Saturday, December 25, 2010

A bittersweet emergency Christmas.

I drove an ambulance for two years. No one ever died in my truck. Not one. Plenty of people were dead when we found them, and a few died before we could load them, and I'm sure many died shortly after we dropped them off.

The one who came closest was D. We picked him up at a nursing home, to take him home to die. When we got there he was already doing that fish-breathing dying people do, those desperate irregular gasps like each breath is a load they can barely lift. His son was by his side, holding his hand.

My partner mouthed to me, "Let's move quick. He's CTD." Circling The Drain. Ha ha! Like in a potty! We are monsters because if we were human we couldn't help people. Have you ever had to pick up human fingers and put them in a bag? It's a lot easier to do if you're a dumb callous jerk.

So we were monsters, and loaded the truck fast, and drove to his home. The whole way there D gasped, on and off, sometimes stopping for a long moment and seeming still but then finding the strength for one more breath. He reacted to nothing in the world, not sound nor sight, but when his son held his hand, D held it back. Weakly. And he held on. For fifteen miles, with my own breath held at every traffic light, he held on. We got to his home. His whole family was there. They were all around him, in his own home where he'd raised his children and played with his grandchildren, when he finally stopped gasping.

We put him in his own bed, and washed his face, and pulled the sheets up nicely. We made him look okay, look comfortable. He'd made it home.


M was the very opposite. We came to take her from her home so she could die in a hospice. It was better for her there--she'd get more care, be kept cleaner and medicated more consistently, and the burden would be off the family. It made sense. But it wasn't her home.

M wasn't old, but she had cancer. When we came into the room and saw her, she was, like D, seemingly unaware of anything. She did not look at us, did not move when we said her name. But when we got ready to take her out of her bed, before we had even touched her, she stopped breathing.

I touched her neck. I felt her heart beat a few times, weak and irregular, and then just a thready little thrill, and then nothing. For long enough to be sure, nothing at all. The family looked at me expectantly. "She's gone," I said. It felt like a stupid cliche, but I couldn't think of a better way to say it.

Her husband lost it. He forgot we were there, forgot his own family even. He just crumpled and sobbed. It wasn't dignified in any way; he wailed. He kissed her and kneeled by the bed and bawled until snot ran down his face. We let him be. I went into the living room and made calls to our dispatch, the hospice agency, and the funeral home. We realized we'd left our jump kit in the bedroom, and I snuck back in as unobtrusively as possible behind the husband to grab it. I needn't have bothered. I could have set off a grenade behind him and he wouldn't have known.

She had to die sooner rather than later to do it, but M, like D, didn't die alone and she didn't die in a strange sterile place. Although both of them seemed to know nothing of the world, I think they knew when they were home.


R didn't die in front of me. We came on the same mission as M, to take her from her home to a hospice. Her home was nice--not fancy, not big, not in a nice area--but nice. It was clean and calm with art on the walls and her bed was was big and old and looked comfy. The place we were taking her was also clean and calm, but the art was all generic soothing landscapes and the beds had plastic mattresses. This was her last moments in any place that was home.

Her husband, quite elderly and moving slowly, followed us out. He wasn't coming in the ambulance. Presumably he later came and visited her in the hospice, but this was the last time he would be home with her. In the parking lot, before we loaded her into the ambulance, we paused so he could say goodbye to her. He didn't say anything. He bent down, slow and unsteady, and kissed her like no one was watching.


We were cleaning a corpse, once, at the ER. Like ya do. The girl helping me clean him was kind of a sensitive type, definitely not a subscriber to the "I'm frivolous and callous because I care" philosophy, but she was holding it together okay. He was on the older side of middle-aged, not really old enough to die, but he'd been obese and a lifelong smoker and heavy drinker and that helps us make it okay in our minds. If someone didn't take perfect care of themselves, you know, that means they sorta deserved it and we shouldn't feel so bad. It's not that we're evil, it's just that we'll believe anything to not feel so bad.

But we took off his shirt and suddenly the girl started sniffling and holding back tears. I looked and I knew why. He had a tattoo that read, "If love could have kept you alive, you never would have died." Underneath was a picture of his daughter.


There are two paintings hanging on my wall. They're from a woman I cared for, way back when I worked at an assisted living facility. She had to leave the facility when she broke her hip and her health got worse, and she gave away most of her paintings--there were dozens--to the aides. One of the paintings is from long ago, back when she was healthy. It's an exotic market scene, rendered in blue and gold with wild, abstract brushstrokes, with birds in cages and vaguer figures suggesting hanging fruit and gourds.

The other painting was from after she suffered the brain injury that put her in assisted living. It's clumsy and simple, painted with the brush held in a twisted, contracted fist. But what's more noticeable is that it's an entirely literal, dead-center and unembellished image of some nice flowers in a pot. All of her paintings after the injury were like that.

But she never stopped painting.


  1. Thank you for these glimpses. The way you write them makes them truly beautiful.

  2. You should work on writing as your escape plan. Fiction, write ups about grocery store ribbon cuttings, anything. You have a gift.


  3. The tattoo story made me cry.

    I may be a soft touch. And fond of tattoos.

  4. I second Sophie's suggestion. You do truly have a gift for writing.

  5. This comment has been removed by the author.

  6. Had to delete because of a ludicrous typo. What I meant to say was, I would never have expected this blog to make me cry today.

  7. Excuse me. I think I have something in my eye.

  8. Reminds me of AD's writing.

    This, BTW, is a Good Thing.

