A Day in the Life

I was standing outside my car, filling it with gas in the rain, when I looked at my reflection in the side window. My face looked hollow and somber, and the rain running in rivulets down the glass panes created the impression that I was drowning in tears. I had just finished an intense 24-hour shift as a paramedic. It was the day before Christmas, but I felt strangely distant from the festive decorations and holiday ambience that was apparent everywhere.

We had experienced a busy shift of one life-or-death call after another. While one might expect emotions to run high under such drastic conditions, I was desperately trying to gain a more positive understanding of the realities I had witnessed that day.

A Routine Beginning

Our first call seemed routine enough: an elderly man who appeared to have suffered a stroke. His wife met us at the door, rather distressed, explaining that her husband was “at it again.” While I’d expect her to display grief, this looked more like anger. The man was seated on a kitchen chair and his skin had that waxen pale look of someone not doing well. She must have recognized this: We’d been summoned by her 9-1-1 call. The man couldn’t speak, only moan and sigh. His face was contorted, with the left side in an obvious slump. His hands responded weakly when I asked him to squeeze mine, and his blood pressure was low.

The wife continued to appear miffed that he had chosen this day to “act up,” and was unable to answer the most mundane questions about his medical history or condition. One of my crew went with her to look at medications in the bathroom with the hope that we might be able to learn more. We gave the husband oxygen, started an IV with fluid and looked at his basically normal heart rhythm on the monitor. He still appeared to be a simple stroke patient who would require a hospital stay, medical direction and treatment, and probably rehabilitation, depending on the severity of the stroke.

His wife came back in the room and apologized for the mess in the house. I looked around and saw that everything was immaculate except for her husband, who had been draped over the table, and now was being unceremoniously moved onto our stretcher. I asked her if she would like to ride to the emergency department with us, but she informed us she had to clean up first, and added that she had been cleaning up after him for quite a few years now. I told her that we would take good care of him and she looked directly at me and said, “Yes, I know that you will,” with an assured tone of voice.

We moved inside the ambulance and the man’s heart suddenly slowed, as if triggered by his escape from the house. He stopped breathing and we began the familiar sequence of efforts known as the “crazy code shuffle” with one paramedic and three EMTs in the back of our small ambulance. We worked steadily with practiced form to establish a secure airway and administer the proper medications to save the old man.

Our concentrated efforts were interrupted by rapid knocking on the ambulance compartment’s back door. Outside was the patient’s wife with freshly applied makeup and a determined look upon her face.

I asked one of my partners to open the door and tell her we would be delayed.

“I don’t want to talk to her,” he said. No one looks forward to telling a family member about this sort of thing.

The wife spoke loudly through the doors. “Young men, you have to move your vehicle if I am to be able to move my car.” Billy reluctantly opened the back door a crack and told her we were working to help her husband breathe and would be moving shortly. The wife looked up in exasperation and proceeded back to her house.

At the ED, it was utter chaos, with the Christmas rush of people in all forms of illness. I had radioed to advise that we were coming in hot with an arrest, and barely got a response. We transferred the man—whose heart rate was being paced with energy from our cardiac monitor, with little success.