Until this week, it’d been a long time since I’d had a real, full on, this-is-what-we’re-here-for cardiac arrest call. In the last four days, I’ve had three. The worst came early this morning. There was nothing unusual about what had happened – an elderly female had passed away unexpectedly in her sleep and been discovered by her daughter. What was more unusual was the daughter’s reaction – she was utterly hysterical. All I could hear was “dead, dead, dead”.

After discovering – eventually – who was dead and why, I offered the resuscitation instructions. The caller didn’t do them and she didn’t reject them. Instead, she described her mother’s appearance – stiff, freezing cold, mauve. It was like she was telling me this so that *I* would say she was beyond help, so she wouldn’t have to make that call herself. But of course, I couldn’t say that. I ploughed on with the instructions, but as it turned out, the caller bottled it when she felt her mother’s icy skin. She couldn’t go on. She knew her mother was gone. The minutes between this decision and the ambulance arriving were long for both of us. There was nothing left to do or say, no way I could make things better. Usually I would ask for irrelevant details like medical history and postcodes to fill this gap and make the caller feel like she was doing something, but she was too upset so I just tried to calm her down and reassure her that the ambulance was coming – as if the ambulance was going to change the situation somehow.

As I mentioned above, this situation isn’t rare. It’s probably one per call taker per shift and while the callers are, of course, upset, it’s rare to find one who is hysterical like this. The difference, I think, was that this lady did not expect her mother to die. She kept telling me how she’d been fine earlier, she was in good health, she couldn’t be dead! Some people just block out the fact that everyone they love will inevitably die. Of course, I’m the opposite. I know that one day it’ll be me finding the lifeless shell of a loved one. This job gives me a falsely inflated impression of the likelihood of the worst happening. I see people and see what could go wrong. My elderly relatives are heart attacks and strokes waiting to happen. Old age can result in your languishing forgotten in a “don’t care home”, lying for hours in your own excrement until your legs rot away or stumbling around in a dazed state swearing at your family because you don’t even recognise them. I don’t wish that the people I love will never die. I pray they will never break their legs or have strokes or lose their minds. I hope that when they die it will be quick, painless and at the right time.

I told her I was sorry, but was I really? I was sorry she was so distressed. I was sorry for her loss. Was I sorry that her mother had died peacefully and painlessly in her sleep at a good old age? No, I wasn’t. Death is the one thing you can be certain of, and as deaths go, this is about as good as they get.

Published Jan 22, 2009 - 17 Comments and counting

17 Comments on “The Best Way To Go”
  1. Dullahan_999 Says:

    Agree about the attitude towards death, it’s part of the job. The unfortunate thing is other people’s reaction to yours. If ever any friends or family are grieving they think I’m uncaring and cold-hearted, and I can’t do sympathy cards or long winded displays of sympathy at someone’s loss. I just think *could have been worse*.

  2. Erin Says:

    You know, it’s nice to hear someone else thinking the same way I do. Ever since I started this job I always think the worst. Always. My house mate was drunk and had fallen asleep on the couch the other night, I came home to him comatose and unresponsive. My first thought was CO poisoning and I opened up the windows of the house and stood watching him for a few minutes to make sure he was breathing.

    When he rolled over and burped I felt a right nong, but I just couldn’t stop myself. (so glad he doesn’t read this, else I’m sure he’d go and change his locks). I never used to be this way. People aren’t just people anymore, they’re potential hazards, and I have to stop myself triaging things that haven’t even happened yet.

  3. Happy Medic Says:

    It has to be rough waiting on the line with these folks, waiting for someone to arrive and take over the awkward situation.
    I feel for you on this one indeed. What else can you do?

