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She was a beautiful young woman. She was so pale as if the blood had been drained from her body. Pigment ink on 9"x12" Bristol Board.

An open thoracotomy is the last recourse in a salvo of life-saving measures in the emergency trauma trauma room. For starters, no one wants to crack a chest in an unsterile environment. This procedure is very rare and most emergency nurses go through their careers without ever assisting in one nor seeing one performed. In the eighties, trauma nurses and doctors called our county the drive-by shooting capital of the state. Only Cook County in Illinois and Washington D.C. had worse gunshot wound statistics. I worked in the county emergency center where I assisted in the first of four open thoracotomy procedures of my career. Most gunshot-wound patients were taken to the county hospital while major motor vehicular accident patients were taken to the private Level I trauma center next door where I later worked.

One beautiful day, an unidentified black man was seen by motorists in the freeway hurling a rock from the overpass. It hit the windshield of the car of a young woman on her way to work. Her car swerved and slammed againts the concrete wall. She was on full-blown resuscitation on arrival but the paramedics were never able to revive her from asystole.

I was the major trauma nurse. The patient was a beautiful young woman in her early twenties. She had no blemishes except for a little abrasion on her forehead. It was around seven o'clock in the morning and I could smell the scent of a fresh shower as I cut her Burberry coat and clothes. She was pale as if all the blood was drained from her body. Anne, who was the chief surgery resident decided to perform an open thoracotomy. This is usually done so we can manually massage the heart. Her heart was not beating and when I massaged it, the effort failed to elicit a heart rhythm. Anne, took over and continued massaging the young woman's heart seemingly frustrated and astonished that there was no change on the cardiac monitor. Then to our horror she lifted the heart from the young woman's chest cavity! The major arteries and veins were totally severed. The impact of the accident was so severe that the young woman's heart was detached! Everyone was numb. We were quietly suppressing tears. Anne walked away as she handed me the young woman's heart. I gently returned it in her chest cavity.

Everyone but me and a surgery resident stayed behind to care for her body. As I searched for identification, I opened the wallet from her elegant purse. She was only 24 years old. I gathered my composure as I called her home phone. I identified myself and before I could finish her mother asked me if her daughter was alive. She told me that day should have been her first day on her first job. They never caught the man who threw the rock.