“I’ve been in this game for years, it made me an animal
There’s rules to this sh*t; I wrote me a manual”
— Notorious BIG
You know, whether you sling crack rocks or not, there are some sage words of wisdom in the late Notorious BIG’s Ten Crack Commandments. Life pearls like “Never let ‘em know your next move” and “Never keep no weight on you” have helped guide me through some challenging life decisions.
1. Never let no one know how much dough you hold
2. Never let ‘em know your next move
3. Never trust nobody
4. Never get high on your own supply
5. Never sell no crack where you rest at
6. That Goddamn credit, forget it
7. Keep your family and business completely separated
8. Never keep no weight on you
9. If you ain’t getting bags stay the f*ck from police
10. A strong word called consignment; If you ain’t got the clientele say hell no
Table 1. The ten crack commandments.
While not much is new in the world of hustlin’, when it comes to trauma resuscitation, the game done changed*. It was easier in the old days: 2L of crystalloid for a hypotensive patient, and then blood. While new science on trauma resuscitation has helped us understand how flawed that paradigm is, the new school can be some tricky water to navigate. From damage control to fibrinogen, from TXA to thromboelastometry, there is no doubt that resuscitating a bleeding trauma patient is a more nuanced endeavor than we originally envisioned it.
So, inspired by Biggie’s Descartesian ten-point discourse on method, I present the ten rules of the contemporary trauma resuscitation game as I see them – backed by science, and occasionally editorialized with personal opinion.