From the archives…
There was some discussion on Twitter tonight about service to ones Country… I don’t care what branch you are currently with or were in. To all of you out there who served… Thank you.
While in Basic school, many things are drilled into your head.
What you don’t document didn’t happen.
Pack a lunch.
You know, the important things.
I’d like to add something to the list. Don’t ever become complacent while doing transfers.
Now before you start jumping to conclusions, I’m not talking about the dialysis transfer that codes on you. I’m not talking about the ECF patient being abused by staff, or the elderly patient being neglected by their family. (Also something that I’ve encountered.)
Those types of runs apply, certainly. But that’s not what I’m going for here. I’m talking about those honest to goodness regular everyday transfer runs. The hospice runs where nothing goes awry. The dialysis transfers where the only intervention needed is a couple of blankets. The ECF to Podiatrist appointments where the patient gets their toenails clipped. Those runs that many of us do every single day. The ones where we sometimes get annoyed because we’re carrying fifteen bags in addition to the patient on the stretcher. The ones that piss us off because we’re just sick and tired of being verbally attacked by the patient, or their family, or even the nursing staff. The ones where you find yourself groaning, “Oh Lord, please, not another transfer.”
“Unit 33, I have a run for you, let me know when you’re ready for the info.”
The sun was out in full force beating down on us in the little ambulance with no air conditioning. I would be lying if I said that my partner J and I were both more than a little cranky after having sweated our backsides off for the last six hours. As bad as we felt after stewing in our own juices for so long (six hours is a long time for us Yankee’s to be boiling in 100 degree heat!), we felt worse for our patients. We had both made promises that we would be talking to management about the pitiful attempt at a/c that our truck for the day was making.
J was driving. He picked up the radio. “Go ahead, Dispatch.”
“Go to Big City Hospital, room 4118 bed one and take them to Midwest Hospice.”
“We’re clear, put us enroute,” J responded. He turned to me instantly. “ANOTHER transfer? Can’t they give us five minutes to get a drink?”
“We’re busy… It’s good for them.” I swallowed the last sip of my water bottle. The truth was that I was just as tired and sweaty as he was. I didn’t want this next run any more than he did. That being said, knowing the owners and where they were coming from, knowing that this would be a run where they would actually get *paid*… Well, when you keep that all in mind and remember that the owners sign your checks. It does make things a little easier. Even when it’s 100 degrees outside and you swear it’s at least twice that in the back of the truck.
We found him laying in a hospital bed, and not so happy about it. He had already emptied the contents of his lunch tray on the floor of his room.
“I’m not going ANYWHERE, you HEAR ME???” Words and saliva were flying faster than I could react. Mr. Johnson was mad as hell, and everyone on the ninth floor of this hospital knew it from those who clean the patients rooms to the charge nurse. We had heard him from the very second we exited the elevators. Twelve rooms down from where he had spent the last three weeks. Apparently Mr. Johnson was feeling feisty today.
“Mr. Johnson, Mr. Johnson,” I rested my hands on the side rail of his bed. “My name is Epi, I know you’re a little apprehensive about –”
“You son of a bitch, I’m not going anywhere!” He screamed, spraying me in spit. All of a sudden I was extremely happy to be BSI’d to the hilt, courtesy of a Nurse who knew why he was on contact precautions.
I wasn’t sure what to say. “I’m sorry medicare wont pay for you to stay in a hospital any longer… We’re taking you to Hospice to die,” surely wasn’t appropriate, as frustrated as I was getting.
“Please, Mr. Johnson, stop spitting on me. We’re here to take you to another hospital. There are amazing people there and they’ll take VERY good care of you,” I started. I paused, searching for the right words. I prayed they’d come to me quickly.
“Wh-wh-ere are you taking me?” His voice was shaking, the first time he had actually spoken to me as opposed to screaming.
I searched the room for something to talk about other than where he was going. Pictures of grandchildren, a sports team he followed, “Get Well Soon” cards… Anything. I couldn’t find anything. Despite the fact that he had been there for so long there was no proof of it. No family members present, no flowers or balloons, nothing remarkable to speak of.
Except a navy blue Vietnam Veteran baseball cap with some pins on it sitting comfortably on his bald head.
“Sir,” I started, “I see you’re an Army man. I was in the Army myself. Thank you for your service.”
“You were in the Army? Did you see any action?” Mr. Johnson perked up.
“No Sir, wish I had the opportunity.” I wasn’t lying either.
“I was in ‘Nam from 1968 ’till 1972. I tried to go back after that but this god damned knee wouldn’t let me.” He motioned towards his right knee, he even pulled up his hospital gown to show me the scar. “Sonofabitch is fulla shrapnel.”
I groaned, while nodding. “I gotcha Sir. That must have been disappointing for you.” I would have talked to him about anything at this point if it kept him calm. Telling someone who has not been prepared for the fact that you are taking them to a facility for the terminally ill so that they can end their life at peace and (hopefully) pain free isn’t the easiest conversation. It seems as if myself and my partner has been thrust into this position more and more lately.
I’ve said it before and I’ll say it again, I don’t make enough for the job I do. None of us do. Private, Muni, Vollie, or other.
