Tuesday, April 14, 2015

faux pas

‘Please don’t do anything. It’s not what she would have wanted.’
‘Is there a DNAR?’
‘A what?’
‘A Do Not Resuscitate order. Without that I’m afraid my hands are tied.’
Sheila is in cardiac arrest, and the paramedic doesn’t have the luxury of debate. Sheila’s daughter Rachel is too elderly herself to help, so she leaves the room and he sets about getting Sheila onto the floor by himself. Luckily she doesn’t weigh much. He’s able to gather the bottom sheet and slide her out of bed in a controlled way. As soon as she’s on the floor he starts chest compressions.
When we arrive a few minutes later Angus has cut Sheila’s nightie off and put the defib pads on. She’s in asystole, and stays that way despite all our efforts.
We stop the resus after half an hour. Tidy her up. Put her back to bed.

Rachel is sitting on the sofa with her husband Geoff when I go in to tell them that Sheila has died.
‘I knew she’d gone,’ she says. ‘We live in the flat just below. I should’ve known something was wrong.’
Her husband squeezes her hand.
‘I’ll make us all some tea,’ he says, and goes off into the kitchen.
‘She always said she didn’t want a long illness, in and out of hospital like Grandma,’ says Rachel. ‘She was a stubborn old thing. She had a habit of getting her way in the end.’
I tell her about the next stage, how the police always attend an unexpected death – ‘...purely routine, nothing to worry about. They’re only here as representatives of the Coroner’s Office. They’ll talk you through the next stage.’
It’s still early. Rachel and Geoff are in their dressing gowns. When he comes back into the room with a tray of tea things he sets it down on the table and says they’d better go back downstairs and get dressed.
‘You’ve got plenty of time,’ I tell them as they leave. ‘The police will probably take half an hour or so.’

Whilst they’re gone we tidy up some more, drink our tea, finish the paperwork. We swap gossip with Angus, then he leaves us to it.
As situations go it’s pretty perfect. The elderly mother in the upstairs flat, independent but still a daily part of things; the daughter and her family just below. It’s a bright and tidy place, filled with family pictures, from the slick-haired young pilot standing by a Spitfire with his arms folded, through black and white baby photos, prams in parks, faded colour scenes of weddings, graduations, increasing family groups in gardens so bright the colour has faded almost to white, outings, Christmas gatherings, parties in crowded halls, all the faces turned towards the camera.
Rachel comes back in – a little hesitantly, like it’s not quite the room it was.
‘Thanks for everything you’ve done,’ she says. ‘Can I ....go in and see her now?’
‘Of course.’
‘How’s the tea?’
‘A lifesaver,’ I say, immediately regretting the faux pas. Thankfully she doesn’t hear me, though. She’s already turned and headed back across the hallway. She hesitates by the bedroom door, gently opens it in the way that you would if you wanted to go into a room without waking someone, then goes inside.


jacksofbuxton said...

Sounds as though the family are at peace with the passing.

Spence Kennedy said...

They were. It's a shame they hadn't arranged a DNAR - they'd have been spared all that ER stuff. But still - as these things go, it wasn't too bad!

Sabine said...

In one of the articles about Sheila Kitzinger, who died last Saturday, her husband said that she had a home death after a lifetime working for home birth and I immediately said to my family, that's what I want (and my daughter was a home birth, too) and now this story of yours just confirms it. We should all have on, if possible. And tea for everyone afterwards.

Spence Kennedy said...

I didn't know that about Sheila K, but it doesn't surprise me. It should be in the national vocabulary, the notion of an easeful death, either at home or in a properly-funded hospice / palliative care centre. In some ways (in this country at least), end of life care is the last health taboo, and it's such a shame. The home birth analogy is really good. There should be an equivalent!

Thanks for the comment, Sabine.

Lynda Halliger Otvos (Lynda M O) said...

My last death had a DNR and we had taped it to the wall over her head. When she passed in her bed and the Medics came, they were pleasantly surprised to see that we had the paperwork all in order and it made the event so much less traumatic for her daughter and for me, too. I still miss her, tho guess that goes without saying.

Thanks, Spence for this blog, I get to relive my medic days thru your writings and it is really my favorite blog of all.

Spence Kennedy said...

I'm a big fan of DNRs (grim as that may sound). It makes the final passing so much calmer and more dignified. Not only that, I think it concentrates the family's mind, and helps them come to terms with the inevitable.

Thank YOU for reading & commenting all this time, Lynda! So very much appreciated. x