This post over at Burned Out Medic reminded me of one of the sickest patients I’ve ever had. It was several years ago, as in probably close to 15, when I was still a relatively new paramedic although had been with the service for almost 18 years.
It was about 0400 on a late fall or early winter morning when we were dispatched to an area of single family, middle class, homes in Sorta Big City. Every city has them, although for the most part EMS providers don’t see them a whole lot. These homes are populated by working or retired people who played by the rules for all their lives. People who pay taxes, take care of their property, demand little from their government other than plowed streets, police and fire protection, and in the rare event they really needed it an ambulance. The type of people that cynical EMS providers might claim don’t exist, but they do in fact exist.
We arrived to the expected single family house to find a car idling in the driveway, a fire truck on the street in front of the address, and a BLS ambulance right behind us. All pretty typical.
As we walked into the parlor (yes, that’s what the owners called it) we found a gentleman in his mid 70s sitting on a wingbacked chair. Slumping more than sitting in actuality. My first impression was “Holy Shit!” Not because he was someone famous, but because he was deathly pale. Take the whitest sheet of paper you’ve ever seen and this man was that white. He was also more diaphoretic and when I touched him, colder than any living person has a right to be. The amazing thing was that he was conscious and able to sit more or less upright. He couldn’t talk much because he was too busy trying to breath, so his son told us his story.
The patient had awoken about 30 minutes or more before we were called not feeling well. Nothing more specific than that other than he kept passing out when he tried to get up to go to the bathroom. So, he did what anyone of that generation would do. He called his son to ask for help. I can empathize because my mother does the same thing and it drives me crazy. His son lived only a few minutes away and did what I did when I lived only a fe minutes from my mother. He drove over to the house to see what was going on. He found his mother trying to help his dad walk down the stairs so he could drive himself to the hospital. Only every time she helped him stand, he passed out.
I know that some of my readers are thinking that these are stupid people, but those readers are wrong. These are self reliant people, even to a fault. The kind of people who don’t ask for help unless there is no alternative.
On with the story.
The son explained all of this while we were busy giving oxygen, checking vital signs, applying the monitor (this was pre 12 lead), and hoping that this nice man wouldn’t die in front of us. Then the son made a request that simply floored us. If you can help us get him to the car, we’ll just drive him to nearby community hospital. That was why they called 9-1-1, not because they wanted us to put him in our ambulance, treat him, or transport him to the hospital. We know you folks are busy with sick people, and we don’t want to bother you. As expected his blood pressure was almost non existent, his pulse was slow, his respiratory rate was fast. His lungs were clear though, so at least we could give him some fluid. We suspected an MI, but it was more guess than anything given the lack of a 12 lead.
We explained that we were in fact there for exactly the type of emergency that they now faced and it was not one bit of a bother to take their dad to the hospital. In fact, we pretty much insisted on it and they finally agreed. Their only demand, if you want to call it that, was that we go to nearby community hospital. We tried to convince them to go to a larger, slightly more distant major teaching hospital, but they had been going to the community hospital for so long that they wouldn’t even consider it. There being no point of entry plan for cardiac cases back then we had no choice other than to transport and hope that the staff at the community hospital would arrange a transport as soon as possible.
The patient got a bit better during transport, his BP had come up, along with his heart rate, and his breathing was less labored. We handed him off at the hospital, did our report, and got back in service.
To this day I don’t know what happened to this nice elderly gentleman, but I hope he did well.
Yes, it’s always the people who need us the most who seem to be most hesitant to call us for help. I just wish we were “bothered” by more people like this and fewer who feel that they are entitled to our service, especially when they don’t need it.
Good post, and even today, there are a few like that still around… My daughter had one Friday night… same thing!
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Sounds like my mom, in her 80’s, she called me at work one day, and asked me come take her to doctor. She said she thought she was having a heart attack, she had all the classic symptoms. She noticed as she went to get gas for the car, and yes she did go get gas. She came home and then called me. I told her to call 911. She told me no, just come take me to the doctor. Now I was working an hour away. I finally told her, she called 911 or I did. She finally agreed, and I told her I was on my way. Made it to my truck in time to the call dispatched on my scanner. Fortunately it wasn’t a heart attack, Turned out for some reason, she had had a drug interaction. Of course then she got a lecture from myself and the doctor about not calling and endangering other people on the road.
Then there was the time she called me, so I wouldn’t be upset when I got home, because she had slipped and fallen while walking, and was still heavily bleeding from the open head wound from hitting the sidewalk. She walked passed the fire station and waited 2 hours to call me, bleeding all the time. Another trip home for me and a trip to the doctor, who was not happy about the 4.5 hour delay.
Every time she should go to the doctor, she says, “we never went to the doctor for things like that when I was growing up on the farm.”
http://burnedoutmedic.com/2010/01/too-considerate/
[…] See? […]
It reminds me of LawDog when he talks about his Nana. The one who, among other tales, extracted her catheter, marched up to the nurse’s desk and told them . . . well, crap, it’s just too much fun NOT to cut and paste:
Next shift puts their heads together and decide that they’re going to Take Steps: they catheterized Gran.
Flushed with victory, they return to the nurses station, just in time to witness my four-foot, ten-inch grandmother place the neatly-rolled, self-extracted catheter on the station desk, while announcing — quite firmly — that she was perfectly capable of going to the bathroom like a civilized human being, thank you very much.
They folded. Wimps.
“Nana,” I suggested, sometime during the next couple of weeks, “You need to tell someone when you’re hurting.”
She squared her little shoulders, fixed me with a gimlet eye, and very firmly stated: “Ladies and gentlemen do notburden others with their pain. It is discourteous, it is rude, and it is simply Not. Done.”
(You can find the rest here if you like: http://thelawdogfiles.blogspot.com/2006/10/you-think-youre-tough.html)