Stories from the Streets: Compassionate Care
I spent nearly an hour in her home, talking with her friend, learning why she refused to get out of bed, refused to stop drinking and refused to join the rest of us in life. Her boss had been there earlier, poured two bottles of vodka down the drain and left with her wallet so she couldn’t get more. She had no family to speak of, just a brother in Maine whom she didn’t speak with; parents dead, and her husband of 20 years dead since August.
A giant black German shepherd cried incessantly at the rear door during what I call negotiations; eventually I let him in and befriended him. You can read a lot from the look in a dog’s eyes, and this big guy was inconsolable. I think that may have been the breaking point—she showed some signs of life once the being closest to her showed concern. She got out of bed, threw on some clothes and gave in.
“I’ll go.”
Her friend closed up the house, promised to take care of the dog and simply looked relieved as this drama seemed to be heading in the right direction. A friendship with an alcoholic is trying, disappointing and frustrating, but ultimately worth the trouble once the disease is put on hold. A cure is unlikely; remission of symptoms and effects are the best one can hope for. Remembering that this is not a bad person trying to be good—but a sick person trying to get well—puts things into perspective, and lets some hope for recovery seep in.
What had started as a seemingly hopeless standoff actually looked like it might have some sort of happy ending. I’ve done this a few times, and it’s never easy. Somebody is refusing to take care of themselves—drinking, not eating, not bathing and just waiting to die. I cannot make them get help if they don’t want to. Just because somebody else thinks it’s in their best interest to get on with things is no reason to drag somebody from their home and force them to rejoin society. It’s still a free country. We are free to thrive, or not.
That being said, I’m free to use all of my powers of persuasion to make a difference. It’s one of my strengths as an EMT. Some of us are great clinicians, others born to teach. I’m more of a therapist. Every now and then I get the tough stick or impossible tube, but talking has always been my strong point. Even if it’s just talking to the dog that makes the patient pay attention, get dressed and get in the rescue. Whatever works.
We rode to the hospital, me and this desperate 44-year-old widow. She was still reluctant to give up the life she had been living since her husband’s death. But she had the courage to get going, this being the first step. I did my best to explain the procedure at the ER—how it can be cold and impersonal at first, but when she gets to her room and wakes in the morning the healing can begin, for real. I think she believed me.
I had her on the stretcher because she really couldn’t walk that well. We wheeled her into the busy ER. The triage nurse barely glanced in our direction.
“Can she get off the stretcher?”
“Not really.”
“What do you mean, ‘not really?’” A look of disgust from the RN.
“She’s hurting.”
“We don’t have any beds. Put her in a chair and throw her in the waiting room.”
Throw her. I swear to god that is what she said.
When you lose perspective and compassion, it’s time to find a new job. Maybe administration, maybe retirement, I don’t know, but get the hell out of the ER.
Perhaps if she had spent an hour in this patient’s home—seen the wedding pictures over the mantle; the notes from her dead husband still on the refrigerator; the dog, well taken care of and still mourning the loss of his master; the NASCAR posters and cars in the living room; the man’s sneakers still in their spot, only unfilled for five months now (probably longer, considering he fought a two year battle against cancer)—she wouldn’t have said, “throw her in the waiting room.”
After explaining the situation, and seeing my words fall on deaf ears, I realized the RN actually would have left her there, alone, to rot.
I swear I will never be that kind of person, no matter what comes my way.
I stayed with her until I found another nurse, and a compassionate registrar, and made sure she was OK.
Her friend walked in and I left the hospital; all I can do is hope for the best. People make our healthcare system work. When some of those people are broken, the entire system suffers. A broken link in the chain of patient care can throw all the good done up until that point into the trash, rendering everything we’ve done useless.
Michael Morse, EMT-C, is captain of Rescue 5 in Providence, RI, and has served on the city's busiest engine, ladder and rescue squads as a firefighter, rescue technician and lieutenant during his 21-year career. He is the author of the books Rescuing Providence and Responding.
