Friday, February 10, 2012

drifting away

The snow holds everything in a hard, blue-white light.

This must be the turning, even though the signpost is completely rounded over.

A press of car tracks heading up the road, presumably the response car that made it here first about ten minutes ago. Despite the early hour, all the estate kids are out on the green, throwing snowballs, dragging mounds of snow together with their boots for snowmen, or towing plastic sledges off to find a slope. A hyper-morning of novelty – snow, ambulances, there’s no end to it. They hardly know which way to go.

The house we want is in the far corner. We take a couple of extra things the paramedic might need and head that way, the snow crumping and squeaking beneath our boots. The front door stands open; we kick the wall to clear our boots, call ahead and go in.
A woman and her son in the kitchen.
‘Upstairs,’ she says, trying to light a cigarette. ‘Will you – tell me?’
‘Yep. I’ll come right back once we know what’s happening.’

The familiar beeping of the metronome as we go upstairs.

A man lying on his back in the bedroom, a paramedic compressing his chest. He tells us what he knows – Mark, forty, no previous medical history; sick in the night and went to bed; wife woke up and found him unresponsive; they got him on the floor and the son started CPR.
‘I’m afraid he’s been asystole throughout, guys. Pupils fixed and dilated.’
We divvy up the duties – airway, compressions, drugs. When it’s all running along and I can be spared for the moment I go back down to get more details. There’s not much to add.
‘What’s happened?’ she says. ‘Has he died?’
‘Mark’s heart isn’t working at the moment and we’re doing everything we can to get it going again.’
‘His heart? Was it last night?’
‘Could’ve been. It’s hard to say.’
The ash of her cigarette bends out precariously. Her son leans back against the sink with his arms folded, the snow-light blazing around him through the window as fiercely as his eyes.
‘I’ve got to go back and help them some more,’ I say to her. ‘But I’ll come back and give you an update.’

But despite an hour of advanced life support the man remains in asystole.
The lead paramedic reviews the situation for the final time. At the end of it he says: ‘All agreed?’
We switch off the monitor and start to tidy up.
‘He was found in bed, so let’s put him back. It’ll be easier for the wife to see him like that.’
I go back down. She’s sitting at the bottom of the stairs with a blanket draped over her shoulders. She looks up at me as I sit down next to her, and knows what I’m about to say before I say it.
‘We did absolutely everything we could, but I’m afraid Mark has died. I’m really sorry.’
She doesn’t cry, but her face crumples in a little, like something vital has been drawn out. Her son stands in the hallway, shaking his head.
‘We’re just making him comfortable upstairs, then we’ll give you time to be with him. Because it was an unexpected death, the police will be coming but don’t worry – it’s just a procedure we have to go through. They’ll tell you all about the next step. Okay? I’ll be back in a minute.’

Up in the bedroom the scattering of wrappers, boxes, syringes, pads and equipment has been tidied away. We all take hold and lift Mark back onto the bed, sorting out the pillows and drawing the quilt over so that now he looks like a man slowly waking up, resting his eyes in the reflected white of the snow rushing in above the curtains, listening to the shouts and screams of the children outside.
‘Do you think we should turn the quilt over?’ says the paramedic.
‘Why?’
‘Look.’
A motif of cartoon words on the cover: drifting away, zzzz.

5 comments:

Chris said...

You and your coworkers are amazing. We just don't do things like that in the States. The deceased would still be taken to the hospital (via ambulance), a doctor would have to declare him dead, all that stuff. That you put him back in the bed, straightened everything up, so the wife would see him in the best possible way - wow. I love coming to your blog - even though the outcomes of your stories are sometimes tragic, the way the entries are written is really fantastic.

jacksofbuxton said...

I think that's how most of us would chose to go Spence.Just drifting away zzzzzzzz

Snow isn't a novelty in Buxton,it's a nuisance.

Spence said...

Thanks v much, Chris.
We can't always put them back to bed, of course. Depends on the circumstances. But I think it's good if you can, because it's tough enough on the relatives without having the added trauma of the post-resus scene. Cheers for the comment. Hope everything's good with you over there. :)

Hey Jacks
Completely agree (except for the age, of course!)

I feel quite ambivalent about the snow. If I'm working, hate it. If I'm off, love it!

If I stumble across a suitcase of mafia money with no chance of being tracked down by Christopher Walken or such (or won the lottery - whichever's the sooner) I'd learn to snowboard.

cogidubnus said...

Are you now actually allowed to declare him dead Spence? If so that's sensible... but years ago a doctor had to be called out to pronounce death and until he did, theoretically the "patient" was alive...silly sometimes...

Spence said...

Hi Cogi

We can declare death and have done for a while - for example, after extended ALS, where the patient remains in asystole with no prospect of change, and what they call signs incompatible with life (ie massive injuries, hypostasis & decomp. etc).

It's quite rare, but sometimes we might talk to a patient's GP on the phone to get some extra details, but then I can't remember the last time that happened. They normally get involved post mortem, gathering the facts.