Wednesday, December 11, 2013

crossing the river

‘Will Jack be okay on his own?’
‘I – hope - so.’
It was the last thing she said.

* * *

I’d never have guessed Jack had Alzheimer’s. He’d met us at the door, a well-dressed man, snugly buttoned in cardigan and corduroys, neatly made tie, nicely combed hair, perfect as a father figure in a doll’s house. In the little room he’d said. Right then right again. And then followed us in to see Vera, leaning forwards in a high-backed chair, breathing fast and shallow, hypervigilant, a pallor to her face like she was approaching some terrifying thing.
Shall I come with you? Jack had said. Or shall I rest here and ring in the morning?
I almost said: Your wife is dangerously ill. You must come with us.
But in the press of the moment what I actually said was: Stay warm. Ring in the morning.
Despite the bitter cold of the night, he watched from the shore of their driveway as we loaded Vera into the back.
I waved.
He went inside.

* * *

Whatever was happening with Vera – no doubt a massive PE but asymptomatic in some respects – there was nothing we could do to correct it. Despite our therapies she remained cyanotic, struggling. As Rae cannulated, Vera’s arm hung down over the side of the trolley like she was trailing her fingers over the side of a boat and the water was turning them blue.

We did what we could as quickly as we could, then hurried on through the night.

Just in sight of the hospital her breathing changed, her pulse disappeared, and I dropped the trolley back.
‘Arrested’ I called through to Rae.
She pulled over.

Five minutes of CPR and there was a return of circulation.
We stabilised as best we could, then ran on the last little way into A&E.
Vera arrested again moments after transferring in resus. The team closed in.

I completed the paperwork, helped clear up the ambulance, made ready to go. I went back into the department to make sure they understood Jack was home alone.

In the half an hour it had taken to do all this, Vera had died, and the team was round another bed.


martine said...

You bought my day to a halt and reminded me I should get off the internet.

Spence Kennedy said...

Hi Martine

Sometimes I worry these pieces might be too voyeuristic. But then I suppose that's an occupational hazard when you're writing about real & traumatic events in peoples' lives. The other thing I worry about (I worry a lot) is that there's too much focus on that one event. I take it out of context, and the sense of the lives that went before it gets lost. Again - an occupational hazard. I'm not sure what my point is, here!

Anyway - to cut a long story short, thanks for reading, Martine. Very much appreciated.

Anonymous said...

Long time reader, first time commenter i think. your posts make for powerful reading, but this, like the last poster, it just stopped me in my tracks.

I think you capture the characters of people brilliantly. When i read your posts i can imagine these people and their lives as if I know them like a next-door neighbour or pub regular. Its that sense of the lives of these people that makes your posts like this so heartstopping. Its not just the events you write about that make me keep reading, its the fact that you do capture the essence of a person, of their life before and you make us feel for them not just read about them. Its not just another name, another body, another story to you or to us.

i worry about jack, do hope hes being looked out for now. Poor man, poor vera.

thank you Spence for writing your blog.


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

Your writing makes me so glad that I read you. Thank you for sharing these stories, they do make one stop and think. I lost my younger sister five years ago, she was 49, to a PE that killed her in less than fifteen minutes. We were shattered by that sudden death. My EMT career didn't last long due to injury but the desire to read about of it and learn as much as I can remains and your blog helps. Thank you.

jacksofbuxton said...

A sad tale Spence.

My Father-in-Law's next door neighbour is suffering with dementia.When his wife died,he forgot it,then remembered it and so on.

Very sad for Jack.

Spence Kennedy said...

Hey Tracey - Thanks so much for your comment. It's really kind of you to take the time. It definitely helps with that feeling of unease I have sometimes (all the time, actually) writing about some of these very personal things. Very much appreciated.

Hi Lynda - I didn't know you used to be an EMT! I don't like the sound of that injury you took, though. (I think I almost joined you on that one, lifting that enormous patient the other day when we really should've called for back-up).

So sorry to hear about your sister. PEs are such dreadful & scary things. We felt pretty helpless in the face of this particular patient. Other than the basics - and then CPR - there wasn't much we could do to help.

Thanks for the comment, Lynda - and your long-term support. I hope everything's good with you today.


Spence Kennedy said...

Hi Jack

It's dreadful to think of the impact this'll have on his life - not least because he won't be in a position to grasp it rationally. Dementia often puts such a cruel twist on these things.

And of course, Vera's death will also mean he'll have to be cared for in some other place. But the good news is, I have no doubt he will be cared for, of course, so that's a positive.

Anonymous said...

The first patient who arrested in my care after registering as a paramedic had a PE. It shocked me to feel so helpless and it brought home the fact that advanced skills really are icing. Sometimes basics and diesel are it.

Dementia complicates everything. I used to work in Elderly Care in a hospital setting and Consultants who described patients as 'pleasantly demented' infuriated me. The patient may have lost awareness of their state but it's a slow mental amputation of the person that you love for their families. It's anything but pleasant.

My father has just been diagnosed with dementia and would be lost without my mum. So basically, you just made cry... But that's okay, because I'd rather empathise than not.

Spence Kennedy said...

Hey Anon

So sorry to hear about your father. I really think dementia and all those progressive diseases that effect the brain are particularly awful. 'A slow mental amputation' is exactly what it is, and must make it so hard to cope. I hope you & your family are getting all the help you need at home.

This job was especially cruel. Vera was actually pretty healthy, hardly on any meds, the active carer of her husband - who in himself was in good nick, despite the Alzheimer's. Fairness never did come into it, I suppose, but still...

Best wishes, Anon - and thanks very much for the comment.

Anonymous said...

Similar thing happened in an extension of our family just before Christmas last year. The husband dropped dead with an aneurysm - leaving his desperately demented wife and two grown-up sons. He'd cared for her wonderfully - but what he hadn't done was arrange for this eventuality. There was no power of attorney so she was "in charge" of all the funds. She needed 24 hour nursing care - not according to social services despite being unable to move at all alone - but although money would have been no problem they couldn't use it to pay privately and she wasn't competent. Mercifully she deteriorated within weeks to needing hospital admission (which otherwise wouldn't have been necessary) and died soon after.

No Spence - nothing fair at all and it is the longest lasting bereavement. The spiritual person has died - but is physically still there. I don't care how I die - as long as it is quick. For me and mine...

Spence Kennedy said...

Hi Anon - A desperately sad story. So even though she was suffering from dementia, there was no legal way of transferring control of the family finances to her sons? I don't think I'll ever understand the law of these things!

I keep talking about making a Living Will to pre-empt some of these difficulties, but so far I haven't got round to it. (Not sure what the legal status of those things are anyway - but I should at least do some research...).

Thanks very much for the comment, Anon. Best wishes for the New Year.