Our hero was in his early twenties and came dressed in a pair of jeans and a t-shirt. He limped into the Emergency Department under his own power complaining of spontaneous left knee pain. I asked if he had fallen, twisted his knee or otherwise injured himself, and he said “no.”

His examination was significant for a painful range of motion. There were no obvious external wounds, but his knee was indeed slightly swollen. His four ligaments were grossly intact on exam.

Diagnostic Imaging

If you sit still long enough in the ER, somebody will throw you into an x-ray machine. This kid’s radiographic study was unremarkable save a small quarter-inch metallic foreign body residing awkwardly within the joint space between his femur and his tibia. At the time we were using old plain film x-rays, so I snatched a copy down from the light box and showed it to him. A look of realization then trekked crossed his face.

This young man explained that he had spent the previous evening out at some sketchy nightclub dive partying with friends. The music was hot, and the women were even hotter. At one point he was fishing around in the right front pocket of his blue jeans for a cigarette when he brushed the trigger on his cheap .25 ACP handgun. The pistol discharged and startled him, but no one else was the wiser. The muffled sound of the gunshot was drowned out by the DJ’s thumping beats. Nobody around him even noticed a gun had gun off. So, this maniac kept right on partying.

Fantastic Voyage

As near as we could tell, the diminutive bullet had transited from right to left, narrowly avoiding his manhood along the way. The round then entered his left leg via his medial thigh and tracked downward until it came to rest within his joint capsule. There was a tiny red spot on the skin that was, no kidding, no more impressive than might be a typical mosquito bite. That’s what passed for an entrance wound. The young man got a little queasy when I explained how close he had come to shooting himself in the penis.

I consulted the orthopedic surgeons and introduced them to their new play date. They fished the slug out and sent the kid home with some antibiotics and a little pain medication that he likely sold to somebody else. No harm, no foul. After all, a guy’s gotta eat…

The lessons to be gleaned from that kid’s sordid sojourn in the ER are legion for gun owners who carry. For starters, gun safety is no joke. Anyone dim enough to pocket carry a hot pistol loose in their Levi’s likely shouldn’t collocate their heater with their smokes. That and, as is invariably the case, always pack enough gun. That adorable little .25 ACP will only just barely kill you. In this case, the wounded was literally able to walk away.

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