I’m swimming out in a cold, calm sea. I catch up with Alison Moyet,
who’s swimming very determinedly in a burkini. She’s heading out to a submarine
on the horizon, a strange, dark vessel, like a ribbed slug with lights out on
stalks. ‘Trinity House’ I think. Even though I’m worried about the distance to
the ship, and how we’ll get back, I swim alongside her. When we get close
enough I can see there’s a bearded man piloting the craft. The Captain? In a respectful
but jokey way I call out to him: Permission
to come aboard? I’m expecting him to be charmed by our pluckiness. It’s a
brave, almost foolhardy swim after all. He’ll know more than anyone the danger
we’re in – from the cold, the tides, the distance back.
‘No’ he says, looking straight ahead. ‘No...No...No.’
My leg starts to vibrate.
I’m not in the cold sea anymore, but a leather chair.
There’s a radio in my pocket, with a job coming through.
I stagger out of the standby room and out to the response car.
*
Jack meets me at the door and shows me through to the bedroom where
his partner, James, is lying propped up with cushions. James is mortally
unwell. His mottled skin is stretched taut across the bones of his face, and
when he coughs there is a sludgy rattle behind his ribs.
‘I’m not going to hospital,’ he says, turning his head to look at
me.
‘No. Absolutely. You don’t have to do anything you don’t want to do,
James,’ I tell him. ‘So. How can I help tonight?’
‘James has got Basal Cell Lymphoma, metastasised to the lung from
his liver. James has decided to withdraw from chemo, and we’re waiting for a
call from the palliative care team later this morning to set things up so he
can die at home. Unfortunately we’ve been caught out a bit. We’re between arrangements,
so to speak. It’s pain relief. We’ve only got paracetamol and so on, and we really
need something a little stronger.’
We talk through the options. I tell them that they’ll need a doctor
to come out and prescribe what they need. I take some basic obs, but James
doesn’t want much and I don’t push it.
‘I’m tired and I want to die’ he says. ‘Can’t you just put me to
sleep?’
‘Well that’s not really in my code of practice at the moment, James.
The best I can do is call in a doctor for pain relief whilst you’re waiting for
the palliative care team.’
‘A gun or something,’ says James, gripping the duvet and closing his
eyes. ‘I’m not fussy.’
‘The other thing we need to sort out is a Do Not Resuscitate order.
As things stand at the minute, if you suffered a cardiac arrest, the ambulance
crew would have to work on you.’
‘No...No...No!’ says James, his eyes opening wide again.
Jack gives me their home phone number; I call the out of hours doctor to discuss the situation. The doctor's extremely clear and helpful. He says he’ll check his Oromorph
supply and head straight out.
I finish the paperwork and gather my things together.
‘Is there anything else I can help you with before I go?’ I say to
James.
He holds out his hand to me and I take it.
‘Thank you for all you’ve done,’ he says.
‘It’s a pleasure, James. I hope you get the help you need as quickly
as possible.’
I press his hand warmly. When I make to let go, he holds on a little
longer, looking up at me with his glittering eyes, like he wants me to
pull him up and take him somewhere.
‘Lovely to meet you, James,’ I say.
He relaxes.
I pick up my bags, say goodnight and go.
7 comments:
I'm thinking James picked up on your warmth, the same warmth that brings me back here for more stories, time and time again. I only hope that you come out to me & my loved ones in our hour of need. Long way though, we are in Hampshire.
Thanks very much, Hel. That's kind of you to say so.
I know I'm biased, but I honestly think most people in the ambulance are the same. They're not in it for the money - or the hours / working conditions, these days - but because essentially they're interested in people, they care about them and want to do what they can to help. We all have our off-days, and everyone has certain things that 'push their buttons', but essentially it's about the patients.
Thanks for the comment, Hel - and for supporting the blog all this time!
Couple of things SPence.
A lovely couple James and Jack.They seemed to be ready for the sad final chapter.
The other thing is don't eat cheese so late at night.
Lovely couple - and so open about the whole thing. It made dealing with it so much easier. A real pleasure to meet them, even if it was under such dreadful circumstances.
Cheese? That's exactly what I'd say to a therapist. Despite the fact I hadn't had any cheese. Although I'd have eaten it if you'd offered it to me. That late at night I'll eat anything.
I'm surprised you felt surprised at his reaction - though it wasn't entirely clear which he was reacting to: the DNR or CPR. I hope I'd be clear enough to understand that whatever I want I do NOT want effective CPR when I am dying anyway. It's bad enough without broken ribs etc.
I must ask what happens here - Italy doesn't like the concept of assisted dying, they might see it as similar.
I wasn't surprised by his reaction to the DNAR thing, Eileen - it was because he said 'No, no, no...' - in the same way as the submarine captain in my dream earlier! (But I must admit, re-reading the piece it's not entirely clear. Maybe I should delete that bit...).
On the contrary, I was hugely impressed by James' open and frank attitude.
Sorry for the confusion!
Eileen - I just realised - I didn't answer that question about Assisted Dying.
Currently in the UK there is no Assisted Dying. The emphasis is on good palliative care, either at home, in a hospice or (worst case scenario) a hospital. It's a huge issue, though. Many people think Assisted Dying should be brought in (I'm one of them). A question of personal choice. But thus far, nothing on the statute.
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