The address was straightforward enough – until we got in the neighborhood. The streets curved around and the numerics visible all were for the cross street. We had been told the patient would meet us in the parking lot, then updated information from MedComm was that he was advised to wait in his apartment. Inquiring for an apartment number, we were told the dispatcher would call back to find out. Updated information? The subject was indeed waiting in the parking lot; we were to go to the rear of the building. Finding the alley, we rolled slowly along, our right flood lights illuminating the successive row of apartment buildings. The problem with this method was that the rear of apartment buildings – including these – often does not have numerics displayed. We’d rolled along behind half a dozen when the radio came to life again. “301, caller is on the line again, advises you to come out of alley, take a left and you will see him outside.” We acknowledge, follow directions and emerge from the alley to find a front light across the street furiously winking on, off, on and off again. I flick our floods on and off in acknowledgement but the furious winking does not subside. Driving up alongside the curb directly in front of the door where the light lives does not make it stop, either. Directly beneath the light, cast by turns into stark relief and pitch blackness in paroxysms of the continuing on, off – is our caller. I roll my window down and he barks with extreme agitation, “I said to tell ya, go around back! AROUND BACK!” “Yes, sir, we…..” “GO AROUND BACK!” “yes, sir.”
We go around back, the light collapses in relief I’m sure, as the door closes and darkness falls, for good. Blinking amid the stars dancing in front of my eyes as my partner navigates Around Back, I see a cramped stretch where the woods have been beaten back into grudging submission. In this stretch are numerous vehicles and a dumpster taking up more than its rightful share of space. As we advance cautiously, I see a man hanging back in the shadows against the building. He withdraws further from our headlight beams. He is not the patient, and of this I am certain as a furiously walking man approaches directly towards our front bumper. He is pushing a walker almost as an affront to the air ahead of him. He appears to not need its assistance; rather, it seems an unwilling participant in a charge of righteous indignation. Almost as an avoidance of a certain collision, my partner puts the truck in park. I open my door, place the first boot on my running board.
“YOU SHOULDN’T HAVE PARKED HERE! ICE!” My partner opens her mouth to ask “where-“ he cuts her off “IT’S FINE, LET’S GET GOING!” I tip my head, put a carefully submissive smile on and put myself in the path of the walker. “Sir, my name is-“ he stops me, “JUST GET ME TO THE HOSPITAL”. I open the side door and he collapses the walker, tosses it inside, and is seated on the captain’s chair before I can say a word. Our nature of the call at time of dispatch was “can’t change dressings, sores on legs” so I am not as alarmed as I would’ve been if someone with an unknown problem was so desperate to begin transport. For a moment I think of the man drawing back into the shadows, of the dumpster partially obstructing egress, of the dark strip of woods immediately behind this strip of apartments who’ve seen better days. But I don’t think the patient appears afraid, and I climb inside behind him.
My partner hands me the monitor and I try again. “Sir, my name is Crystal-“ and again I am cut off. He reiterates “LET’S GO” so glancing at my partner and her raised eyebrows, I nod. Maybe I’ll have better luck establishing rapport and getting some information once the truck is in motion. She navigates her way out and I begin to apologize for the slight delay with the address. Mollified now that we are moving, the patient waves aside my apology. Apparently this is not his first transport by our service, as he tells me this happens every time. “Screwed up address. What’s that? I don’t need any of that crap. Just need a ride.” I’m holding the blood pressure cuff and I explain that I do need to ask him a few questions and take some vitals. He isn’t loving it, but he sticks an arm in my direction. His eyes are rolling hard enough to scrape the back of his skull but they return to me quickly as I say, putting the cuff on “I’m really sorry you’re having such a bad night, sir. I’m Crystal, not sure if you caught my name, but I’d sure like to hear how I can try to help. What’s been going on?”
His face softens a smidge and his shoulders sag forward. The hand on the arm I’m taking the blood pressure on is bandaged, seeping yellow – spots dried in concentric circles and new ones visibly damp. The fingers remind me of when I was in elementary school and we would put our fingers in Elmer’s glue, then peel it off when it dried. He tells me in a softer voice that he’s been battling cellulitis on his legs, and he is supposed to change his dressings every three days. Today is day four, and his hands are getting worse. He shows me the other hand, painfully red and swollen to what appears to be maybe twice it’s normal size, judging by the wrist and arm above it. He tells me in this soft voice – still with his brusque, staccato cadence – that both hands have been like that but yesterday the one got “real bad”. He looks at it and then I see it on his face, under the gruff exterior – fear.
“I just can’t even change my leg dressings now, sorry I was such a – well, you know. My right leg is just raw meat, I stink, and it stinks, now my hand-“his voice catches. I shake my head in sympathy but careful not to offend him with any pity. I reach out and hold his hand in my gloved ones. He needs some empathy more than anything I can find in this state of the art truck, so I give him that. I inspect the hand, tell him it looks painful. Ask him how he’s been dealing with the pain. He earnestly describes the non-stop burning, his dwindling independence and his fear that the other hand is soon to follow. His blood pressure taken, I sit back in my seat, computer ignored, and give him a human who will listen.
He tells me he was a HazMat trained first responder at a local business, tells me with pride that he loved learning how to help others. There’s a pause, then, and he looks down at his old boots. In an even quieter voice, he tells me how he couldn’t help his brother though. Hanging out with his brother one night, the brother told him he was not feeling good. Couldn’t catch his breath just right. My patient advised his brother they should go to “the doc”, get it checked out. His brother said if he wasn’t feeling better by morning, he would go. My patient got up every two hours throughout the night. His brother seemed ok, not great but ok. When my patient went in at 7am to see if he was ready to go, his brother was cold – gone.
My patient takes a minute, then. Purses his lips. Nods to himself. Looks up at me. “Of all the people I shoulda helped….ya know?” Somewhere I register in surprise that this patient understands something few people do. I get it – it’s that wish, no matter how many strangers you help, that you could’ve helped a family member. If only you could go back in time. I buried a father at 14 and a brother at 21 but I don’t say any of that. I simply nod, and he nods, watching me. “Yeah, you do know, dontcha?” He says that his brother’s autopsy showed a pulmonary embolism.
After an appropriate amount of respectful time, I turn the conversation to more stable ground. We both love to watch Game of Thrones, it turns out and the remainder of our time is spent laughing about TV shows and actors. Who’d have guessed it? My patient is conversant in Hollywood gossip!
Report given to receiving facility via radio, upon arrival my patient straightens his spine, follows me out the side door. Briskly he pops open the walker and sets off at a furious pace past the nurse meeting us in the garage. The patient told me en route that he brought his own bandages and indicated his trusty walker. He just needed a wound nurse, he said – and he is clearly out to find one. The charge nurse directs him to the triage room, I obtain a signature and bid him farewell. His mask firmly in place again, he nods curtly and says as I leave, “thank ya, lady.”
Waiting for my face sheet at the registration lady’s desk, I’m half listening to her cheerful voice telling me about her Christmas – and half wondering what it must be like to have one halfway healthy limb, out of four.
And that flash of understanding I just shared with a human being almost completely opposite of me in every way. Aren’t we all so very the same, underneath it all? And why does that keep on surprising me after these years on a truck?
Happy Holidays, Happy New Year. May you often in this coming year have someone cross your path that makes you stop, and look at life a little differently.
“I truly believe that everything that we do and everyone that we meet is put in our path for a purpose. There are no accidents; we're all teachers - if we're willing to pay attention to the lessons we learn.” -Marla Gibbs, Actress, 1931-?