Communication

Three of his twelve kids hovered around him, making sure we did everything right.

"He's a great dad," one of his daughters said as we gently secured him to the stair chair.

"Obviously," I replied, noting the concern on the families faces. It's gratifying to see a family come together at times like these, a true testament to the character of the patient entrusted to my care.

He had a brief period of unresponsiveness before we arrived. His blood pressure was high, 168/120, his heart racing at nearly 150 beats a minute. Skin warm and dry, he must be fighting an infection of some sort.

"How are you feeling, Joe," I asked.

"He has Alzheimer's," said another of his daughters. "He comes and goes now. Right now he's not aware of anything."

The family members stood back as we wheeled out of his home, the place he raised twelve children. I imagined the living room as it used to be, orderly chaos, kids things, books, crayons and toys rather than medical equipment and empty space.

He met his wife in Portugal some sixty years ago. He was a fisherman, she said he was special. More kids arrived as we got ready to transport him to the hospital. He managed to look me in the eye as I carried him down the freshly shoveled front stairs and into the cold.

"How long has had Alzheimer's," I asked the daughter who accompanied us in the rescue.

"About a year and a half," she replied, leaning over to hold his hand. He stared intently at his daughter as we drove.

"Have you been able to communicate with him at all?"

"We communicate just fine, she said. We're not ready to let him go, not yet."

"Joe," I said, shaking his shoulder from my seat behind him, "are you in any pain?"

I didn't think he would answer but you never know.

"He can't hear you," said his daughter, never breaking eye contact with her dad.
"He was born deaf and mute."

Great dad indeed.

I Know

"Besides the allergic reaction do you have any other medical problems?"

The question is part of our patient assessment, one we ask every patient under our care. Beatrice, a forty-four year old woman suffering from a possible allergic reaction to hair detangler lay on my stretcher, oxygen mask covering her swollen but pretty face and answered quietly.

"I have an under active thyroid, Acid reflux, and...Multiple Myeloma."

I stopped writing and took a closer look. Of course, I thought. Her close cropped hair was in stark contrast to the images displayed in the family portraits that decorated her living room. The swelling in her face wasn't a result of the allergic reaction, rather a prolonged battle with cancer. I've seen the look before, close to home.

"You mentioned the Multiple Myeloma last," I said to her.

"I know."

Ninety-nine out of a hundred people would have told me about the cancer before I had two feet in their door. It is all consuming, a diagnosis as frightening as that, tough to get out of your mind.

"You are going to survive," I said, not really sure why I said it.

"I know."

Stragglers

Despite some nasty weather the party went on. New Years Eve, 2008 was memorable for a lot of people, and better off forgotten by others. Six revelers crossed my path last night, lonely stragglers abandoned by their friends, left to battle the elements and fend for themselves. The first we found barefoot in a snowbank, semi-conscious and semi-dressed. How she ended up alone, heavily intoxicated and lost is a mystery. We wrapped her in some blankets and took her to the ER. A little later a lost soul wandered into the lobby of a downtown apartment building. Another one without a coat on a frigid, (8 degrees, 40 mph wind gusts) New Years Eve. He was almost as drunk as the guy on the other end of the phone he handed to me. Both were lost. We took him to the ER.

There was the stunning twenty-four year old at the Westin. Her dress and shoes probably cost more than my car. No idea what happened to her, we found her curled up in a ball, lying in a puddle of her own vomit on the floor in the lobby. The obligatory combative twenty-year old male was next. He was in the back of a police cruiser, unconscious, until he got on the stretcher and turned into the Incredible Drunken Hulk. The Incredibly Disgruntled Rescue Guy quickly put to rest any idea of insurrection that may have crossed the drunken boy's mind, he didn't make a peep after the initial, short-lived outburst.

A restaurant employee mysteriously appeared at the Providence Place Mall at 0500, drunk and disoriented. He was actually pretty funny. Had to take him to the ER anyway. That makes five. I know there was six. I can't for the life of me remember the sixth one. I'll probably have a flashback when I least expect it.

Speaking of the ER, the people there ware amazing as always, keeping things positive in the midst of the circus. The night shift set up a buffet in the break room and invited some of us to partake some of the goodies. It was a welcome respite, away from the sea of stupidity that threatened to drown us.

And speaking of stupidity, where were the friends of the "stragglers" that continued to pop up as the New Year progressed? These kids are supposedly more connected to each other than ever before. I never lost a friend at a party, not once, and I didn't have GPS, cell phones, text messaging, My Space, Face Book, U-tube or a Wii. We just had each other, and that was enough.