, I believe that! I've thought of many things after intercourse, but somehow suicide has never crossed my mind. Furthermore, Joe was shot in the back of his head and the angle of the wound indicated that it was not self-inflicted. Besides, who would even try to shoot himself in the back of the head? Having precious little common sense and no appreciation of forensic science, Mary actually thought we would fall for the story that she and Jim had concocted. Guess again.

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