Sunday, March 21, 2010

The Hospital Story

My wife and I often talked about volunteering so we could give back to the community. Both of us had, at one point in our lives, been involved in Emergency Medical Services, so volunteering in our local hospital seemed a good fit. After months of "on again, off again" talk, Judy decided we'd talked enough and called the volunteer coordinator at one of the local hospitals to get us signed up.

Much to our pleasant surprise, the volunteer coordinator turned out to be the man who was our instructor when we went to school to be Emergency Medical Technicians. We found he'd recently retired from the hospital's EMS service and was working at the hospital part time to keep himself busy. We both had great experiences in our EMT classes with him running things, so we were quite happy to learn he would be our "boss" at the hospital.

Larry was the kind of person people either loved or hated. Those who went through his classes knew him to be a tough man who demanded high standards of his students. Those who got to know him learned that his toughness came from a sense of responsibility to the future patients of those students when they graduated. Those who were just looking to cruise through the class didn't get that message and thus considered him just mean. Fortunately, Judy and I both got to know him when we went through his class and understood the "method behind his madness." We respected him for that and I believe his methods made us better EMTs when we worked in emergency medical services.

We started our first day of training with Larry promptly at 8 A.M. on a Saturday morning. He met us outside the main doors to the hospital and led us to his office where we spent an hour or so doing paperwork and catching up on our lives. It was great to get reacquainted with Larry again after quite a number of years. I was rather surprised he remembered me so well, even down to parts of the class I had problems with. 

Even though he was retired from his regular job, he was not retired from life by a long shot. We learned his wife of many years had recently passed away and he decided to retire and slow down, but only a little. Judy pulled out pictures of our kids and showed them off. We told stories, true and not so true and laughed as we got reacquainted.

When we were done with the paperwork, Larry got down to business. "I know you two have medical training. But, even if your EMT certifications are current, you're not allowed to do any medical procedures at all except CPR. You may only do CPR if specifically told to do so by a doctor or nurse, too. Our main function as volunteers is to help people in small ways so we can free up the hospital staff to do what they are trained and paid to do. If someone wants something to read we can fetch a magazine for them or if someone needs directions we'll give them directions or even take them to where they need to go rather than try to explain it. That makes the patients and their loved ones feel better cared for. It relieves a lot of stress for them and for the staff." Judy and I nodded at Larry and then to each other. We understood the concept of helping people, that's why we were there. It made a lot of sense that we could help with small things so the doctors and nurses could take care of the bigger things.

Larry continued, "Since this is your first time volunteering, I'll have you follow me around so you can get acquainted with the routine and how we do things. I'm sure you'll pick things up quickly enough. We do prefer volunteers to work in pairs, so you two working together is perfect. Let's go." That was how Larry did things: short, to-the-point and get going. He was a man of action.

He led us out of his office in the administration area of the hospital to another room a few doors down. There he gave some of the paperwork we filled out to a clerk who entered information into her computer. Then, she had us stand in front of a camera so she could photograph us for ID badges. While we waited for them to be made Larry told us we'd be primarily working in the Emergency Department since that area was usually the busiest place on a Saturday. "So many people come in who don't have regular doctors and because they can't take time off work during the week. I'm sure you two remember from your EMS days that Saturdays are usually pretty busy for emergencies too. That makes it so these folks have to wait a very long time. Any little things we can do to help them relieves the stress of waiting and helps the staff keep things running smoothly."

As soon as we got our ID badges, Larry led us off to the Emergency Department waiting area. From the administration area it was quite a hike down numerous hallways and corridors. "At least," I joked to Judy, "we're getting some exercise out of this." Judy and I often chided each other about our lack of exercise and bad dining habits. Although we enjoyed decent health, we could certainly have stood to lose a few pounds. Unfortunately, we were too lazy to do more than talk about it.

Larry led us through the door into the Emergency Department. The room was laid out in an "L" shape. In the area making up the long length of the "L" were chairs, hundreds of them, back to back in groups of 5 or so set up like a typical waiting area. On the long wall of this part of the room were high windows overlooking the parking area at the front of the building. Between the windows attached to the walls were large-screen televisions tuned to either a 24-hour news or cartoon channel. On the far end of the "L" making up what would be the bottom part of the letter, was a smaller room where children were playing. I elbowed Judy and motioned towards the room. "Good idea," I said and she nodded in agreement. The rest of the shorter end of the "L" was where the reception desk was situated. Two nurses were doing intake behind the desk. Two lines of people waiting to talk to the nurses went through the entryway and out the door into another parking area located at the side of the building.

