I was doing my visits when the surgery telephoned me. Ambulance Control had called—a crew were attending an 82 year old woman who had collapsed—would I go? Three weeks before, Phyllis had had a coronary event; she was treated at home by one of my partners and was doing quite well. Her daughter Diane had called to make some lunch. For the first time since she was ill, Phyllis said she would have some pudding. As she ate, she suddenly clutched her chest, gasped, gazed at her daughter, and died, falling from her chair. Diane, in her anxiety, did what most people would probably do—telephoned the emergency services.
As I drove into the quiet little cul de sac of terraced council houses, I saw, there at the end and occupying the whole width of the road, two stunningly painted emergency vehicles with blue lights flashing—a paramedic car and an ambulance. Phyllis's front door was open, and just inside was Diane, sitting at the foot of the stairs with her head in her hands weeping. “She wouldn't have wanted all this, doctor. She hated hospitals.”
As I stepped into the living room, I was greeted by a scene that would have done justice to Frankenstein's laboratory. There were monitors, large bags of kit, oxygen cylinder, tubes, wires, bits of debris, and three uniformed stalwarts, one thumping, one blowing, and one twiddling knobs. In the middle of the chaos on the floor lay the buxom form of Phyllis—dress ripped apart, ample breasts, pendulous with age, bouncing in rhythm with the cardiac massage. A disembodied, Stephen Hawking-like voice was issuing instructions: “Check patient. Analysis: no shock advised.” Even an untrained eye could see from her blue-grey blotchiness that Phyllis was now a corpse.
As I picked my way through the jumble on the floor, Phyllis's other daughter arrived with her own 12 year old girl. They had been told to hurry over, and they came straight into the room. I glimpsed the look of horror on their faces as they recoiled into the hall. The child had probably never seen her grandmother's breasts before.
“We have given her two shots of adrenaline, doc. There is still some activity on the scope if we enhance it.” I knelt down by Phyllis, took out my stethoscope to establish my medical credentials, and listened knowingly to her chest. I shone a light in her widely dilated, fixed pupils—it was now at least 20 minutes since she collapsed—and said, “I think you have done all you can, gentlemen.”
Without a word the resuscitation team disconnected their kit, packed up in no more than a minute, and were about to leave when I asked, “Can you give me a hand to tidy her up and put her on the bed before you go?”
“We are not supposed to lift, doc.” And they were gone.
I tidied her up and went out to the hall, where the three female relatives were gently weeping. Putting my arm round Diane's shoulder, I said, “I'm afraid she has died.”
“I knew she was dead, doctor, and I told them that she wouldn't have wanted them to try and revive her, but they asked if I had that in writing. I just wanted to cuddle her.”
I have learnt since that ambulance crews and paramedics are particularly worried about being sued if they fail to attempt resuscitation. How the murky spectre of the legal profession lurks round every corner, affecting all our lives, and our deaths, in more ways than we could imagine.
Paramedics are well trained and skilled, and I respect their professionalism. They surely save some lives, but has not the advent of the technology deprived us of some humanity? Phyllis's demise was undignified; the image of her lying on the floor looking like the victim of a rapist will stay with her daughters and granddaughter for a long time.