I sometimes tell folks an amusing story about a lunch I had with my grandmother. Well, it’s amusing to me.
A couple of years ago I was at my grandmother’s condo for our weekly lunch (it’s been less than weekly lately, but I digress) and my grandmother’s best friend, Joanne Brant, was visiting. My parents lived in Washington state when I was four or five years old and Joanne served as my de facto grandmother so it’s always a joy to see her.
We were eating lunch when my grandmother, having come back from the kitchen and standing near her seat at the table, made a weak coughing sound and gave the universal sign for choking. Joanne asked, “Are you okay?” My grandmother shook her head. Joanne asked “Do you need help?” My grandmother nodded her head. Joanne turned her head to me as if to say:
you are the guy who works for 911, this is right up your alley.
At that moment I knew I had to do one of two things:
a) Explain to Joanne that, while I am indeed a 911 call-taker and police dispatcher, the only thing I do for medical emergencies is transfer the call to the fire department for the paramedic dispatchers to give emergency instructions. Besides, Joanne was sitting closer to my grandmother so perhaps she should step up.
or
b) Rush in and give the Heimlich maneuver, which I had been trained to do while working at the Hotel Captain Cook but had never done in an actual emergency.
The fact which tipped the scales toward jumping in and Heimliching my grandmother (which is illegal in several southern states) was that it would take too long to explain to Joanne all the things in plan a).
So I performed an amateur and very undramatic Heimlich, my grandmother successfully cleared her airway of a piece of apple, and we continued lunch as if nothing interesting had happened.
While I always expect that I will react quickly in an emergency, I cannot assume that I will. I get plenty of calls from otherwise very competent citizens who seem to lose their wits during emergencies and I try to remember that I’m not immune from that kind of reaction.
Luckily, during today’s excitement I performed as well as I could have hoped.
After getting the third of four weekly iron infusions to battle a bout of anemia, my grandmother went with my mother back to my parent’s house for an Easter brunch of homemade pork carnitas. On her way up the stairs from entryway to the living room, my grandmother became extremely weak and dizzy. My mother helped her up the stairs where my father met them both and picked my grandmother up and gently placed her on the couch.
Shortly afterward, Kelli and I arrived to find her reclining on the couch nibbling on chips and feeling weak but otherwise fine. About thirty minutes later, and before my mother started sautéing the onions and peppers to accompany the carnitas, my grandmother decided she needed to visit the bathroom.
She got up and had taken a few steps when she became very dizzy and weak once again. Kelli thought she might be leaning over to see around the corner for a light under the bathroom door to see if it was occupied but she was actually performing a graceful slow-motion leaf-falling-from-a-tree type of plunge to the carpet. My mom asked if she was okay and her response was a weak “no.”
I was closest to her so I quickly slid behind her and grabbed her under the arms to prevent her from doing a face-plant on the carpet (always embarrassing and potentially expensive and painful if the plant-ee is wearing eyeglasses).
My grandmother was still conscious at this point but very weak. My mother aptly described it later as “boneless.” I helped my grandmother up and we took a few more steps then she went limp again. By the third time she had collapsed we were in the bathroom. I let her sit on the floor for probably thirty seconds before she requested being sat up on the toilet (cover down, like a chair). I helped her up half-way, she again did the boneless chicken routine, so I picked her up and placed her on the toilet.
All the while I talked to her very calmly as if mimicking invertebrate poultry was a traditional Easter custom in our family.
Then the real excitement began. When I got her sitting upright on the toilet my grandmother totally lost consciousness and did the deep breathing one might expect from a heavily sleeping person. Then again, I thought, it could be agonal breathing* (the death-rattle I have heard over the phone but never in person, God forbid ptooey ptooey**).
I don’t remember what I said but Kelli heard a very calm “Someone needs to call 911, can someone call 911 right
now please.” I remembered a Stephen King story*** where a med student woke up a person who had fainted by pinching her earlobe really hard. So I did. And it worked to a certain extent. My grandmother looked up, her eyes opened, and she gave me a look as if to say “
hey, what was that for?” then she dropped off again.
At this point, and I wish my grandmother was conscious and alert enough to witness it because it would have made her proud, the five of us did a kind of ballet.
My mother called 911 very calmly and, from what I heard, she was the perfect caller. She described the situation clearly and calmly and told the paramedic dispatcher that, no she was not standing near the patient but her son was a police dispatcher and was with the patient and could shout answers to all of their questions.
Kelli heard me tell my grandmother that I was going to lay her on the floor and saw how difficult it was going to be for me. Kelli called my dad to help me. Kelli then asked for the keys so she could move our SUV out of the driveway so the paramedics could drive right up to the door.
My dad assisted me get my grandmother laid flat then helped direct the paramedic, firefighter, and police traffic through the house. It turns out I knew the main paramedic (Ken Craver, paramedic God) and the responding officer (Doug Fifer, the funniest officer on the force), although neither Ken nor I recognized each other until later and I never saw Doug, who was in the other room.
By the time she was flat on the floor, Grandma had regained consciousness and was weak but mostly lucid. In the couple of minutes it took for the paramedics to arrive she had regained full lucidity and was able to answer all of their questions (and add that, for their information, she was on Medicare and she had AARP supplemental insurance!).
There was no question about whether the medics would transport; she was going to the hospital, like it or not. My mom got to ride along in the front seat of the ambulance. Kelli and I followed shortly thereafter and my dad (who probably has a case of pneumonia right now but was too stubborn to cancel his Easter carnitas just because he could hardly breathe) held the fort at home, made calls to my brothers, and awaited further instructions.
The rest of the day was boring. The emergency room did some blood and urine tests which were inconclusive but suggested that she probably had a reaction to the infusion medication as well as may have been dehydrated. They checked her heart and lungs, ruled out a cardiac incident or a stroke, and pronounced her well enough to go home unless we wanted her admitted for observation (although the doctor suggested that infections or other diseases caught while in the hospital would be a lot worse than what she went in for).
I volunteered to spend the night with my grandmother at her condo to make sure she did not have any further difficulties. (Bless my wife, who was not consulted about this but was fully supportive when I told her).
And that’s where I am now, getting ready to go to bed on the pull-out couch. Grandma seems fit as a fiddle, although a little weak. Tomorrow I’ll take her to an appointment with one of her doctors which will hopefully shed a little more light.
I’m blessed to have such a great family and I’m proud to have been a part of our little “Medical Emergency Ballet.” Perhaps we could get music written to it and have ourselves a hit on Broadway.
Or maybe not.
Happy Easter,
E
* From a tiny amount of research on the internet, I found that dyspnea (shortness of breath) can be caused by anemia. Obviously I had not heard ataxic (agonal) breathing but instead probably Cheyne-Stokes breathing, a type of dyspnea which is sometimes normal for someone who is asleep but is abnormal for someone who is conscious.
** Robin Hartlieb (aka Shaindlin), who was my recruit for a couple of months prior to her going into observation and being cut loose as a dispatcher (thank you very much) probably taught me as much about being a Jewish grandmother as I taught her about being a dispatcher. Saying “God forbid, ptooey ptooey” after mentioning any ailment or catastrophe so as not to cause it to happen to one’s self is probably my favorite Jewish grandmother mannerism.
*** The story is called “The Raft” from Stephen King’s collection of short stories “Skeleton Crew.” While this is not one of the stories that Robin’s dad, Herb, read to his audience over the radio back in my formative years, it was Herb who piqued my interest in Mr. King’s work by reading “Quitters, Inc.” in his inimitably chilling voice.