Larry led us to the volunteer desk, which was situated against the wall about half-way down the large "L" opposite the windows. The desk was about 10 feet long and made of wood covered with a nice woodgrain laminate veneer. Behind the desk were numerous drawers and cupboards. The only thing on the top of the desk was a phone next to a sign which read in English and Spanish "Not for public use." There were two chairs behind the desk, towards which Larry motioned for us to sit. "I'll go get another chair so we can all sit down and I'll explain a bit more of what kinds of things we can do to help the people here."

While he was gone, I started to open the drawers and cupboard doors to see what was in them. I was nosy that way. There were phone directories, pens, pencils, note pads, and other office supplies in many of the drawers. One cupboard was filled with dozens of coloring books of various themes and about 100 8-pack crayon boxes. Some of the drawers were empty and two were locked. I thought the coloring books and crayons were a nice thing to have to pass around to the kids who found themselves waiting around. Waiting can be very hard on kids, so anything to help them would surely be welcome.

Larry was a long time in returning, so I decided to have a look around the waiting room. I walked across the room to the windows and looked out at the parking lot. It was a cloudy day and looked rather dreary. I knew it was warmer outside than the cloudiness made it seem. Still, the weather made the outdoors looked sad to me. I walked along the wall towards the playroom at the opposite end of the room from where we entered. There were a dozen or so kids playing on the floor with toys, which I assumed were donated by charitable folks who supported the hospital. I glanced across at the reception desk where the two nurses were busy interviewing the incoming patients. They both looked rather harried. Considering the number of people waiting to talk to them and how many people with whom they had probably already spoken, I could hardly blame them. I noted a small room with vending machines selling various refreshments beyond the lines of people. I made note of that in case we might want a snack or drink later.

By the time I made my way back to the volunteer desk, Larry had returned with another chair. He and Judy were sitting and having an animated conversation about kids and grandkids. Both our boys had just graduated college and were out on their own in other cities. Judy had her pictures out again and Larry was showing pictures of his offspring and his offspring's offspring on his phone. I went behind the desk and grabbed some coloring books and crayons and walked through the room giving them to the kids who wanted them. Those who took them were very appreciative. The kids looked so sad sitting there. I was glad to be able to cheer them up a little.

When I returned to the desk Larry asked, "Do you want some coffee? I could go for a cup." I nodded, "You might remember, I never turned down a cup of joe." He jerked his head to the right as a sign to follow him. I waved to Judy and blew her a kiss as we walked away. I knew better than to ask her if she wanted a cup because she hated the stuff. "More for me," I always said about that with a smile. Even though Judy and I were married over twenty years, we were still very much "in love." It wasn't unusual for us to hold hands as we walked or to blow each other kisses when we parted ways, even if only for a few minutes.

Larry swiped his badge in the card reader next to the door leading to the clinic part of the Emergency Department. "Next time you guys come your badges should open the door. The security folks only enter new people in during the week, so your badges won't work now. When they do, you can come and go through here. Just remember to stay out of the way. It can get pretty hairy back here when it's busy." He really didn't need to say that. Because I spent enough time around emergency departments in various hospitals, I knew how crazy they could be. It can be described as organized chaos. I always admired those who work as doctors and nurses in emergency medicine. The dedication and hard work it takes to provide excellent care is amazing.

Larry led me down one corridor and then left down another. There was a nurses station in the middle of a large room and on the wall opposite was a snack bar with a coffee maker, ice machine and refrigerator. Larry motioned to the snack bar, "You can come and grab yourself some coffee or ice but the 'frige' is off limits to volunteers." That didn't phase me a bit since I had already seen some snack machines in the waiting area and there was a cafeteria elsewhere in the building. If I really needed something I didn't need to go rooting around in that refrigerator.

We got our coffee and turned to start back to the waiting room when some medical personnel hurried by in a large group surrounding a gurney with a patient on it. The way the people were moving around the rolling bed, it looked as if it was moving along under its own power and the people were orbiting around like the electrons in some kind of rectangular atom. As the group passed, a lady in the group turned to Larry and said, "We need some help with compressions, can you assist?" Larry nodded and followed the group, motioning for me to follow. I put my coffee down and hurried along behind the group.

The gurney along with the group of people moved into a large room. As soon as the bed came to a stop, the people in the group scattered around the room as if the atom had just hit critical mass. Some people were hanging plastic bags of liquid, others were sticking needles into the arms of the patient, still others were hooking up wires and sticking electronic sensors to the patient's chest. One man was furiously pumping on the chest while a woman sat at the patient's head holding a plastic mask to the face and pushing air using a large plastic ball attached to the mask. Larry handed me a pair of latex gloves which I quickly put on. He motioned for me to stand next to the man doing the check compressions while he went over to the lady at the head of the patient. The man doing the compressions looked tired, and he probably was because doing CPR chest compressions properly does require quite a bit of exertion. He looked over to me and asked, "Will you take over?" I nodded and got my hands ready to push. He stepped aside and I stepped sideways to where he was standing, placed my hands on the person's chest and started pumping.

