Shakabuku: a swift, spiritual kick to the head that alters your reality forever. (from the movie, Grosse Pointe Blank)
We, as emergency medical professionals, are not here for our own benefit. We do not go through the training, long hours, low pay just to feel better about ourselves. These truths often get lost, when it’s oh-dark-thirty in the morning, we haven’t slept in 18 hours and there are still 6 hours left in the shift.
The run is just like every other run. We are called to a nursing home for altered mental status, nausea and vomiting. We are tired, it’s dark out and I have it stuck in my head that this is another BS run that could have waited until the sun rose. I can’t seem to shake the grumpy out of my mind, but as always I put on my show face and act like the professional. The woman is in her sixties, she doesn’t look overly well and her family is waiting with her. The family could be a blessing or a curse.
I get the usual run down from the nursing home staff. The patient is not very responsive; I believe I gave her a Glasgow Coma Scale of 10. I knew something just wasn’t right, but combing through the stack of paperwork that was shoveled into my hand was not feasible. The patient’s daughter started to provide some information. The patient’s name was Sue, she is 63 and this is her third bout with cancer. The first two rounds of radiation and chemo treatments were successful. Each time the cancer sprouted in a different location, the third time in five years. I am immediately astonished that Sue has been subjected to chemo twice already and was doing well, until today. She began feeling sick and vomiting. Sue had a fever and her lung sounds were junky. Sue needed a doctor, without a doubt; there was not much I could do for her. I began my usual assessment, with family members present was asking questions and telling them what I was doing. The daughter told me that in the two previous battles with cancer Sue never once got sick. I first found this hard to believe, but I suppose it could be true. The daughter began to cry while giving me the medical history of her mother.
That’s when it suddenly occurred to me, the daughter had just realized that losing her mother is a real possibility. She was scared. I had to quickly change my thought pattern, mannerisms and intonation. I was not only here to care for Sue, but I had to provide emotional support for her daughter.
I was not prepared to provide this service for the family and I did not begin this run with the correct attitude. I had a quick one eighty and began explaining what I thought was going on with Sue at the moment, and what they might do at the hospital.
The entire transport to the hospital I would perform my interventions and explain what I was doing to the daughter in the front seat. Sue was marginally better at the hospital. The daughter expressed her gratitude for all we had done multiple times. The few times we get to make a difference is not always related to patient care. I remember those few, the ones who needed someone to explain what was going on and provide a little encouragement (not false hopes).