I like it when someone else volunteers to drive when we go out. It rarely happens, so it’s a treat. I enjoy looking out the window and watching as the view slides by. There is usually something new or interesting to see and it’s relaxing to let go of responsibility.
But this time it was different.
It was 1pm on Friday, January 3. This time the view was what I could see through the doors of the ambulance from the gurney I was strapped into as we sped to the hospital Emergency Room. Shelby, the EMT, held my hand and gently talked to me about her cat, as Alan, the other EMT, drove down the highway, siren sounding and lights blinking, the day darkening ahead of the predicted rain storm.
I had been looking forward to the New Year.
The past 12 months had not been kind or easy and December had ended with my complicated surgery and ongoing difficult recovery. I knew something was wrong a few days earlier. My body was not responding to treatment, my pain was increasing and my mobility had not improved. But I was stubborn. I didn’t want to deal with any more doctors or medications, foolishly hoping it would somehow all just get better and go away.
There was more than a bit of denial too. After all, I was the healthy one in my group; the one who took charge, made all the plans, did all the driving and shopping, never even had a cold! I was the one who watched the others get sick and die. The one who spent their last days with them. I was the strong one! Until I wasn’t.
That morning I tried to get out of bed in what had become my normal procedure. It was a complicated process since my operation. I used the hook from my cane to drag my left leg to the edge, then lower it to a step stool, reach for the walker, place the good leg on the floor and hook the weak leg once again to bring it gently down.
This time, the good leg buckled, unable to withstand the weight. The pain was excruciating! My left leg hit the floor and then I saw it! I can only describe them as elephant legs! Both were swollen beyond recognition, purple and blue stumps from toes to thighs! I dropped to my knees and crawled to the living room.
I was lucky. In a few minutes, Stephanie, my wonderful physical therapist, would arrive for our morning workout. She would know what to do.
“You need to go to the Emergency Room right away, Carole. I’m calling an ambulance!”
I was stunned. Surely this was an overreaction.
“No!” I said, my voice loud and shaky. “We will do what the Handbook says … elevate and ice. I’m not going to the hospital!”
I was adamant. My decision was panic driven. If I went to the hospital, I believed I would never come home!
Stephanie remained calm. Her caring manner and determination were steadfast. “I’m calling your doctor.” She did. Then called the Visiting Nurse, the head of PT, and the Triage Group. Each call was on speaker, so I could hear what was being discussed. The answer was the same each time … Get to the Emergency Room now!
“No!” My whole body was shaking. I have never been so afraid.
“I’m calling the ambulance. When they get here, you have the right to refuse to go. It’s your decision, Carole.” She made the call. They arrived in what seemed like an instant.
Shelby and Alan. Possibly the two kindest, most patient people in the Universe! They listened to my refusal. Then, slowly began to explain what I already knew but did not want to hear.
I had all the symptoms of a blood clot. The silent killer. It is one of the three dangers of my type of surgery that require vigilance along with heart attack and stroke. I was already at greater risk because I had a stroke a year ago. Gently, without judgement, they presented the case. Be safe. Not sorry. It could be an infection. Or something else that was not life threatening. I could be home again that day.
At that moment, my sweet cat, Lovebug, entered the room, moving from one visitor to the next, rubbing against their legs, seeking and giving affection. She seemed to understand we needed comfort. I began to cry.
Shelby picked her up, petting her behind her ears (her favourite spot) and said, “Let’s get going, Carole.”
Alan went into the kitchen and filled the cat bowls with fresh food and water. Shelby helped me to the bedroom, gathered a few things together in my overnight bag, made sure I had my phone and charger, and sat me down while Alan joined us. “You’re making the right decision. Let’s go.”
The three of them carried me down the steps, locking my door behind them. Stephanie said she would do all the necessary follow up. She knows I am a Solo Ager and have no local emergency contact.
I was placed on a stretcher, the wheels squealing loudly as we moved across the parking lot. The doors to the ambulance swung open and I was lifted and loaded mechanically into the back. It was my Magic Carpet. I was on a ride to some place foreign. I had no idea what would happen when I got there.
The ride took a minute — or maybe hours. I had no sense of time. Somehow I managed to call Jen, my wonderful neighbour who cat sits for Lovebug. She would take care of her. Then, I remembered that I had arranged for my Shop From Home food delivery to come this day. I called to cancel it. The woman on the phone was astonished that I was calling from an ambulance!
We pulled up in front of the Emergency entrance. I will never forget the sights and sounds. So many people in different coloured uniforms rushing in every direction. Machines whirring and clicking. Doors continually opening and closing. Some patients were lined up in beds against the walls. A few were moaning or sobbing.
Shelby and Alan navigated the chaos, pushing me to a vacant spot in the hallway. Alan stayed with me while Shelby gave what I assumed was the necessary information to an official looking woman behind a desk. They pushed me further up the hallway, talking to me all the while and reassuring me they would stay until I was admitted.
I learned that Alan had been a fireman for many years. He fell from a roof during a rescue, breaking his neck. Spent a year in recovery. Retired. But missed the action. He certified as an EMT.
Today was his first day on the job. I was his first patient. He could not imagine a life without helping people.
Shelby had served in the Army, doing several tours in the Middle East. When she was wounded for the third time, she decided to end her military career. She had been an EMT for 10 years and was qualified to do search and rescue in a helicopter. I was blessed. Two remarkable people were put in my path this day!
Finally, a nurse arrived and explained that I would be moved to a holding room. This would allow me to be constantly monitored. I said goodbye to Alan and Shelby. I could not find the words to tell them how much their kindness and expertise meant to me. I watched as they walked down the crowded hallway and out the door. I was alone.