I looked down and saw we were working on a frail-looking, little old lady. The mask over her face had been replaced by a tube going into her mouth and down her throat. Larry was squeezing air into her lungs through the tube using the large plastic ball while I pushed on her chest. Her eyes were open, but they were staring straight up empty and devoid of life. I had a feeling that no matter what we did it was too late for her, she was gone.

As I compressed her chest, the old Bee Gees song "Staying Alive" went through my head. Ever since I read that the beat to this particular song mimicked the perfect rhythm for CPR, every time I did chest compressions that song went through my brain. Although I hated it, it really was a catchy tune to keep one's mind occupied while doing CPR.

On two occasions one of the doctors yelled "Clear!" This was our signal to stop what we were doing and step back while she administered a shock with the paddles. After the shocks she would wait a moment to watch the monitors and then loudly announced, "Continue compressions!" At that point I continued what I was doing and Larry started squeezing air into her lungs again. After what seemed like an hour, but was probably only fifteen minutes or so, the doctor told me to stop compressions. The heart monitor showed a flat line. She pushed some medicine into one of the intravenous lines and told me to continue. After a few minutes she stopped me again and watched the monitor. Nothing. At that point she declared, "Time of death, 11:46 AM." And it was over.

Larry and I were thanked for our assistance and then quickly ushered out of the room. I didn't feel too badly for the lady because she was probably dead before we entered the treatment room. I'd worked in EMS long enough to know that sometimes there's nothing one can do but try and help; and, sometimes we try even though we know the outcome won't be successful. I did feel sadness for her family, though. Somewhere in that vast waiting room was a husband or a child or a grandchild who just lost a loved one. That was the hard part of working on a patient who passes: telling the family.

Thankfully, that was not my job this time. I was a minor player in the drama which just finished playing out. Larry told me to wait there outside the door and he wandered off, returning with Judy in tow a few minutes later. He said we needed to help someone find another part of the hospital and motioned for us to follow him. "Sometimes we can give directions, but this place is so big that often we end up just escorting people around. It's just easier that way at times." We walked down the hall and made a turn where an older lady was waiting. When she saw Larry, her face lit up and she said, "Oh, thank you. This place is so confusing to get around and I really appreciate you taking time to show me where I need to go."

We walked down one hallway, then another, turning here and there until we finally stopped in a small waiting room. It was a square room with some typical waiting room-style chairs along two of the walls. On another wall there was a large sliding door with a sensor above it; presumably meant to open the door when someone approached. The door was glass and I could see a collection of different types of medical equipment on the other side. There were no markings on the door, which was unusual since every other doorway in the hospital was marked.

Larry and the lady sat down on one set of chairs; Judy and I sat perpendicular to them on the chair against another wall. Larry and the lady spoke softly to one another, so softly that I couldn't quite make out what they were saying. I sat and watched for while, when Larry finally ask, "Well, are you ready, ma'am?" To which the lady replied, "Yes, I guess I am, now. Thank you." Larry said, "Just go through that door and someone will let you know where to go next." The lady thanked Larry and made her way through the door. As the door closed behind her, Larry said, "OK, time to head back to the E.D."

Lunch came and went, as did the people in the waiting room. When Judy and I returned from the cafeteria, some faces I noted were still there from the time when we arrived in the morning. Some were new, too. Two or three times through the afternoon I grabbed a stack of coloring books and crayons and went around to distribute them to the children. Although I felt rather inadequate to relieve their suffering and boredom, I was happy to do what little I could. Judy helped, too, telling people how to get to the cafeteria and where other things were. She has a great sense of direction and was very skilled at showing people where places were on the map of the hospital. Oftentimes she would advise people to go outside and walk around because it would be a shorter trip that way. Keep it simple and very smart - that's my Judy.

In emergency medicine, nothing brings more tension than a critically ill or injured child. For whatever reason, be it youth, lost potential or because parents shouldn't have to bury their children, things are very tense and intense when a child in trouble comes in. The whole area is electrified as soon as word comes in there is a critical child on the way. The tension is palpable as the staff gear up for the arrival and word spreads quickly that something important is about to happen. During the late afternoon of our volunteer shift, we got word that a 5-year-old boy who had been hit by a car while riding his bike was coming in by ambulance. Even though I was not to be a part of his treatment, my chest tightened as my adrenaline started to flow. It was a visceral response, one I could sense in Judy and Larry, too.