“Sir,” I started slowly making direct eye contact with him, “We’re going to take you to another hospital. The staff there, the nurses and the doctors, they’ll be able to better manage your pain. You’ll have your own room, good food, a TV and DVD player to watch some movies…”
“Well hell, that sounds purty good,” Mr. Johnson responded, straightening his hat.
I was driving while J was in back with Mr. Johnson. In hindsight, I should have taken patient care. I had established that bond. J had been a little put off, and as a result he ended verbally berated by our patient for an entire hour and a half long transport time. When we pulled up to Midwest Hospice J sprung out of the back of the truck with renewed energy. “Well, we’re here, Mr. Johnson, let’s get you off of this uncomfortable stretcher and into your cozy bed!”
“Fuck you, you dirty bastard!” Mr. Johnson yelled back.
Here we go again.
For my part, I lowered the stretcher legs while J pulled it out of the back of the truck. We barely paused at the front desk when the secretary mumbled “Room Three-Seventy-Two. Follow the long hallway up to the right and catch the elevator to the–”
“We know the way,” J returned flatly, sprinting towards the elevator.
One of my favorite Hospice Nurses at this facility met us halfway down the hallway. “Any family coming,” he asked under his breath. He was doubletiming it just to keep up with us while simultaneously flipping through a copy of Mr. Johnson’s chart.
“No.” J and I said in unison. It was unusual that there wouldn’t be someone to go with the patient to Hospice. Considering this patient’s mental state, I was to the point where I couldn’t blame them. He was an older gentleman, very set in his ways. He was hardcore. He was also confused and afraid. Probably two emotions he wasn’t terribly comfortable with.
I thought I knew him. Or at least the type of patient he was. Turns out I didn’t know him at all, and at the same time, I knew him very well.
We had managed to “unload” Mr. Johnson as quickly and as comfortably as possible. We were done, he was comfortably resting in his new bed. His care and paperwork had been transferred to my favorite hospice Nurse.
As much as I had hoped to bond with him, and I felt like I had, he was off of our stretcher now and we were quickly approaching being “back in service”. We were making the cot in the parking lot with a flat sheet I stole from a random closet in the facility when the unexpected happened. A vehicle pulled up alongside our ambulance, a simple dark green Toyota Corolla. I recognized the driver as a close elementary and high school friend immediately. She eyed me suspiciously before she smiled, lowering her oversized sunglasses. “Epi! Hey girlfriend!”
“Tammy, Oh my GOODNESS, how have you been?” I couldn’t believe it, I hadn’t seen her in at least ten years. Her cousin, my junior prom date, was sitting shotgun. He waved, smiling with the same goofy grin I remember from all those years ago.
“I think you just brought my Dad in,” Tammy said, her smile slowly fading into the look that most of my Hospice family members wear. I knew the look well. It was the look of a caregiver. A caregiver who has spent the last year plus holding their breath while their loved one skipped amongst the border between life and death.
Oh Gawd No. Not Tammy’s Dad. Not Cary.
I always assumed that Cary was Tammy’s biological father. I hadn’t known that he was actually her Stepfather. I felt my stomach turn as I walked towards the drivers side of the car. “Tammy, I… I had no idea.”
She nodded, “He’s lost a tremendous amount of weight,” she tried to explain. “He doesn’t look anything like he did before he got the cancer.”
“Tam, I’m so sorry. How’s your Momma holding up?”
“She passed away last year. In here, actually,” Tammy motioned towards the building we had just come out of. “They were so amazing with her, and they took such great care of us too. When Pop got sick in January, when they told us that his cancer was terminal… We knew we had to get him in here.” Tammy’s face wore a sad, tired, smile. “I know they’ll do a better job with him than Kevin and I could.”
“It’s exhausting, Tam. I know you beat yourself into the ground every day for him. I know you. You deserve the break, and you know they’ll treat him like a king.” I squeezed her hand. “If you need anything, anything at all, call me.” I scribbled down my cell phone number and handed it to her.
“Did he do okay on the ride over? We tried to prepare him the best we could, we even cleaned out his hospital room and brought everything here so he would have some familiar things, pictures and such, around. I dont think he was understanding everything that was going on…”
I flashed back to his empty hospital room and how angry Cary, Mr. Johnson, was. “Tam, he was a little confused, but he did fine. I made sure the staff knew to talk to him about the Army. That seems to calm him down a little.”
Tammy laughed, “It sure does. We’re gonna go in, thank you for taking care of him, Epi.”
“No problem. Give me a call, I’m serious. It’s been too long.” I headed back towards the ambulance and climbed into the driver’s seat and fell apart.
Tammy’s phone call finally came two weeks later. She was crying. I knew Cary had died before she even spoke. As much as I had wanted to, I couldn’t bring myself to visit him while he was at Hospice. It was too hard to see him that way. I felt like a coward for it.
“The funeral is on Monday, Epi… Do you think you could come?”
“Tam, I’ll do my best. I’m supposed to work but–”
Tammy cut me off, “Then you go to work. You do so much good there, Epi. Dad would want it that way.”
I choked back more tears.
And on that Monday, in an anonymous cemetery somewhere in the mid-west, another Soldier was buried. Someone’s Hero. Someone’s Daddy. Someone’s Uncle. Someone’s Husband. Our Patient.
Godspeed, Mr. Johnson.