"It's not really pain, it's pressure."
If I had a nickel for every patient who told me that, I'd have a lot of nickels.
"When did it begin?"
"A few days ago."
"Why didn't you call somebody?"
"I didn't want to bother anybody."
We attached the leads, she looked dreamily out the rear windows of the rescue. The essence of Jean Nate' filled the small space, masking the lingering aromas that normally accompany us. It reminded me of my grandmother, long gone now. I swear she had a closet dedicated to the Jean Nate' gift sets she received as presents from her brood. She lived to be a hundred. That's a lot of birthdays, and a lot of Jean Nate'!
"Besides the pressure, how are you feeling?"
She took my hand, the one that had been resting close to her as I breathed in the memory of Nana.
"I think I'm going to die."
We locked eyes, and in hers I saw no fear, no remorse, no anger or sadness. I have no idea what she saw in mine. I hope they didn't reflect the image of Ventricular Tachycardia that glared from the monitor. and the worry that that image conveyed. V-Fib could be seconds away. Or worse.
"We need to do some things," I explained as an IV went in and oxygen went on. Her vitals were consistent with V-Tach, but she was calm, glowing a little but not diaphoretic and resigned to accept whatever fate awaited her.
I pushed lidocaine, hoping to see her rhythm return to stable, but it was ineffective. cardioversion is next, normally, but the cowardly Rescue Lieutenant, knowing that Our Lady of Fatima was two streets away decided that rapid transport was preferable to sedating a ninty-eight year old lady, then shocking her heart.
We arrived at the ER before I could administer the second dose. Her condition hadn't changed, nor had her demeanor.
I have a feeling that the sweet smell of Jean Nate' in the back of the rig will be around longer than she will.
And I think she is ready to go.