Our volunteer trio carried on, though, as if nothing was going on. Occasionally a doctor or nurse would come out and Larry would inquire as to the boy's condition. Though I couldn't hear what was said, the look on the faces of the staff member talking to Larry told the story; he wasn't doing too well. After an hour or so, sobs and shrieks could be heard from the treatment area through the door off to the side of the volunteer desk. The final step was taken and the boy was gone. The mood throughout the department darkened as if some of the overhead lights had been switched off. I said a silent prayer for the parents of the young boy. No doubt he was in a better place, but their place had just become empty as a huge piece of their lives had been ripped from them.

I noted that Larry had slipped away when I wasn't paying attention. No matter, though, as Judy and I could certainly handle whatever came along. After all, we were volunteers and our tasks weren't too difficult. A few minutes after I'd noted he was gone, he reappeared, half hanging out the door which led to the treatment area. He waved at me and Judy to follow him. He led us along the hallways, telling us we needed to escort someone again. We went to the very spot where we met the old lady earlier that morning. This time, there was a young boy waiting for us. He smiled when he saw Larry and said, "The nice man in there told me to wait for you 'cause you're gonna show me where I need to go next." Larry nodded and said, "Yes, let's go."

We walked down the same hallways and ended up in the same small waiting room where we'd been that morning. It was the same room to where we escorted the old lady. Larry and the boy sat down along one wall while Judy and sat along the other, just as we had done that morning. Judy and I looked at each other. I whispered, "Does this seem odd to you?" She nodded in agreement but said nothing. We sat while Larry and the young boy spoke in whispers which I couldn't hear. Finally the boy said aloud, "I guess I'm ready. I'm a little scared, though." Larry replied, "It's OK to be scared. New things are scary sometimes. But, everything is going to be OK once you go through that door." "Can you come with me?" the boy asked. "No," Larry replied, "I'd go with you if I could, but I'm not allowed to go in there." The boy stood, smiled and waved, and then walked quickly and resolutely through the door.

Larry looked at us and said, "Yes, this is rather odd, isn't it? You see, my volunteer work goes beyond just helping those who come here looking for help. Part of my job is to assist those who can no longer be helped by the medical staff." Judy and I looked at each other, again. I gulped; this was certainly going in a strange direction. Larry stood. We stood, too.

Larry continued, "You see, people who pass on need some help going to the next stage of their lives. I was chosen to show people the door to go through. Most times it's pretty easy, sometimes a little difficult. It's an important job, though, and one I enjoy doing very much. I spent my whole life helping people who needed emergency care and this is just an extension of that."

"I'm not an angel or anything like that. I'm still just a regular guy, much like I was when we first met years ago. I've gotten older and slowed down a little, but that doesn't mean I stopped wanting to help people. Because of my willingness to help anyone at any time, I was asked to be an escort to those moving on. It's no coincidence that we escorted that nice lady and this young boy right after we learned of the deaths. You see, those were ones who passed on. We showed them where to go."

"I said this job is sometimes difficult. The difficult part comes when I have to tell friends it's time to move on. You two don't realize it just yet, but you were both killed in a car accident yesterday. Because we were acquainted, I was allowed to let you hang around with me for a while. But, now it's time for you two to move on to the next stage in your lives. Your time on Earth is finished and now we must say 'goodbye.'"

My mouth must have been hanging to the floor. Dead? How? I don't remember being in an accident. I looked at Judy, who was leaning on my shoulder crying softly. The next thought that came to my head was, "Well, at least we went together. I'll miss the kids, but they'll be OK."

"We can still wait a short time yet, but not too much longer," said Larry. "You've already been allowed to linger more than usual. I want you both to know I think you've lived good lives and I appreciate all you did to help others in need." He was smiling broadly, his hands were clasped together in front of his chest. He was, indeed, proud of us.

Judy regained her composure enough to stand up on her own. She wiped the tears from her eyes and looked at me. "I guess I'm ready," she said. After a pause, she continued, "At least we're going together. I'll miss the kids, but they'll be OK." "Ah," I said, "great minds think alike. I was just thinking that to myself." I grabbed Judy's hand and led her slowly to the door. Enthusiastically, Larry exclaimed, "Goodbye. So long. I'll probably be seeing you guys again soon enough." As the door opened and we stepped through, I looked back and saw Larry smiling and waving. 

That's the last vision I have of my time on Earth. 

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