Sunday, October 01, 2006

Celebrity vistor

During my role as a PTS officer I often transferred cancer patients to the Oncology department for treatment. This was sometimes very disillusioning, particularly with seriously ridden terminal patients who were usually coherent and appeared normal on the first visit but would be lethargic, bald and drowsy by the third or fourth time we picked them up.

Often they ended up dying anyway despite the radio or chemotherapy. I felt sometimes that it was almost just a cruel treatment that was doomed to failure. To me it appeared to be a last ditch effort attempt which gave them false hope only to end up making them worse and killing them anyway.

I clearly remember the first ever terminally ill cancer patient I ever transported. It was back in my PTS days and I was still fairly new to the job. Fresh out of training I had been taught all these life saving skills but they forgot to tell me what to do with a terminally ill patient if they should die while being transported.

I was single crewed and so I loaded the patient feet first into the ambulance so I could keep a close eye on her while I was driving. She was being transported from her house to the St Josephs hospice at the Mercy hospital, presumably to die a peaceful and dignified death. Her adult children, who were visibly upset, accompanied her in the back of the ambulance. This was fine but they were hugging her all the way to hospital, which made it difficult for me to monitor her in the rear vision mirror.

It also presented a huge moral dilemma for me while I drove. She was clearly near death but what was I supposed to do if she stopped breathing en route?

With her children by her side I felt it would have been unethical for me not to carry out a resuscitation attempt but on the other hand I thought it would sound stupid calling backup to help resuscitate a clearly terminally ill patient.

Fortunately she stayed alive for the whole journey and a difficult decision was avoided. I sought council from my station officer afterwards to clarify what the correct procedure was.

As it turned out I was faced with similar scenarios many times again and I discovered the correct thing to do is simply to consult with the family at the time and provide conservative treatment until you either arrive at your destination or the family accepts that the inevitable has occurred. Death, while socially undesirable, becomes a stark reality in the world of medicine and our job was to make it as dignified as possible.

I also transported many dialysis patients in my first few years with the ambulance service.

These poor individuals suffered from kidney failure and would spend five or more hours being hooked up to a machine three or more times a week to detoxify their blood.

Some of the really chronic patients were amputees as well, a result of further complications from the condition. It always astounded me that such large machinery was required to replace the job of our relatively small kidneys that we have. I could also never really understand how the dialysis process worked and certainly never anticipated that one day I would be selling such equipment as I do today.

One thing was for sure though, working in the health industry sure made you appreciate and value your own health.

Another relatively common complaint I was called to was hypoglycaemic Type I diabetics. These patients were dependent on insulin injections to regulate their blood sugar levels and most commonly would not eat enough sugary food after injecting themselves.

One regular customer of ours was a young male diabetic who drove for a pavalova delivery company. I attended to him several times and in each scenario he would have a hypoglycaemic attack while driving his van load of pavalovas. Fortunately he had the foresight to pull over to the curb and stop before he became semi conscious but I could never understand why he didn’t just reach back and help himself to some pavalova. It probably would have fixed him every time!

There were a couple of older diabetics I attended who became extremely aggressive when they became hypoglycaemic. The brain like other organs needs sugar to function correctly. With hypoglycaemia, or low blood sugar, the brain doesn’t get enough glucose and so the patient becomes confused, irritable, drowsy and eventually unconscious.

If the patient is still conscious enough our first treatment was to give them some syrupy glucose to drink. Failing that we would inject them with a glucose solution into their vein or inject them with Glycogen shot intramuscularly which mobilised any sugar stored in the liver. Within ten or fifteen minutes they would return to normal and most of the time we would leave them in the care of relatives.

Other common medical complaints included heart attacks, chest pain, renal colic, abdominal pain, dehydration through vomiting and diahorrea and various breathing difficulties including asthma, hyperventilation and chronic obstructive airways disease (COAD).

As an Ambo we got to meet some important and famous New Zealanders but I would never have expected to have Michael Jackson walk into my ambulance.

I was working with another Ambo by the name of Claire and we were at the famous singers Auckland concert. We had our ambulance parked right near the stage and which gave us a fantastic view of the concert. In between dealing with minor patient complaints we enjoyed the music and show.

At the end of his routine the famous performer got into his Limo and started driving out of the concert. Suddenly the Limo stopped and he got out and walked along the road waving to his crazed fans. His path took him past the ambulance and suddenly he just walked inside!

Claire sat there speechless but I thought I cant get this close to him and not say something so I said welcome to our ambulance and shook his hand.

He was very friendly and chatted briefly to me before leaving and getting back to his Limo.

When he had left and the concert was finally finished we ended up transporting a young teenage female that was supposedly overcome by emotion. She admitted to me with great awe that Michael Jackson had looked straight at her during the concert and it had taken her breath away. I replied, “so what…he walked into our ambulance and I shook his hand!”

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