This Day Was Different
November 2014 Issue
I hate mornings. I do not like waking up to an alarm blaring and the light streaming into my eyes. I'm a slow starter, but once I am up, I can operate at full throttle, and this particular Wednesday was no exception. Bobby rolled into the front door of my practice in his wheelchair, cussing and complaining about the list of recent wrongs and general ineptitude of the staff at the assisted living facility he reluctantly called home.
Bobby had been a patient for many years, and I was as close to being his friend as anyone. He had been declining in both mind and body over the past few years, and it had gotten progressively worse in the recent months. He'd call regarding some crisis with his prostheses that needed my immediate attention, and when I'd go see him I would find that he was trying to wear the legs without gel liners, or had them on the wrong side. I would usually troubleshoot the issue quickly, resolve it, and be on my way. One strange thing is that Bobby had been telling me that he loved me, in a longing-for-a-connection kind of way. He had been calling more frequently and professing his gratitude for my friendship.
As we headed into the exam room that morning, I noticed the problem with his prostheses: His left leg was on the right side, and vice versa. I had him switch them, and as he stood in the parallel bars, he said that they felt much better. Walking the length of the bars, he turned and made his way back to the wheelchair. As soon as he turned around to sit, he died! As he collapsed, I caught him and eased him to the ground. Screaming for Pam, my wife and office manager, to call 911, I began listening for breaths and feeling for a pulse. Seeing him go limp, with his lifeless face and body, my adrenaline kicked in as I began chest compressions.
After what seemed like an eternity, the emergency medical services (EMS) technicians arrived, took over, and revived him. But once they got him into the ambulance, he coded again. Bobby exited the world as dramatically as he had entered my office that morning. The EMS technicians tried to reassure me that any chance that they had of saving him was greatly enhanced by my actions, but I have always wondered if I could have done more.
In the days following Bobby's death I ordered emergency defibrillators for each office and reviewed our policy and procedures manual to see if I could tweak anything to increase the odds of survival should a future incident occur.
Although I'd gone more than 23 years in clinical practice without experiencing a medical crisis in my office that an extra-large bandage would not cure, within a few months Bobby went into cardiac arrest and expired, and another patient had a violent seizure and had to be transported to the emergency room. As a result of these events, I no longer protest when I have to undergo first aid and CPR training. Taking the time to prepare for the medical emergency that may never happen will pay off on the slim chance that it does.
It has been more than a year since Bobby died, and while the story would be better had he lived, sometimes in real life stories end badly even when you do everything right. I sleep well at night because I know that in both medical emergencies I did the things that anyone could reasonably expect me to do in the situations presented. The only option that I did not have at the time was the defibrillator. I found that the cost is not prohibitive, so I strongly encourage you to get one for each of your offices, and get the training to use it properly should the need ever arise. It may be your peace of mind or a life at stake.
James O. Young Jr., CP/L, FAAOP, is the owner of Amputee Prosthetic Clinic, headquartered in Macon, Georgia. Young also has a transfemoral amputation and provides peer counseling to other individuals with amputations.