Going home to die

Most people think of ambulances in terms of emergencies: lights, sirens, broken glass, blood, and pain. However, most of our work is just helping people who need a hand. They are too sick to walk to the car and ride to the hospital. Or they fell in the bathroom and need help getting up and back to bed. It's just part of the job; it's not glamorous or exciting.

Yet, sometimes they are most rewarding because you actually get to deal with the patient as a person, not as a problem that needs to be fixed. In a real emergency, there is often no time to ask about a name, hometown, or shared interests. It's all asses and elbows, frantically trying to hold the line until the hand off at the ER. While exhilarating, it quite honestly sucks.

We had sad but rewarding one yesterday. We took a transfer from the local hospital to a residence in the county. It was an older man with cancer, and he was going home for hospice care. Everybody knew, even the patient, that this was it. There was no more negotiation, no hopeful miracle. There was nothing more to be done, and now it's just an awful waiting game.

He was quite cheerful, a long time farmer, and told us stories about the area and households as we bumped down dirt roads to his house. As always, the family was waiting for us with smiles and good spirits. Yet, when they turned away or the patient wasn't looking, their faces fell. There were lots of hugs, and people kept stepping out of room to get control of their emotions.

As always, the hospice bed was set up in the front room so that there would be space for visitors and for hospice nurses to work. As always, the bed was positioned so the patient could look out the window.

We carefully brought the patient up the steps on our stretcher and rolled him next to the bed. Taking extra care, we adjusted the sheet he was lying on so we can lift and slide him over. We really didn't need their help, but I usually ask if the family could give us a hand, especially if men or the younger generation are standing there. They almost always lunge at the chance. They feel so helpless and want to be able to do something - anything... The patient winced as we gently lifted him up and moved him to the bed.

We tucked the patient in and answered any questions we could. Hands were shook, and I used my favorite parting line, which always gets a laugh, "I hope I never see you again."

We said our goodbyes and loaded the stretcher in the ambulance. We climbed into the cab and sat there for a long moment. Then, as always, a version of an eternal conversation happened. "That sucks," one of us said. Long pause. "Yep. Makes you think...," replied the other. Long pause. "I think I'll call my wife..." And off we drove to the next one.