Half-Hearted Medicine

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The call came in as a mutual aid to a neighboring community. It was an overdose of unknown origin.

We pull up to the scene and see a police cruiser. An EMT from the local town is already on-scene, treating the patient. I run and grab a backboard from the rig. Our patient is unconscious and in respiratory distress. He is only breathing 6 times/minute, far below the normal range for an average adult male. He is naked and in his bathroom. His pregnant girlfriend and young relative both look on worriedly.

We drag our patients body out of the bathroom and, in a small attempt at modesty, cover him up with a sheet off the stretcher. The EMTs get vitals and evaluate his body for any traumatic injuries. I am quietly worried about brain damage and the like. Our patient is showing classic signs of opiate use and abuse. Decreased level of consciousness, depressed respiration and pinpoint pupils were all present. He has clearly overdosed and is in need of immediate medical attention.

As we load him onto the stretcher, our patient's young relative looks up at me and smiles. I try to be reassuring, but am distracted by the job I am doing. I want to say something to him, but suddenly find myself outside and loading the stretcher into the ambulance.

I am worried. I weigh the pros and cons quickly of overstepping the lines seniority has drawn and decide to say fuck it, this is a matter of life or death. Or, at the very least, permanent brain damage. I ask the EMT from my department as subtly as possible if I should set up oxygen. He says that it's a good idea. He instructs me to place a non-rebreather mask on the patient, a mask that is only effective if the patient is breathing within a normal range, which our patient isn't. In fact, he is literally half of what it should be. I know this. I assume the EMTs in the ambulance with me know this too, or know something else I haven't learned in my EMT class yet. Even still, I ask as politely as I can, "are you sure?" He says "yes" and goes back to filling out the PCR. I set up the oxygen and watch our patient with the fierceness of a mother bear. I wait for him to crash.

We get to the hospital. I am so furious that I walk outside after delivering our patient to the ER and don't see the nurses revive our patient with Narcan, the miracle drug. I don't see our patient regain full consciousness. I don't see our patient become belligerent and combative. I don't see our patient rip the IV line out from his forearm and demand to know where he is. I don't see our patient try to leave without the slightest acknowledgment to the rescue workers or ER nurses.

I feel angry. Angry at the incompetent EMTs, angry at the junkie patient I spent the last 15 minutes worrying about advocating for. I ask the EMT in charge as respectfully as I can manage why we didn't bag the guy. The EMT says that the patient was "in a deep sleep." I don't know what to say to someone that confuses "deep sleep" with "opiate induced coma" so I shut my mouth and get to work replacing the oxygen tank. The EMT makes a remark about "fucking junkies," and I suddenly understand.

If this patient where an elderly patient who was in respiratory distress, the situation would have been approached differently. But because this was a drug overdose, key medical elements were overlooked because of providers' assumptions.

Half-hearted medicine can and will kill people. It's what I learned tonight.