  9. I teared up too. Starting around the second one.

  10. I mean, it's different when you are the caregiver because you are at or past the point of physical exhaustion. Given the nature of illness, you may have your last real conversation or leave-taking a long time before the person's body dies, in the last bit of lucidity days or hours before the person dies. Neither of my parents had what Western culture has called the "good death", nor did my friends who died in various terror attacks, and it involves a certain amount of guilt--I, with my equivalent of an EMT-advanced and LPN license, was useless about 3 days before my dad went into hospice, and I did the last 72 hours of feeding, wiping, and cath-changing in a haze, and I felt grateful and helpless as he went into hospice and sad that holding his hand as he died was useless because of the Parkinson's, because he was constantly shaking loose. I think there is a certain amount of guilt at the helplessness, and certainly being able to place everything within the framework of traditional Judaism helped, kavod Ha'Met, etc. Of course, ZAKA doesn't have gallows humor, and everyone I've picked up fingers (and other bits) with has been a bit older than you (and I was late-twenties at the time). Not that I want to do outreach, but there are other cultural references available than American morgue culture, and a bit of poking around in your own nominal tradition might (I say this guardedly) be interesting or useful.

  11. Wonderful stories, reminds me of Stan Rogers' song

    First Christmas Away From Home

    This day a year ago, he was rolling in the snow
    With a younger brother in his father's yard
    Christmas break, a time for touching home
    The heart of all he'd known
    And leaving was so hard.

    Three thousand miles away
    Now he's working Christmas Day
    Making double time for the minding of the store
    Well, he always said, he'd make it on his own
    He's spending Christmas Eve alone
    First Christmas away from home.

    She's standing by the train station
    Pan-handling for change
    Four more dollars buys a decent meal and a room
    Looks like the Sally Ann place after all
    In a crowded sleeping hall
    That echoes like a tomb.

    But it's warm and clean and free
    And there are worse places to be
    At least it means no beating from her Dad
    And if she cries because it's Christmas Day
    She hopes that it won't show
    First Christmas away from home.

    In the apartment stands a tree
    And it looks so small and bare
    Not like it was meant to be
    Golden angel on the top
    It's not that same old silver star
    You wanted for your own
    First Christmas away from home.

    In the morning, they get prayers
    Then it's crafts and tea downstairs
    Then another meal back in his little room
    Hoping maybe that the boys
    Will think to phone before the day is gone
    Well, it's best they do it soon.

    When the old girl passed away
    He fell apart more every day
    Each had always kept the other pretty well
    But the kids all said, the nursing home was best
    Cause he couldn't live alone
    First Christmas away from home.

    In the common room, they've got the biggest tree
    And it's huge and cold and lifeless
    Not like it ought to be
    And the lit-up flashing Santa Claus on top
    It's not that same old silver star
    You once made for your own
    First Christmas away from home.

  12. @Eurosabra - " Of course, ZAKA doesn't have gallows humor"

    You don't hang out with the right ZAKA people, then. *grins* So you know the meshulash, right, the triangular strip of cloth that serves as just about everything and anything? These guys I used to hang out with referred to them as pizza (due to the shape). They would joke about going out to eat after their duties (and later, I made this a tradition on the ambulances I rode); pizza, if it was a meshulash night, or steak/kabobs, if it was a night of burn victims.

    Gallows humor. Israelis are full of it, and the Israeli EMS guys are full of it *squared*.

  13. Oh, yeah, "see you on the memorial" etc, but I'm a pretty uptight dude and all the ZAKA people I was with were as well. A lot of my family is Haredi and I may have been sought out (I was on a MADA Lavan, Moked Yerushalayim) by people anxious to find out what I was up to but equally anxious to make a good impression and not rock the boat when I discussed them with my family. If you are at the meeting point of two communities (I am secular and my family is split between the Old Yishuv and Ba'alei Teshuva) you only get the "edited for publication" version of anything from anybody.

  14. You absolutely have a gift for writing, and the way you wrote these little glimpses made them seem so real. The tattoo story made me cry.

  15. I work with a lot of hospice nurses, ambulance drivers and funeral homes, but only on the periphery of everything. This kind of gave me a glimpse into what they do and why. Thank you.

  16. Thank you Holly. I've been reading through all the posts from old to new, and this glimpse into some of the things you see on a day to day basis made me more appreciative. In general. Of my job, of my life and the lives of those around me. Thank you.

  17. It feels silly to comment on an article from four years ago. But I will anyway, because this really touched me. The last one in particular. Even then, she never stopped painting...

    I don't want to die.

    But when I do, I hope I never stopped making art.

  18. It kind of breaks my brain that you drove an ambulance for two years--that people let you do this, that you got away with it, that nothing bad happened! goes the story in my mind--despite the dyspraxia thing.

    I've always been tempted by a number of careers that I've told myself I just can't have because of my various minor disabilities (and some major ones). I can't be a commercial truck driver because I have crappy depth perception and I space out a lot. I can't be an EMT because I need 9-10 hours of sleep a night and I do poorly with irregular sleep schedules. I can't be an accountant or an actuary or a statistician (I know those are all very different, but bear with me) because even though I like columns of numbers sometimes, my attention deficit would prevent me doing it long-term. I can't be a teacher because I'm too weird and openly queer/kinky/etc. (not really a disability, but then again, it kind of is in this culture). I can't be an engineer or computer programmer because I get headaches from looking at the computer screen too long. I can't be a security guard because I have an hour-and-a-half bladder and also I get diarrhea a lot. And on and on and on...

    Reading that you drove an ambulance for two years right after reading about your dyspraxia has sent me into a total BSOD "does not compute"--of the good kind that challenges long-held beliefs, though, not of the bad breakdown kind. :-)

    I honestly have no idea what I would do if I didn't have all these things I "can't" do, lol, but maybe now is a good time to think about it.