Saturday, September 22, 2007


I was thinking about this the other day, and the day after that, and then this morning. I don't know what got me onto it, but the concept, the idea of being in a bad situation got stuck with me. I suspect it had to do with a patient I saw, one I actually have transported on a couple of occasions. A 53 year-old female with a long history of alcohol abuse. This past week I transported her twice, the first time because she had said she wanted to get into detox (this didn't happen), and the second because she was with two male companions, stumbling around drunk, and she fell and hit her head twice. Very possible head injury due to the falls. My overriding concern, however, was the immediate social one that was in front of us. She was, as I said, in the company of two men, both of which were also impaired, though not as much as she was. She was on the lap of one, and the other had his hands all over her. I don't even think she realized what was going on. All of that said, however, when we were trying to assess her for injuries, the one whose lap she was perched on started answering questions for her in a manner that was, for lack of a better word, rather belligerent. I shut him down immediately by telling him that I was talking to her, not him. He continued to mumble bellicose things under his breath while all the time a bunch of people were milling around, trying to help her (or so they thought), and in general getting in the way.

Well, we got her out of there and onto the ambulance to take her back to the hospital. When we arrived, the ED staff knew who she was (as did we - remember I said that we had her earlier in the week and other crews probably transported her at different times). We told them what had happened and where we'd found her. We also had found a hospital bracelet from another facility on her wrist - I don't know which one as it was one of the old Addressograph type of bands, and neither of the Manchester hospitals uses them anymore. So we gave them report, transferred care, and got on our way.

You might be wondering what this has to do with adversity. Or, you may be thinking that I'm thinking this is an adverse situation for us as a crew to be in. First, this really doesn't have anything to do with those of us who went on the call. Sure, the situation could be taken as one that is potentially adverse for us, especially if the two drunk guys decided to act like lions and treat her as a fresh kill - if that did happen, I'd certainly have been worried, but it didn't, and these two clowns didn't have the ability to do that because of their own inebriated status.

I was thinking more about our patient, the woman who was drunk out of her mind both times we transported her this week. You could look at her like many people probably do, as less than human because of her being drunk, and stupid for letting herself get in that condition as well as in the situation she was in. I will admit it - I have already thought of her in that way, multiple times. Does that make me a bad person? No - it makes me human. I get angry when I see the way the health care system is abused, because if someone really needed help, there would be one less response vehicle available. At the same time, however, I have to step back and realize that this person probably doesn't want to be in the mess she's in; who does? If you really think about it, this person probably does not want to be out of control. But she is. And she doesn't have a good way to get her life back together; at least I wouldn't be surprised if that's her situation. And that is a bad place to be in. It's adverse.

It's people like this who, probably more than those with real medical problems, who need help the most. But the bottom line is that she has to want the help, and I don't know if she does or not.

I would offer up the following for her. Bobby McFerrin's take on something written a very long time ago.....

The 23rd Psalm (Dedicated to my Mother)

The Lord is my Shepard, I have all I need,

She makes me lie down in green meadows,

Beside the still waters, She will lead.

She restores my soul, She rights my wrongs,

She leads me in a path of good things,

And fills my heart with songs.

Even though I walk, through a dark and dreary land,

There is nothing that can shake me,

She has said She won't forsake me,

I'm in her hand.

She sets a table before me, in the presence of my foes,

She anoints my head with oil,

And my cup overflows.

Surely, surely goodness and kindness will follow me,

All the days of my life,

And I will live in her house,

Forever, forever and ever.

Glory be to our Mother, and Daughter,

And to the Holy of Holies,

As it was in the beginning, is now and ever shall be,

World, without end. Amen

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