St. Jude

It was early in the evening. My partner and I were expecting to get our 10-19 soon, a call to head back to station for the night. It never came. Instead, we got a call to a nearby cancer center. It seemed a little off, patients are rarely ever transported out of there, especially not by ambulance, but we shrugged it off and took the call anyway. It was an inter-facility transport, the patient was going to a nearby hospice. I wondered why she might possibly need an ambulance for that, but again shrugged it off as an easy call.
We arrived, and I pulled the nurse aside for a report.
"56 year old female. Non-ambulatory, A&O times one, MAYBE. We just gave her some painkillers, she's DNR."
"What's her diagnosis?" I asked, wondering why that wasn't contained in the first few words out of her mouth.
"She's terminal."
"Yea, I got that. Terminal what?"
"Just terminal. What do you mean?"
I rolled my eyes, getting slightly irritated with the oblivious nurse. "'Terminal' is not a disease, a person does not go to the hospital for 'terminal.' What is the original DIAGNOSIS?"
"OH! End stage liver cancer. Terminal liver cancer. Sorry."
"Thanks. Can you give me a copy of the DNR, please? Just put it with her paperwork. And you said she's basically comatose?"
"Yea. She wakes up from time to time, but doesn't really say a lot, just looks around, moans a little. She's not in any pain, like I said. We gave her morphine just a few minutes ago. She's just going to the hospice to umm... Pass..." She said the last word quietly, leaning in towards me and glancing nervously over at the patient's family. I nodded in understanding and headed towards the room. I was trying to keep my demeanor a little more downbeat, no one was in the mood for a 'ray of sunshine' to be walking into the room.
The patient was, as promised, unresponsive. She was a fairly young but fragile looking woman. Her eyes were slightly open, but appeared glazed and extremely jaundiced upon inspection. We moved her very carefully and gently onto our gurney as the family all glared menacingly at us. I suddenly felt like I was the grim reaper himself, coming to take her away from the world. We got her into the rig, I instructed my driver to be incredibly careful as to not disturb the patient, and we went enroute to the hospice.
About 10 minutes into the ride, I heard a moan escape from her. I looked up, and her eyes were wide open, her yellow hands reaching towards me. It frightened me for a moment. I hate to say it, but she was almost zombie-like in her state. I calmed myself, removed my latex gloves and took her hands in mine. I put them gently back in her lap, holding them for a few seconds before letting go. She looked at me again, still moaning quietly as tears fell down her cheeks. Tears welled up in my eyes, and I took her hand again, trying to relax her.
What do you say to a dying woman? I'm sure she knew what was happening, sure she knew it was coming a long time ago. But now it was time, that wait was over. If a patient is dying in the back of my rig, I can usually at least ATTEMPT to stop it. In this case, I was completely helpless against God. Her time had been predetermined and there was nothing I could do to intervene, even momentarily. As we pulled into the hospice and brought her in, she gasped one final time and then was silent. I looked up at the nurse I had started to give a report to with sheer terror and urgency in my face. "Put her in her room, I'll wait for the family," she said quietly. I nodded and fought back the urge to cry again. As we left, I saw her family pull in behind us. I looked away, not wanting one of them to catch my eye and see in my face that she hadn't made it.

I've never been a religious person. I have been to church a few times, but could not understand the undying faith people had in an entity they had never seen, never touched, never talked to. Working in this field, it's hard to believe in a God that would let good people die on the side of the freeway, or keep little babies from seeing their 1st birthday. Some EMTs believe that the Saint of EMS is St. Jude. The patron Saint of 'hopeless' or 'lost' causes. The belief is that when all else fails, pray to St. Jude to help you.
I prayed that night to St. Jude. I understood a little more what it meant to have that faith that someone is with you, that you aren't alone, even when it seems completely hopeless. I don't know much about religion, I don't know how true anything in the Bible really is, but it's nice to think that there might be someone at my side, especially when I feel helpless against that greater power that might take my patients from me.

Over and out-
thePSYCHwrangler