client passed away
May. 13th, 2010 06:37 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
gina_r_snapeLJ-cut for details that may be triggery.
Today at work I witnessed one of our clients die. It was so very, very hard to watch.
Though I had not seen him earlier in the day, I heard reports that he was feeling ill, a nondescript sort of "not feeling well." He even saw the doctor from the medical team (who comes on Thursday) and she did not pinpoint anything specific. His vital signs were okay. Nothing unexpected was found in the lab work that had just returned for him.
Several hours later as the doctor and I were closing out, doing case summaries, we heard a loud thud and some shrieking. The client had fallen out of the chair in which he was sitting, in the first floor lounge, hit his head hard on the floor and passed out cold.
She ran to his aid while another staff member called 911 and I cleared the lounge of all the other clients. He was not moving. Eyes rolled back in his head, body still, skin suddenly ashen (he was a very dark skinned black man in his 60s), a chill came over me. Yet after a minute the doctor coaxed him into waking. He tried to sit up, delirious, and they checked his vitals while we waited for EMS to arrive. From there it was a descent, in about 45 minutes. He passed in and out of consciousness as they tried to treat him, attaching an EKG machine, fluids, etc. Then he stopped breathing on his own and they pulled out that balloon thingy used to manually breathe for the client. When the EMS person said "We have to intubate him" I just knew it was over.
His heart had a weak but ineffective pulse. He moved; he stopped; he moved; he stopped; he was in cardiac arrest. They lifted him up onto the gurney and took him outside where they tried using the paddles. Then they took off their gloves and drove away quietly.
Afterward, the doctor and I processed it a little bit. She kept wondering what else she could have done (there was nothing), contemplating the measure of responsibility and how as a doctor she doesn't see death as a defeat but the inevitable truth for all of us at some point, even with interventions.
I told her I thought about how this compared to watching Grey's Anatomy. Don't laugh. It came up because she is in family practice for a reason. It takes special kinds of people to do emergency medicine. We were in awe of the head EMT, who was amazing, sharp, in charge, unflinching. I thought about how the show tries to manufacture drama for effect, and how much different it is to witness someone you know, someone who is really dying, and the reality of the measures they went through to try to save him as opposed to whatever pushes the narrative ahead.
He died in front of my eyes and I felt it. I did not know him well. He was a nice man. Polite. Soft-spoken. Followed through with whatever was needed to get him housing.
I spent the rest of the afternoon trying to track down a next of kin. I am still working on it, will do more outreach and detective work tomorrow. We had a name but no phone number. They found a cellphone in his room. There were no numbers saved in the address book.
I live with the sobering reality that this man died homeless, and may wind up in Potter's Field, because the path of his life left him with no one to turn to as a dependable connection.
I do not speak with members of my family every day. But we do keep in touch. We do care about one another. I have friends and co-workers who would notice if they had not heard from me for a couple of days. This man did not have that. He came to us post-incarceration after serving time under the Rockefeller laws for sale/possession of controlled substances. He had no other resources but the shelter system. This is a common story for homeless older adults who served a long prison sentence that was much longer than fit their crime.
All of my grandparents died with care around them. My paternal grandmother died slowly in hospice, with my father whispering lovingly in her ear until her final breath. I sat with her for an hour during her dying. This was so much different.
It makes me glad to know he died in a safe place, cared for by the hands of my staff, as we fought to save his life. But literally watching a man die before my eyes, struggling in his death, there really are no words to encapsulate the mix of emotions I feel.
Today at work I witnessed one of our clients die. It was so very, very hard to watch.
Though I had not seen him earlier in the day, I heard reports that he was feeling ill, a nondescript sort of "not feeling well." He even saw the doctor from the medical team (who comes on Thursday) and she did not pinpoint anything specific. His vital signs were okay. Nothing unexpected was found in the lab work that had just returned for him.
Several hours later as the doctor and I were closing out, doing case summaries, we heard a loud thud and some shrieking. The client had fallen out of the chair in which he was sitting, in the first floor lounge, hit his head hard on the floor and passed out cold.
She ran to his aid while another staff member called 911 and I cleared the lounge of all the other clients. He was not moving. Eyes rolled back in his head, body still, skin suddenly ashen (he was a very dark skinned black man in his 60s), a chill came over me. Yet after a minute the doctor coaxed him into waking. He tried to sit up, delirious, and they checked his vitals while we waited for EMS to arrive. From there it was a descent, in about 45 minutes. He passed in and out of consciousness as they tried to treat him, attaching an EKG machine, fluids, etc. Then he stopped breathing on his own and they pulled out that balloon thingy used to manually breathe for the client. When the EMS person said "We have to intubate him" I just knew it was over.
His heart had a weak but ineffective pulse. He moved; he stopped; he moved; he stopped; he was in cardiac arrest. They lifted him up onto the gurney and took him outside where they tried using the paddles. Then they took off their gloves and drove away quietly.
Afterward, the doctor and I processed it a little bit. She kept wondering what else she could have done (there was nothing), contemplating the measure of responsibility and how as a doctor she doesn't see death as a defeat but the inevitable truth for all of us at some point, even with interventions.
I told her I thought about how this compared to watching Grey's Anatomy. Don't laugh. It came up because she is in family practice for a reason. It takes special kinds of people to do emergency medicine. We were in awe of the head EMT, who was amazing, sharp, in charge, unflinching. I thought about how the show tries to manufacture drama for effect, and how much different it is to witness someone you know, someone who is really dying, and the reality of the measures they went through to try to save him as opposed to whatever pushes the narrative ahead.
He died in front of my eyes and I felt it. I did not know him well. He was a nice man. Polite. Soft-spoken. Followed through with whatever was needed to get him housing.
I spent the rest of the afternoon trying to track down a next of kin. I am still working on it, will do more outreach and detective work tomorrow. We had a name but no phone number. They found a cellphone in his room. There were no numbers saved in the address book.
I live with the sobering reality that this man died homeless, and may wind up in Potter's Field, because the path of his life left him with no one to turn to as a dependable connection.
I do not speak with members of my family every day. But we do keep in touch. We do care about one another. I have friends and co-workers who would notice if they had not heard from me for a couple of days. This man did not have that. He came to us post-incarceration after serving time under the Rockefeller laws for sale/possession of controlled substances. He had no other resources but the shelter system. This is a common story for homeless older adults who served a long prison sentence that was much longer than fit their crime.
All of my grandparents died with care around them. My paternal grandmother died slowly in hospice, with my father whispering lovingly in her ear until her final breath. I sat with her for an hour during her dying. This was so much different.
It makes me glad to know he died in a safe place, cared for by the hands of my staff, as we fought to save his life. But literally watching a man die before my eyes, struggling in his death, there really are no words to encapsulate the mix of emotions I feel.