    HM

  4. Jo Says:

    I’m not medical, but I feel exactly the same way; I’ve watched a number of elderly relatives go in a variety of ways (cancer, slow lung failure whilst in intensive care, stroke, mental disintigration in a nursing home), I know that I’d like (and would like all my relatives…) to die the way that my great uncle did – he’d had a minor heart problem (not sure if it was a heart attack, angina or something else…) and had been given a portable heart monitor for a week. He was on his way to take it back to the hospital, and stopped off for a round of golf with his best friend. Half way round, he had a major heart attack and was dead by the time he hit the ground. He was in his early eighties, and had had a very full and active life – the perfect way to go.

  5. oliviascotland Says:

    I couldn’t agree with you more. To die is inevitable, and to die in one’s sleep is a blessing. I’ve watched elderly relatives die peacefully and in terrible pain, and can only hope that when it’s my parents’ time to go (and my husband’s parents, as well as ours) that the end is peaceful and in pleasant surroundings.

  6. Julian Meteor Says:

    May she REST in Peace :(
    A VERY sad tale.

    Does anyone know if Jo (two comments above) is single?

  7. Jo Says:

    @Julian,
    LOL – sorry, I’m afraid I’ve been very happily married for the last year and a half :-)

  8. Always Tired Says:

    I have had the reverse, one of the calmest calls I ever had was from a daughter who found her father dead. I offered the usual help and she stated calmly that there was nothing that could be done and that she needed to let the rest of the family know so that she could make arrangements.

    By all accounts she did break down when the paramedic on scene confirmed death, but even then they said she seemed more relieved that someone had confirmed her thoughts for her than out of total grief.

    It is strange how people react to death.

  9. Petrolhead Says:

    I hate taking calls like this. I’ll never forget one particular cardiac arrest call I took, the patient had died while watching TV on the sofa but the wife just couldn’t accept that he was gone. Their daughter did resus, while she relayed the instructions. But every time there was a pause, she was repeating “Don’t let him die. Not my Bob.” over and over again. It was really hard to listen to, because I knew that there probably was no chance of him surviving, and that we were just delaying the inevitable. Calls like that just break my heart sometimes.

    But then you take the next call and get abused by a drunk, and you just have to smile. Life goes on.

  10. Uncle John Says:

    Erin; “[I] stood watching him for a few minutes to make sure he was breathing.”

    I used to teach basic resus to new mums – and I usually started by asking “Who has gone up to the cot and given baby ‘just a little nudge’ to make sure…?” EVERY hand would go up.

  11. Stan Says:

    I can’t believe that you are obliged to give resuscitation instructions to someone faced with a cold and purple corpse.

  12. Mark Myers Says:

    Stan, we are not obliged to give the instructions at all. We are obliged to offer them – the caller then makes the decision as to whether they think the patient is beyond help or not. It’s not for a call taker to judge whether or not someone is dead when they can’t even see what is happening and their only information is from a very distressed and scared caller. There have been cases of people being described as most definitely dead who actually turned out to be breathing.

  13. Always Tired Says:

    Or there have been cases where they say the person is conscious and breathing when it turns out the person is unconscious and NOT breathing. Lets just say, quite common in care homes where the staff are non English speaking!

  14. Sewmouse Says:

    I don’t think you were lying to her.

    You WERE sorry she had lost her parent.
    You WERE sorry she had to be the one to find her.
    You WERE sorry there wasn’t anything you could do to make it easier for her until the ambulance arrived.

    Perhaps she put a different spin on your “sorry” – but I’m sure the sentiment made her feel better, so why not offer?

  15. Vic Says:

    I can remember the night 23 years ago when my father died – six hours after being released from hospital. The belief that all the signs were wrong. The coolness of his body, the way my fingers sank into his wrist when trying to test for a pulse.

    It’s not pleasant and it does take time to accept. Time. The cureall. It doesn’t cure.

  16. Viking 83 Says:

    Good attitude, same as mine….. just hope I’m not too cycical about it

  17. ci7alex1 Says:

    Sad story beautifully written.

    Nee Naw
    Nee Naw was a blog about life in the London Ambulance Service control room. It was written by Suzi Brent from 2005 to 2010. The blog is no longer being updated, but the archives will remain here.
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