When I was a resident in my final year of training at the Christian Medical College in Vellore, a malnourished lady onerously walked into the emergency carrying her six-year-old child in her arms. Blood pouring out from his lacerated scalp had soaked them both. He had been run over by a car close to the hospital, and rather than wait for a ride, she had simply picked him up and run to us. He was unconscious when we saw him. She looked like she was going to follow suit. The ER doctors expeditiously plugged in an intravenous catheter and shoved a tube down his throat to protect his airway, while I pressed on his head with a dozen Gamgee pads to control the bleeding. Once we got the blood pressure up and stabilised his heart, we rushed him for a CT scan. The temporal bone was shattered into pieces and beneath it was a large extradural hematoma, a blood clot between the bone and the dura mater. The underlying brain, however, looked surprisingly okay.

We took him straight to the OT and cleaned out all the debris and rubble of the road from his skin, the stench of dried blood permeating though our masks. We fashioned a skin incision to expose the fractured bone and removed all the pieces. There was a large hematoma underneath the fractures pressing on the brain, which we slurped out in our suctions, and I coagulated the artery that was slit by one of the sharp fracture fragments. For that kind of injury, I was surprised to find the dura intact.