It was late; around 1am as we drove up to the house. Urgency and sadness grasped us: our pager’s had told us enough:
We were attending a miscarriage with associated haemorrhage.
Being led into the bedroom, we met eyes with the woman and it became instantly worse.
We knew her.
Not well, but well enough. She was a police officer and we had crossed paths enough times over the last 12 months to have developed a friendly relationship.
Through tears, she told us that she had had bleeding and then contractions, and then passed their child. They had just passed the first trimester, and she had invited some of her friends over to celebrate.
Instead of an exciting celebration, with laughter and joy the house was filled with the awkward silence of sadness. People did not know whether to stay and try and comfort or simply leave and give space.
Cradled in our patient’s hands was a small bag filled with tissues: she slowly allowed my partner to look inside and confirm that the fetus was intact: and there was no obvious indication of retained tissue.
Our patient held that little bag close; a mother already mourning a child.
As we loaded into the ambulance to head off to the hospital and the friends departed, our patient’s husband arrived.
He was blind drunk.
Since the birth of their first and only child he had not had a night away from his family. This evening he had taken the opportunity to enjoy a night with the boys for the first time in more than two years, and it was obvious he had been making the most of the opportunity right up until he received the bad news.
Despite his best attempts, each word that came from his mouth was more cringeworthy and painful than the last. No one else was available to be a support person. This man was it.
Few events are as saddening as a miscarriage. The emotional trauma was compounded further by having people over to celebrate, when all of a sudden the bleeding began and it the future that was, suddenly and painfully grew out of reach. Our patient’s private and personal life were now exposed to us as colleagues as we entered her home and had to ask the very private questions. The line emergency services try so hard to keep; the separation of work and personal lives had been broken.
For fear of being recognised by the hospital staff or a police officer in the ED (mental health/ drug and alcohol patients often have police escort) we quickly moved out of the main triage area to a more private space.
We were ramped for more than 2 hours.
And during this whole time, the one person our patient needed to support her; her husband, was being utterly selfish and inappropriate. No matter what he did, it just made things worse. No matter what he said it just made things harder for his poor wife. He has dug himself a hole and now it was filling with water. Despite our suggestions, the concept of therapeutic silence was simply beyond him.
As I tried vainly to sober up the poor man, my partner held the patient’s hand, found her some counseling and provided advice for referrals. As I made strong cups of coffee, force fed him sandwiches and water, and fetched warm blankets, my partner hugged and gave pain relief.
Occasionally as a paramedic you get privileges. For some that means “the uniform discount”. For others it’s a lack of speeding tickets. That night we had the honour of being able to spend an extended period of time with a patient who needed our care and support, far more than our drugs and diagnoses. For the 3 hours we were with her, we were her family.
In a job with such a focus on speed and criticality, it is rare that sufficient grace is provided to us such that we may have the time we desire to truly give a patient what they really need.
If such an opportunity presents itself, I beg that you would not let it pass you by.
For your sake, and theirs.