She lies there, between life and death. Sure, she breathes, she eats what is placed in her mouth. When her father comes to visit, as he does every day, is there a glimmer of recognition? Does her face light up, just the tiniest bit? He'd like to think so. He tells me, with a tremulous voice, that she squeezed his hand today. Six months ago, she was wrested from the jaws of death, dragged from the wreckage of her car, and FORCED to stay alive, with drugs and tubes. But, what is this life she now leads; what is the life her family now leads?
I walk down the stairs, heavy hearted, doubting myself, my purpose.
And then I see her: Kate. She's 19 this week. She smiles so sweetly at me as she walks towards me, a little awkwardly, as she often is with me. She kisses my cheek, that gentle act of tenderness. She tells me how she has been accepted to college, and we talk about her new life, always skirting around the events of two years ago, when she, too, was dragged from a wrecked car, and from death's cold embrace. And I know: as long as I can, I will always try.
A few years ago I had (indirectly) a message from a bereaved wife of a thirty-something traumatic cardiac arrest patient I attended.
ReplyDeleteAt the time we obtained a ROSC but he was tachy with no resp effort, so I never held much hope for him. Lasted about three days in ITU before the decision was made to switch off.
Pointless waste of effort and resources resulting in false hope for his wife? I thought so until I had the message, which thanked us all for our efforts and for giving her three more precious days with her husband.
Made a bad job seem worthwhile. I can't predict patient outcomes, so just have to do my very best for them while they're in my care. What happens after that, and long-term, is out of my control, but if I didn't do what I do some of them would have no chance whatsoever.
(OK, I know I'm bigging myself up a bit and there'd be someone else there doing it if it wasn't me, but you get my point).
I always considered my ambulance as the 'last chance' taxi.
ReplyDeleteIf we could deliver the patient to the medics, then it was job done.
There was no way, even in casualty, the prognosis of the patient -other than decapitation- could be predicted with accuracy.
A stable, and reasonably viable patient was better than a corpse.
From a relatives point of view:
ReplyDeleteMy father was taken very seriously ill in 1997. He was aged 74 and very overweight with blood pressure issues. A doctor was called immediately and attended him at home. The Dr told my mother that he had simply fainted due to his BP dropping. She has medical training and told him exactly what she had witnessed. Further, she pointed out that my father had lost both bladder and bowl control. The Dr agreed to do a proper examination and then called out an ambulance.
The paramedics were incredible. They got IV access all over his body and started to pump in saline. Once they felt he could be moved themselves and the police manoeuvred him down the stairs flat on a stretcher and proceeded to take him to hospital. The police had been called to provide an escort.
Once at hospital my father was taken straight into surgery where it was found that he had been suffering from an Abdominal Aortic Aneurysm. It was a big one measuring approximately 13cm. The surgical team worked on him all night and into the next morning. Remarkably he came through the surgery and was taken to ICU for 10days. From there he went to High Dependency for three weeks. Then to a ward for a couple of months and then, amazingly, to a local hospital for two weeks of preparing him to come home.
He turned 87 last Tuesday and he is getting frail, his body is letting him down but, thankfully his mind is very sharp. He doesn't remember much from that period of time and what he does remember isn't very accurate. I have never told him the reality of it all, I don't like keeping secrets from him but this is, I feel, for his own good.
My point is this. I know that you are not a paramedic and the situations you find yourself in may not be anything like this in terms of trauma. However, I feel that if you have the opportunity to do *something* then always take it. Even if it ends in the loss of a casualty you will know that you did your best and the family (from my point of view) will thank you for taking the time to try.
I met the two paramedics who helped save my father that night. I thanked them for everything they did. One of them told me that they knew there was very small chance of my father surviving the journey to hospital never mind treatment. They gave him that chance and gave me another 12yrs and counting with my Dad. What else did they say? "We were just doing our job."