The room seemed to be an office/storage area/makeshift patient accommodation. A nurse helped me to undress and put on the hospital gown. She did not say a word except that the doctor would be there soon. A technician followed, hooking me up to something that beeped and burped. Another wordless encounter.
I had read about blood clots in my Guide To Your Robotic Hip Replacement Surgery. I knew how dangerous they were, how quickly they could move and that they could be fatal. Time was of the essence. I had procrastinated. Was it too late?
My thoughts were interrupted by a young woman at the doorway. “May I come in?” she asked pleasantly. I motioned for her to enter.
She had a notepad and pen in her hands. “If you wish, do you want to tell me if you have a religious preference?” I told her I was Jewish.
“We have a Chaplain on call tonight. If he has the time, would you like him to stop by and talk for a while?” My voice caught in my throat. “Yes. That would be nice”.
I was surprised by the readiness of my answer. She smiled, said “Good luck” and left. Again, I was alone with my thoughts. I waited. It was unlike any other time in my life. I could not think. I felt nothing. It was a terrible dream and I could not wake up. I was helpless.
Finally, the doctor arrived. A young man with a genuine smile and gentle manner. He introduced himself. The only thing I heard was “Doctor Phil”.
How odd, I thought. Was I hallucinating? He pulled up a chair, looked at the machine and a printout, and asked me how I was feeling. The only word that came to mind was “numb”. He did not seem surprised.
Apparently, I was in shock. He moved closer, explained what had happened, why it was dangerous, and the next steps. I would see a technician who would take several ultrasounds. Both legs, hip, spine, and knees. It was necessary to determine if there were any blood clots, although some were so small they evaded detection. I would have to wait a bit before someone was available. And then, a few hours until the tests could be reviewed and evaluated. In the meantime, I was to try and relax, maybe sleep or watch TV. Was there anyone I wanted to call?
No. No one. I was terrified and alone, although I did not tell him that.
The tests were administered by a talkative woman who told me about her family and their Christmas celebration. I barely listened, although the sound of her voice helped drown out the sloshing of the ultrasound. It was over quickly and I was wheeled back to my room.
Once again, I waited. It was four hours before the doctor returned. What happened during that time? Four hours that seemed like a lifetime!
I reviewed almost dispassionately what it would be like to die on this day and in this way. I had contemplated death of course. I was, after all, almost 75.
My three close friends had died just recently at that age. And so many others — acquaintances and classmates as well. But I never envisioned it happening like this. An ordinary day. No advance notice. From something rarely talked about. Not a disease or an accident. In a place so strange it could have been Mars. And perhaps, because I had refused help in a timely fashion.
“Good News, Carole! There are no signs of a blood clot!” Dr Phil took my hand and looked at me directly. “I want you to listen carefully. You can be discharged tonight. I have a list of instructions for you. Nothing complicated, but you must follow them. You will also need to schedule follow up ultrasounds in the next week. We need to make sure there are no clots that were too small to detect or hiding. Rest for a few minutes. The nurse will be in to help you get dressed. Who will be picking you up? Should we call them now?”
“There is no one available to take me home,” I replied. Dr Phil’s brow furrowed. “No one? Who will be with you tonight?”
“I will be fine by myself,” I answered with a conviction I did not feel. “I am used to taking care of myself.”
He sighed, reminded me to follow all the precautions, return if the pain and swelling did not begin to dissipate, prescribed something to deal with the inflammation and told me he would send a social worker to help with the arrangements to get me home. Then he was gone.
A few minutes later a woman appeared at the door and handed me a list. On it were the names and phone numbers of five local taxi companies.
I got dressed. The painkillers were beginning to work and I was able to use a walker to get to the waiting room. I dialled the first four numbers. No answer or voicemail. Just one more chance. Please … Let them be available. They were. and 15 minutes later I was in the cab.
It was pouring rain and freezing cold. We drove in silence. I struggled to get out of the car. The driver did not offer to help. Somehow I managed to get up the steps. As I reached for my keys and unlocked the door, I experienced a chill and a sensation I cannot really describe. It was 11pm and I had never felt so alone.
Lovebug stretched sleepily, greeting me with lots of head bumps and rubs. She was fine. But she soon sensed that something was wrong. It was the smell of a hospital, I think. And the way I struggled to walk just a few steps. She did not leave me alone for the rest of the night and all of the next day.
It has been several weeks since my blood clot alarm. I am on other medications, a new physical therapy routine and restrictions, and tired all the time. But most of all — I Am Different! And not in the way I would have expected.
I always thought of myself as a woman who could learn something from every experience — be it good or bad. Something that somehow enriches my life or helps me to be a better person. I like this quality. It has served me well as I grow older.
Yet I struggle to make sense of this experience. Instead, I feel as if I have fallen into a deep hole. It’s a very dark place. Ugly. Hopeless. My usual optimism is replaced with pessimism. I lack the energy to climb out. I don’t have the tools to build something useful. It’s sad and frightening.
Perhaps, this is where I am meant to be at this time of my life. Perhaps I need to come to terms with the fact that Death is not just a part of the Cycle of Life, but that I do not get to decide how I will handle it when my time comes. I wanted to believe I would meet it with grace. Did I pray that God would let me live that day? I did. (The Chaplain did not come.) Truth be told, I may not be able to ‘handle it’ at all.
Death, I have learned, picks the day, the time, the place and the method. If only it would keep me from dying alone.
What does this all mean? How does this new knowledge affect me? What do I do with my remaining time? Will someone be beside me when my time is ending? Will anyone remember me? Is there a way to leave a legacy if there is no one to mourn my death?
If the question is: Is this the day I die? Then what must I do if this is the day I live?