Posted by: medicblog999 | August 16, 2009

From one extreme to the other

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There is always someone who can come along and remind  me why I  love this job so much. To offset the aggression of last nights post I would like to share with you a job that recently made me feel very lucky to be a paramedic.

Its a shame I have to change the details on this case, as I would love it if I could let the family involved know about the blog and that I have wrote about them. I would like for them to realise the impact they had on me, but confidentiality comes first, so as usual, various details have been changed to protect the patients and their families identity.

This was one of those cases where I stayed on scene much longer that was medically required, but I think it was time well spent. Sometimes a shoulder to cry on and an ear to talk to is just as important as a drug.

Called to a 42 yr old female fitting.

Im working on the car so as I arrived, I unloaded all of my kit and made my way into the house. I was met by a man called Tom who looked very sheepish and very tired.

M999: “Good evening Sir, where is she?”

Tom: “She is just through there, she is angry that I called you, she says she is fine now”

M999: “Thats Ok, I’ll give her a quick check over and see what is going on and if she needs any help. Whats her name?”

Tom: “Its Sam”

I walk into the front room in this small house. I notice a lady sitting on the sofa, with a young  girl next to her,  clinging on to her arm, sobbing. She watches me as I enter the room with a look of suspicion on her face.

Sam, looks a little out of it, without even asking any questions, I can see that I am dealing with a cancer patient. She has patchy hair, and has that very recognisable gaunt look in her face. I very quickly realise this is more than just a simple fit. I introduce myself to Sam, and ask her whats been happening.

Tom steps in and tells me her medical history.

 She has been getting very confused recently and tends not to say much. She has terminal breast cancer which has spread to her brain and lungs. She has a ‘huge’ tumour in her brain which is causing her to have multiple fits each day, and that seems to be the main problem for her at the moment.

Tonight, she was walking through to the kitchen when her legs suddenly gave way and she fell to floor, hitting her arm off a table before landing face down on the carpeted hallway floor. Tom had tried to help her back up but was finding it difficult to carry her back to the front room. He eventually managed, but by this time his daughter (aged 9) had come downstairs. At the same time as Tom was trying to care for Sam, he also had to try and deal with his daughter who obviously thought that this might be the end for her mum and had started hyperventilating and crying hysterically, clinging onto her mothers arm with all her might. Somehow, Tom managed to coach his daughters respiration’s to calm her down and comfort  her and at the same time, care for his wife, who was now coming out of the fit, but acting in a very confused and post ictal way.

Tom prides himself with caring for Sam. He has input from both Marie Curie nurses and his GP, but so far he has refused all types of inpatient respite care, as he feels it is his duty to be the one to care for his wife. He is on long term leave from his job and he has dedicated his life to trying to be there for Sam until the day they part.

Tom tells me that he has finally agreed to Sam going into the local hospice for a week for some respite care, but he cannot get past the thought that he is abandoning her, when it should be him looking after her.

I quickly assess Sam and look for any signs of injury or reason for a trip to hospital, but find nothing new. All of her obs are fine, I can move her arm through a full range of movement without any apparent discomfort. If I ask her any questions, she answers, but only after a short delay whilst things seem to get processed before a considered, but slightly confused and slurred answer comes out (again, this is all normal for her)

M999: “Well, there doesn’t seem to be anything new going on here. It appears that there are no new injuries from the fall or the fit, so I don’t think she needs to go to hospital at this point in time.”

Tom: “That’s great, I’m really sorry I called you out. Its just I had no-one to call with it being the weekend. I know I shouldn’t call 999, I hope you  don’t think I was wasting your time, its just sometimes I don’t know if I am doing the right thing or not. One of my friends is a GP and I usually ring him, but he is on holiday and I just didn’t know what to do. I’m really sorry!”

Why is it that some of the most genuine patients hold off from calling 999?

M999: “Tom, you have to stop thinking like that. We are here for those who need us. Most people who ring, don’t need an ambulance, some of them abuse the system and some just aren’t aware of the correct people to ring. Every now and then, we get a ‘proper’ patient who is having a serious medical or traumatic problem, and then there are some people out there in your situation, doing their very best caring for a loved one in very difficult situations. I have no problem whatsoever coming out to see you and checking over Sam. Its a privilege to be invited into your home and witness such a loving family. We are here 24 hours a day, 7 days a week. If ever you need help just call 999 and someone will be here to help you”

Tom: “Sometimes I cant support her weight when her legs give way and I have to leave her on the floor until I can get some help to get her up. She had to stay on the floor for 50 minutes until my brother came round to help the other day”

As Tom is saying this, his eyes start to well up and I can sense the despair that he is trying to keep out of view from his wife and his child.

