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Wednesday, June 30, 2010

Her Cry for Help

She was rather pretty. And in pain. Scared.

The dispatch sent us to a "hemorrhage with abnormal breathing", which was nice and vague, and could be really anything. While responding, additional information came down that this patient was suffering from an incurable condition, and was vomiting.

Engine 51 and I were first due, and I was trying to be ready for whatever.

Let's see..... bleeder (source unknown) equals big band aid box, breathing trouble equals airway bag and 02, vomiting equals suction unit, and the general what-the-heck-are-we-getting-into vibe might equal an AED if a free hand remains.

Ready to go to war el solo, I walked in and found a young lady seated primly on a living room chair, coat on, purse at her feet.

Fire Department. Did you call?

Yes.

..... Where is the sick person?

It's me.

(Oh. No blood. No gasping for air. ........ OK.)

Bleeding? She claimed trace amounts of blood in her vomit (the nausea a response to her pain). Any left for me to evaluate the amount of blood loss? No, it was flushed down.

Trouble breathing? Only on deep breaths, because of the pain. Color normal, skin is cool and she is sweating a little bit.

The pain. She's tired and somewhat gaunt. She had been crying, and was getting close to more tears. She started telling me her story.

I was finishing my initial assessment and vitals, and not finding anything urgently wrong, as the rest of the cavalry arrived.

The medic asked her more questions, and I had time to look around. Pictures on the walls and bookshelves showed a much more vibrant version of our patient, perfect smile and cheekbones the envy of many models, fabulous blonde locks, clearly the life of any social gathering. Back then.

Long story shorter, she was in pain. Things were not going to get better. Her pain meds were not getting it done, and she did what everyone does when they don't know who else to call. 911 will make it all better.

Except this time, we can't. The medics explain that they can't really do anything more than what she's already got, but perhaps the hospital can.

Then, the tears again. She'd tried the hospital and run into some sort of roadblock with her insurance carrier, and she was afraid of going outside of their coverage because of the expense. We were her last hope for more relief, and we have nothing of substance to offer except an expensive ride to the ER for expensive interventions, which she hoped to avoid.

I am torn a little. She clearly knew the magic words to tell the dispatcher to get us in her living room when there was no emergency. We hate that. But all of her doors were closing, and we had nothing to offer, no way to save the day. We hate that.

The pain was real enough, as you could see in her face, but it was the fear that was taking over. And that led her to take advantage of us. We hate that, but we get it, too. Maybe I am rationalizing so as to not be angry.

There has to be more to the story. No caretaker? No family? No friends?

She signed a refusal, and cried softly.

If I ran 10-20 calls a day, I know I would blow this off and just be irritated before forgetting about it, but I don't, so I can't.


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