It was the last week of my EMS elective. I was incredibly lucky to ride with one of the EMS captains who was eager to take me to any call that sounded interesting. We were called to a possible stroke. An 82-year-old woman with sudden-onset unilateral weakness and expressive aphasia. The paramedic and EMT on scene were two I had met before. We actually talked earlier that day about the love we share for the medical field. The captain told me to hop in the back of the ambulance with them while they got the patient set up for transportation. I sat in the back next to the patient and smiled at her trying to think of how I could interact with this woman who couldn’t speak. That’s when I heard it. The crew was talking about the “f-ing stroke this woman is having.” I was taken aback. Maybe I had misheard them? No. There it was again. They said it again, and again, and they were laughing. “I mean she’s over here having an f-ing stroke.” They were maybe a foot away from the patient, and they were making jokes about her condition.
She may have had a stroke, I thought, but she’s not deaf, what are they doing? I turned red. My cheeks have the unforgiving habit of gradually but surely painting themselves the color of any emotion I feel. Wasn’t I just having a conversation earlier with the both of them about how much they love caring for patients? I know they have seen a lot. I know they might be burned out. I know they have seen the system be abused and misused, but I don’t understand why they think it’s OK to talk inches away from a patient about her probable stroke and joke about it.
At that moment, I wished I was bold. I wished I was the kind of person who could speak my mind if something irked me. I wished I was a better medical student. If I couldn’t even speak up now in front of people I likely would never meet again, then what kind of doctor would I be? If I couldn’t do something to stop this woman from hearing the words “f-ing stroke” being spat out repeatedly and carelessly behind her, then what good am I? Ashamed, I bit my lip. I was too meek to ask them to stop. Whoever said, “The meek shall inherit the earth,” clearly has never spoken to me. All I could think to do was distract her. I may not have been able to muster up the courage to say anything, but I wasn’t going to let her listen to it any longer. She wasn’t able to speak, but her ability to comprehend what was being said behind her was indisputably intact as one could visibly see the tears that were pooling in her eyes as she heard the words “stroke, stroke, stroke.”
“You look a little chilly. Do you want a blanket?” It was all I could think to say. A yes or no question. She could still communicate that way, after all. And she did look cold. She was pulled out of her own bed, from her home, into the pouring rain, and into a freezing, metal truck. She gave a small nod of yes. To my surprise, the truck finally became quiet. All that could be heard was the rumbling of the loud engine. The paramedic looked up at me, seemingly caught off guard and said, “Oh. Thank you,” and she handed me a blanket for the patient. The conversation had ceased. No more was said about her possible stroke, and they continued to perform their duties in silence. I sat by the patient and reached for her tiny, cold hand, and she gave mine a tiny squeeze in return.
I did not ride in with the ambulance to the hospital. Once all had been done in the back of the bus, and the EMT was in the driver’s seat preparing for departure, I turned to leave for the captain’s truck where he had been waiting for me. I made sure she was still warm enough before I left and told her that they were going to take good care of her.
I couldn’t be absolutely sure they would actually take good care of her in the remainder of that ride, but I had a feeling that somehow, even without being bold, I had gotten through to them. That day taught me that there are many ways to handle any given situation. Reflecting on that experience, I don’t believe boldly scolding and shaking my finger at the two that were on the bus with me that day would have done any good. Causing a scene certainly would not have made the patient feel more comfortable. But the warm blanket did. Someone sitting by her and acknowledging her did. Being meek did. In the end, less truly was more. It’s often easy to forget other people’s comfort and fears and lose it in the intricacies and duties required of one in the health care profession. I believe the paramedic and EMT from that day are actually good-hearted, caring people, who once never forgot to check on a patient’s comfort and never joked about a patient’s condition within arms distance from them. I have seen many health care professionals who seem to forget. Forget why they went into medicine. Forget the patient’s comfort. Forget the patient.
My biggest fear is that one day, I too will forget. We’re taught in our clinical learning center during our first and second years always to ask if the patient is comfortable before beginning an exam, it’s become routine. However, it’s important to remember comfort isn’t just defined physically. I will carry the memory of this moment with me for the rest of my career. I will remember how I handled that situation and keep the patient at the forefront of everything I do.
After all, that’s why I went into medicine. I will not forget.
Ariana Trautmann is a medical student.
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