Blog No 39 Man Attempts Suicide with Nail Gun
In January 2010, I gave a talk to the Caducean Society of Greater Ft Lauderdale (made up of physicians who give a 3-minute presentation about something of interest in their specialty) about a patient I had treated who had shot himself in his head with an industrial nail gun, intending to commit suicide. It would have been a good “Florida Man” story except our patient lived in New Jersey. My associate, Randy Powell, performed the admitting “History and Physical “ and the document began with, CHIEF COMPLAINT: “I want to kill myself.” Doctors and nurses enjoyed to read Dr Powell’s H & P’s in which he described things in earthy, everyday language. On one or two occasions, Dr Powell was called into the Chief of the Medical Staff’s office (Randy referred to it as being called into the principal’s office) for having offended a reader’s sensitivity.
The patient, who I ended operating on, had shot himself in his right temple with a construction-style nail gun, but he did not lose consciousness or pass out. When nothing bad happened in a few days, he decided to drive to Florida where a sister lived, and he spent a few days sight-seeing in the area. His sister suspected he had come to Florida and when she checked out a few local motels she spotted his car in the parking lot and called the police.
His surgery was straight forward, designed to remove the staple, debride the entry wound and remove bone fragments to prevent infections. He didn’t turn a hair and his follow-up CT scan showed no intracranial bleeding. He was treated with antibiotics and as I far as I know he did not develop an intracranial infection. The nail was in the substance of his fontal lobes but there was no injury to a blood vessel or a vital structure that caused any noticeable neurological deficit, although his plan had not gone as he had intended.
