Reverberating for Decades
Three amazing stories of medical professionals going outside protocol to be fully human in the face of death.
If there’s any profession the public deals with on a regular basis that’s bound by rules and protocols it’s medicine. In life or death situations, scrutiny is high, and professionals — particularly in the United States — know that everything they do might be reviewed by lawyers looking to justify a lawsuit. But some do the human thing anyway, guided by their Uncommon Sense.
There was a story my newsletter about something rather unusual that paramedics in Australia did that wasn’t about dumb people doing stupid things. It’s called Final Wish:
Paramedics in Hervey Bay, Qld., Australia were taking a terminally ill woman to a hospital when she sighed, she wished she could “just be at the beach,” rather than go to the palliative care unit. “Above and beyond, the crew took a small diversion to the awesome beach at Hervey Bay to give the patient this opportunity,” says ambulance officer-in-charge Helen Donaldson. “Tears were shed and the patient felt very happy.”
My tagline on the story is: “Life’s a beach, then you die.”
Sadly, the story made it into a “weird news” newsletter because it’s so unusual. Readers loved it, and the tagline.
The reason we know about this event is Queensland’s Ambulance Service posted about it on Facebook, with a picture shown here. I’m afraid that in the U.S., medics could be disciplined for doing something like this. But Down Under, the crew was praised. The service concluded their online post, “Great work Hervey Bay team Danielle & Graeme. The Service is very proud of you.”
And as a current volunteer medic in a rural area in the U.S., I’m proud of them too. In the photo, we can see they took the gurney out of the ambulance and rolled the patient out on a bluff overlooking the ocean so she could not only see the water one last time, but feel the breeze and taste the salt air.
Graeme is standing there, back a little bit, waiting with her, watching over her to make sure she’s OK, but just giving his patient that last moment. This isn’t a drive-by “hey look out the window when we go by here and look at the beach.” No. They stopped, they took her out, and rolled her off the pavement so she could really experience the ocean one last time.
In a field bound by protocol, medics do learn to think outside the box. Still, it’s unusual. Medics are usually in hurry-up mode, get things going and get back in service so they can take the next call. But instead these medics took a few minutes out to give their patient what she really needed. They exhibited Uncommon Sense.
It reminds me of when I was a full-time medic in California. We were called by a doctor to go to one of his patient’s house and bring him directly to Intensive Care. It was a sobering scene for me as a young medic: the patient, in his 30s, was on a hospital bed in the living room — a common thing to see with terminal patients. This man’s young children were there, as well as his wife, and his problem was that he was having muscle spasms in his back, which pulled on his spine, which was riddled with cancer. That caused waves of pain, which caused him to flinch, which triggered muscle spasms — in a nasty feedback loop.
My partner and I carefully moved him to our gurney, and gingerly took him out and put him in the ambulance. I was the driver that day, and I remember driving about as slow as I ever did, making sure to guide the ambulance around every bump or pothole that I could avoid. The doctor at the hospital could wait; we didn’t want to make anything worse.
So when we did get to the hospital, as instructed we bypassed the emergency room and went straight to ICU, and sure enough, the doctor was there waiting for us. I watched his face as he realized just how bad his patient was, and that’s when his Uncommon Sense kicked in. If we didn’t mind, he asked me, could he start treatment on the patient there in the hallway, on our gurney, rather than taking him into ICU? The man was groaning in pain and the doctor said he just didn’t want to disturb the other patients in Intensive Care.
No problem, I told him.
Now, the doctor decided not to dope the guy up on opiates, but rather try to break the cycle that was causing the pain. He sent the nurse in to get a syringe of Valium in hopes of settling down the muscle spasms. She brought him the usual dose, 5 mg, which the doctor shot directly into a vein. It had no effect. He sent her in for another dose, a bigger one this time: 10 mg. Still no effect. He sent her back for 10 more, then another 10, and then another.
All told, I watched as he gave the patient 85 mg of Valium I.V. within about 10 minutes. The usual “not to exceed” dose for I.V. Valium is 30 mg, so that much would knock most people completely loopy. But cancer is a powerful disease and after all that, our patient was only mildly sedated. Still, it was enough that the doctor was satisfied, and let us roll the patient in to ICU and transfer him to a bed. I never saw the patient again, and wondered how much longer he lived.
It only cost us 10 minutes or so, and it was a true honor to be there in that young man’s time of need, and witness a truly caring doctor helping him. This was many years ago, when I was maybe 19 years old, so there’s no picture to see other than the mental one you have right now.
Still, that’s not the only case of hospital-based Uncommon Sense I’ve noticed lately. In 2017 a photo went viral online: a patient was admitted to Denmark’s Aarhus University Hospital.
He was in bad shape: Carsten Flemming Hansen had an aortic aneurysm that was leaking — he was bleeding internally. That can be fixed surgically, but Hansen was so ill doctors said he wouldn’t survive surgery, and would bleed to death within hours. Surely it would be a better death for him to be with his family, rather than die unconscious on an operating table.
Hansen, who was 71, took the news in stride. Now, one of the big rules in hospitals is no smoking. A no brainer, right? But Hansen was dying anyway, and asked if he could have a last cigarette. Or maybe a glass of wine. Or, at the very least, could he look out the window to see his final sunset?
Nurse Rikke Kvist said yes to all three. And she did it without really breaking the rule. To ensure there was no smoking in the hospital, she wheeled Hansen’s bed onto a hospital balcony — on the west side, so he could see the sunset. And got him a glass of wine.
Where so many people would be ruled by — well, the rules, the paramedics in Australia, the doctor in Marin County, California, and the nurse in Denmark all showed the best thing they could do in the circumstances they were faced with: they exercised Uncommon Sense, even if they couldn’t do anything to save their patients’ lives. I was privileged to see one of the cases first hand, and it affected me profoundly: it’s part of who I am not just as a medic, decades after this happened, but as a human being.
And that’s another important aspect of Uncommon Sense: you never know who is watching, and learning, from the example you set. Think of that the next time you’re doing something with your kids, grandkids, or even random children in your neighborhood. Your actions — positive or negative — could reverberate for decades.