"84 year old male, cardiac arrest, no access available"
It was the night before christmas, families gather for the festivities, last minute wrapping is done and there is a general feeling of good cheer. Our first job came down as a cardiac arrest. Not an ideal start to the shift and certainly not festive, but when it's your time, it's your time. We raced round there, a crowd had gathered in the road outside this guy's house. We screeched to a halt, jumped out and without saying a word to each other grabbed all the kit we might need. Response bag, oxygen bag, paramedic bag, life pack, defibrillator and suction unit. Loaded up like pack horses we did the 'emergency walk' to the front door. It was locked. No one had a key but our patient could be seen in his armchair, motionless, through the window. No time to waste, I entered the porch, dropped my bags, took purchase on the door frame and in a blaze of glory kicked the door in! It was much easier than I thought it would be. In fact, the door came right off its hinges. Aware there was a crowd, and quite proud of myself I felt a shiver run down my spine. I grabbed my bags and in we went.
Sitting in his armchair was our parient. He looked pale. Eyes shut. A small amount of sputum sat on the corner of his mouth. He was in his pyjamas. He'd been dead for some time. His temperature was so low we couldn't get a reading. Surrounded by unopened christmas presents ans cards he'd passed away quietly. He just looked asleep. It was a very surreal moment. It always is when confronted with a dead body. I can't describe that unique feeling. Doing paperwork and trying to piece together some sort of medical history in the presence of the body is a little unsettling to say the least. We cancelled all other resources and requested the police. This is standard procedure in the event of an unexpected death. The guy wasn't terminally ill but had simply died. It happens. It wasn't long and drawn out. Sudden and peaceful. I think that's how i'd like to go. As we were doing our Recognition of Life Extinct paperwork and our report, the family arrived. The eerie silence was broken with that of tears and distress. It's the single hardest thing we have to do. Telling a relative that their loved one is dead. We have no training for it, and nothing really prepares you for having to do it. I found myself fighting back the tears trying to assure them he died peacefully.
After being left alone for a few minutes, the son and daughter in-law emerged from the sitting room. Their mood was changed. It appeared to some extent, peace had been made. They began sharing stories about the incredible life he had led. They built a fantastic picture of him. The daughter in-law then said:
"Oh my god, we are supposed to be going away tomorrow"
She instantly rebuffed her comment.
"I'm so sorry, that must seem so callous and cold"
Initially I agreed, it did, but the reality is, people do have plans. Death can come at anytime and the world doesn't stop. People have jobs, people have children and continuing with a sense of normality helps the grieving process. They were flying out to see their daughter abroad for christmas and would be gone for two weeks and that is exactly what they were going to do. From what I learnt about our patient, he would insist on it. Today was his day. He's got up for breakfast as he does every day at 9am. He out his teabag in the mug, and boil the kettle. While the kettle boiled he would sit in his armchair and open the post. This he had done. Opening christmas cards from his loved ones was the last thing he did. Still apologetic about her apparent lack of focus on her father in law and his funeral arrangements, her husband and our patient's son said it perfectly.
"It's ok love, he'll keep"
And it's true, he will. They were a nice family, a close family, genuinely kind but realistic people. The funeral can happen after proper planning and when it suits everyone. Making arrangements over the holiday period was always going to be tough so why not wait. No matter what anyone plans for, life throws out it's fair share of curveballs and people deal with them in different ways. There is no right or wrong way. All I know is that our patient will have a great send off and his life will be celebrated. Until then, life goes on.