In a counselors office at a state run facility specializing in juvenile psychiatric issues a mother and daughter sat in their therapist office in an attempt to hash out their differences. The girl was sixteen, her mother thirty-six. Things got heated during the session, words as weapons, hostility, some yelling, anxiety and stress. The mother was so upset she passed out, and could not be roused.
The counselor asked the receptionist to call 911, she did, and we responded.
Having seen it all, and quite familiar with these kind of "anxiety attacks," I walked nonchalantly through the doors of the place I have been to dozens of times for similar reasons. The receptionist directed us to an office toward the rear of the building, and we made our way down the corridor. I entered the small office;the therapist, who had also seen it all gave me a quick rundown. The daughter sat in her chair on one side of the room, her mom the other.
"Half way through our session things got a little crazy," the therapist said. "There was some emotional outbursts, some shouting, and Elizabeth had an anxiety attack."
I approached Elizabeth, tried to rouse her but couldn't.
"Does she have a history of seizures?" I asked.
"No, no medical history but she does take zanex for her nerves," said the lady behind the desk as the girl in the chair looked bored and the lady in the other chair remained unresponsive.
I lifted her eyelids-nothing. I noticed she wasn't breathing, then found no pulse.
"Derek, get the stretcher and the monitor."
"Rescue 1 to fire alarm, send a company to this address, Code 99."
She was in Pulse less Ventrical Fibrillation. The therapist and daughter looked on as I got her to the floor and started CPR. She remained in V-fib the entire time, three shocks, EPI and Atropine ineffective.
Her daughter rode with us as we raced to the ER.
The woman never came back. Thirty-six years old.
I hope her daughter recovers.
I felt responsible to some degree. Should we have driven faster? Should we have brought the stretcher, and all of the equipment instead of just the bag like I used to do on every call until thousands of similar calls with borderline patients wore me down? Should I call it quits, and let somebody unjaded by decades of non-emergent calls take over?
It's been a while since that call, and dozens more emotional patients since that time. I'm always ready now, but at what cost?
I'll never really know.