She managed to scream “Help!” through a slur.
It was the last word he heard her utter in his isolation. He desperately called 911 after finding her limp body on their couch – the couch where they used to share life, and where he feared hers was ending.
There had been no time for EMS to gather much information as she circled the drain of death. They were able to obtain a blood pressure that was barely present, a medication list, and hit her with a shot of Narcan for a possible opioid overdose, but to no avail. There were no scattered pills around, there was no recent illness reported besides a slight cough. Her husband had not seen her since last night when they had decided to self-isolate from each other across the house after having a fight.
I was barking orders at the nurse as we hooked the patient’s listless body up to the monitor. She was the only nurse available in the ER due to all the cuts in staffing the hospital had made, trying to salvage their huge, bleeding profits.
“She needs another line, she needs fluids, give her more Narcan, what’s her blood sugar… shit, is that her real blood pressure and heart rate?”
Turning my attention to the patient, I dug and twisted my fist into her chest: “Hey, hey, did you take something?” I thought I saw her smile though she only briefly opened her eyes, responding to my sternal rub, and then without my painful stimulus, she returned to unconsciousness.
Reviewing the medication list, another “Shit!” escaped my lips. Any one of her blood pressure medications could be causing this. If she had taken all five, I feared her death wish was near.
It was not time to retake my oral board exams, but damn, this patient gave me a refresher. The antidotes I had started pulling out of my ass felt like enacting one of those scenarios they give you on the final exam. Each wrong choice could lead you closer to failure — except this wasn’t a hypothetical scenario. This was a life, the same age as mine, that might end, no matter what I did. Poison control confirmed that the kitchen sink of potential remedies needed to be poured into her veins.
And then it was if I was being thrown a lifeline by a compassionate examiner who had enjoyed watching me struggle long enough. Mysteriously, a well-packed black bag of clothes was delivered to the room, with a sticky note and a number to call in case of emergency. Of course, there was no answer when I phoned. Plus, I had a suspected COVID patient with lung cancer deteriorating in the next room who I needed to attend.
I bought the virus-ridden patient more time for the moment by administering high flow oxygen, before jumping to intubation on a guy who had little chance of survival. The husband of my OD called in a panic, just as I had donned my PPE. I guess my blunt message that his wife was dying got his attention.
He couldn’t believe this. She had never done such a thing as what I was insinuating. She was not mentally ill. It was his fault. He had been angry about her recent affair. He had left her alone, thinking this would be protecting them both. Cutting his desperate, lamentable cries short, I explained that I needed his help. I needed him to be a detective and bring me every medication bottle he could find.
Mr. Sherlock not only found the empty blood pressure meds, but he also brought in the empty Tylenol and insulin bottles, along with a note saying goodbye to her children. It was all neatly organized in her yellow floral medicine bag, sitting in her isolation bedroom that he had been avoiding.
Returning to her room, everything still seemed dismal as I looked at her monitor. But this time when I called her name, she opened her eyes. I didn’t have to pinch or push. And they stayed open, quizzically taking me in. Hope filled an empty piece of me, even if ever so slightly.
“You are making it really hard for me to keep you alive. Please help me. How much Tylenol did you take?”
“All of it,” came a whisper.
“And the insulin? How much did you inject?”
“All of it,” she sobbed.
“And the other meds?”
“As much as I could swallow. I wanted to die. I’m so sorry. I thought the world would be better off without me, but it won’t.”
This woman was a mother, a sister, a wife – and she could have very easily have been me. As I held her hand, she fell back into a fitful sleep.
—
Just like the virus, mental illness or trauma doesn’t care about your financial statements or your college degree. It will cross races, age groups and political affiliations.
We have prepared for the storm of the virus with ventilators, protocols, and isolation measures trying to flatten the curve of the impact. It’s been working so well that doctors, nurses, and paramedics are being laid off.
But what are we doing to prepare for the other storm that’s upon us? We are sitting in the eye of heightened mental illness. In a culture and system that does not fund or treat mental health as a priority, I hope our new normal attempts to prepare quickly for the gravity of the devastation at hand. It’s here and I’ve yet to see the urgency it deserves from our health systems or our leaders.
I’ll do my best to hold on to that slight feeling of hope Mrs. Sherlock’s voice gave me.
Image: DepositPhotos.com
