Thursday, February 26, 2009

the change

Five o’clock in the morning and the sky has a fuzz of blue about it that marks The Change. I can feel it in me, too, as if my blood and bones are orientating to the same rising point. I’m through the three o’clock subsea numbness, that dead or alive slump that makes shift work so difficult. The only way is up.

I knock again. There are lights on through the house, but all the curtains are closed and nothing moves.

We’ve been called here to help with a lift. Apparently a crew was dispatched to pick a large woman off the floor, and Control has sent us, too, pre-empting a request for help, and because we happened to be passing.

No reply.

I knock again whilst Frank steps across the flower bed and bangs on the window.
The first crew’s ambulance is parked right outside, so I can’t think that we have the wrong number.

‘Maybe they’re mid-manoeuvre and can’t come to the door,’ says Frank, goose-stepping over a desiccated lavender bush. ‘Or trapped under a heavy piece of furniture.’
Just as I reach out to knock again, the door is yanked open. Rich, an EMT from out of town, stands there looking hot.
‘Resus,’ he says, and then turns to go back inside. We follow close on his heels. He gives us the main facts over his shoulder: Ninety year old female. Husband thought she’d fallen over when she got out of bed to go to the loo. Rang for an ambulance to help get her up. Didn’t do any CPR. Doesn’t know how bad she is. Took us twenty minutes to get here. Asystole since we started. No cardiac PMH.

We follow Rich into a room where a woman is lying on her back, rolled flat by the cataclysm that has been visited upon her. Two single beds have been pushed together and a table and chest of drawers piled on top to make space. The woman is naked, her nightie cut in two, flowing out either side of her like trampled wings. Sophie is kneeling beside her, compressing her chest.
‘Here. Let me take over that,’ I say to her.
‘Thanks, mate,’ she says, stiffly getting to her feet. ‘God. My knees are so creaky these days.’
Rich takes over the ventilations.
‘How long have you been going now?’
‘What is it? Ten minutes?’ says Rich.
Frank goes back down the stairs to fetch his para bag; Sophie goes with him to chat to the husband.
‘How’s he taking it?’
‘I don’t think he really understands what’s happened.’
Rich wipes his forehead with the back of his hand.
‘Christ, you know – we weren’t expecting any of this. It came through as an assist back to bed. She was crammed over against the wardrobe. We had a hell of a job to get some space cleared and get her on her back.’
The woman’s body shifts beneath my compressions with lifeless passivity. I hear Frank clumping back up the stairs with his gear.
‘They didn’t tell us this was a resus,’ I say. ‘We were sent by just in case you needed a hand.’
‘That’s lucky, then. We were just about to call for back-up…’

All the drugs and extra equipment are to no avail. The woman is beyond rescue. After more than twenty minutes, we all agree that nothing more can be done. We tidy the woman up, lift her into bed and make her presentable, restore the furniture as best as possible and stuff all our rubbish into a yellow bag. Whilst Rich finishes off, we head off back down the stairs. We stop off in the living room to say goodbye.

An elderly man in tidy blue pyjamas and a dressing gown tied at the waist, is sitting forward on a floral-patterned armchair with his arms resting on his knees, staring down at his hands. Behind him on the wall is a generous spread of framed photographs: weddings, holidays, formal family portraits, a dog looking out from a garden – many of the photos looking leached out now, further away, their greens and yellows and reds and blues drawn up and ghosted by all the bright sunlight this window must have let in over the years.


Anonymous said...

Its always hard when the relative doesn't comprehend what is occuring.

I had a call to a 'Fall', we walked in the front door and the wife stated "My husband is unconscious in the bathroom" she said this quite calmly as if it was the most normal thing in the world. He was a lot more than unconscious.

I think its the same part of the brain that allows us as ambulance staff to 'switch off' to the effects of these jobs. It kicks in to others when they don't want to face what is happening yet and don't know how to.

Spence Kennedy said...

You're right, L - it's an overwhelming experience that I guess you could only really make sense of after time had passed.

I suppose there's no way round the terrible grief that surrounds death - nor should there be. My impression with this case was of a couple who'd been together for many years, raised a family - but of course this all had to end, quite naturally, at some point, like anything else. So whilst it's fantastic that they'd had such a time together, worthy of celebration, the grief would be devastating nonetheless.

Writing about it is so difficult. I suppose you can only allude to the depth of feeling. It's such a huge life event. What can anyone really say, when someone you've relied on for so long suddenly gets taken away?

Anonymous said...

Well that's left me feeling pretty choked. So while you can only allude to the depth of feeling, you do a pretty damn good job.

Luka said...

Writing about it may be difficult but you have done an astounding job of capturing the moment here. Very moving.

Spence Kennedy said...

Thanks v much, Helen & Luka - for your lovely comments, and for reading the blog!

The Happy Medic said...

Fantastically well written, great story. Thanks for sharing. You were mentioned over at medicblog999 and I thought I'd wander over.

the Happy Medic

Spence Kennedy said...

Thanks HM! :)

Pat said...

With some minor changes to how the patient was found, you could have been writing about my mother and her untimely death. She went to bed and expired quietly in the night. My dad, who was suffering from a myriad of medical issues, slept in a second bedroom, and discovered that she was VSA (vital signs absent) when he realized she was not up, and went in to wake her for church.

What is most interesting is that you put her back to bed, and covered her up to maintain her dignity. My mother was left on the floor of the hallway, without so much as a sheet covering her nakedness with a police officer 'standing guard' until the coroner arrived to officially pronounce death. My dad was furious, and actually had to step over her to get something to cover her up. As I told you in an earlier comment, he was an 'old school' ambulance attendant, and he felt that leaving my mum in that position was lazy and lacked compassion and respect for the family. Unfortunately, simple acts of compassion are not stressed in the college paramedic courses, and the young'uns only learn that sort of thing with time and experience, or with any luck, at the side of a man like my dad.

Thanks again for your insight and are a credit to the profession.


Spence Kennedy said...

I'm very sorry to hear about the circumstances of your mother's death, Pat. I don't understand how anyone involved in the case could've behaved with so little common sense and decency. It's shocking. I hope that your father was able to come to terms with what happened, and managed to find some peace about it.

Maybe the way to think about the business of dying is similar to the way of thinking about birth. Often the circumstances are confused and confusing, mishandled, messed-up and sometimes just plain awful - but beyond all these things are the deep and abiding feelings of love and connection which will never and could never be put in jeopardy.

A practical approach. And not always of great comfort, I know. I suppose what I mean to say is that tough though these entrances and exits may be sometimes, the stuff to hold onto is the stuff that happens in between times.

Thanks again for your comment and support, Pat. I appreciate it. x