Tom: “I want to keep her at home, I really do, but the doctors say things are going to progress quickly. I know I need a break, and Im sure she will be looked after in the hospice, but she should be with me…….till the end”

M999: “I know, but you need your strength too. You need to recharge your batteries so that you can be here for her. I can tell you are struggling. I cannot imagine what you are all going through, it must be so hard. But you are an amazing family and I know you can deal with almost everything when you are together, and when things get too much you can ring us and we will step in”

Tom: “I know, but she will just get upset with me again if I call you”

I look over to Sam who is now coming around a little more. She is gently stroking her daughters hand in hers.

M999: “Sam, I have checked you over and you seem ok now, I don’t think you need to go to hospital. Is that okay?”

She nods and has a little smile. Her eyes twinkle for a moment when she smiles, then as her smile drops back down, the sadness returns like a veil.

M999: “The days of calling an ambulance meaning that you have to go to hospital are long gone now. You can ring us whenever you want and we will come out and check everything is ok. If all is well, I can reassure you of that, but if you (addressed to Tom) are concerned about anything or there seems to be something new going on, then we can sort something out and get you (addressed to Sam) to the right people to help you. You are not an inappropriate caller, you are a long way from that!”

Sam nods to me and smiles again. Tom goes over to the sofa and has a cuddle with his  girl and his wife. I feel a little bit like I am intruding now, so quickly finish off my paperwork and start to say my goodbyes.

Tom thanks me for my help and shakes my hand.

Tom: “Thanks for everything Mark, Ive never had to call an ambulance before, but thank you!”

M999: “Its my pleasure Tom, anytime”

Then came the bit that really hit home for me.

Sam struggled to her feet, she was very unsteady and at one point I thought she was going to fall backwards onto the sofa.

M999: “Its okay Sam, just sit there for a little while, we don’t want you falling over do we?”

Up until this point Sam had only spoken very few words and some of them appeared to be more of a confused speech than a specific response to a direct question, but in a quiet voice she said:

“Thank you Mark, you have been wonderful. I didn’t understand everything you have said, but I know you have been a great help. Tom is finding it really hard…..and the girls too. Thank you for what you have done for us”

And with that she leaned over and gave me a hug……………

 

I am a very lucky man.

I am lucky to be in a position to help others

I am lucky to have a family at home in good health

I am lucky that I don’t have to look at my beautiful wife and see her slowly dying before my eyes.

I am lucky that I don’t have to look at my beautiful children and see nothing but fear and sadness hidden their eyes.

I am lucky that when I get home in the morning I will be cuddled into my wife, listening to her quietly breathing and hoping for many more years together.

I am lucky…..

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Responses

  1. […] See original here: From one extreme to the other […]

  2. Reading this story brought tears to my eyes because I know the family you have described are going through lots of pain at the minute and it makes me think how lucky me and my family and lots of other families are because they are in good health. You do a brilliant job Mark and so do all paramedics you deserve lots of credit which you sadly don’t get all the time.

  3. Wow. A staggering situation. There for the grace of God etc etc. Terrific writing from you. The strength and love in that family come through in your words.

  4. Dang it Mark! I’m not supposed to get a tear in my eye from surfing the net…

    It all comes down to this. I’m a religious man and I realize that some aren’t and that’s ok with me, but when you approach EMS with the Heart of a Servant and you realize how lucky you are to be able to touch people like you are… well then significant moments and gifts like these aren’t lost on you.

    When my kid (and future kids) ask me why I wasted their chance at a college fund and an inheritance by being a paramedic… I’ll tell them my similar stories like this and hope they can understand.

    Great post buddy.

  5. Darn it, Mark, I’m going to have to stop reading you blog at work. Sniffling in the crew room is not cool. 🙂

    Good job.

  6. Wow, what an incredible piece of writing, and what an amazing story you told. I will hug my husband and son just a little bit tighter tonight!

  7. It is important that people realise they can call us when they have no other option or even when they do. For us just to be a listening pair of ears will help no end.

    If only the people such as those that put a bottle through an ambulance window in London the other day would realise how impeding they are.

  8. […] back, it seems minor stuff compared to what I see at work sometimes. I think I need to go and read ‘from one extreme to another again’ and give myself a shake and a slap around the […]


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