The "Missing" Brain

*** I have tried to keep the story as real as possible, but please note that all names, places, and times have been changed in compliance with HIPPA regulations. ***

   "Hey, what's this?" I asked my EMS partner as a small weighted paper dropped out of my certification file and fell gently to the floor. With a distinct "ka-thunk" I set the file I had been sorting on the desk and grabbed the wayward paper. "Oh, it's my TPA award!" I said, slightly surprised. "I was wondering where this brain had gotten to. It's been missing for several months." 

    "Missing for several months? No wonder the last while has been quite busy!!!" my partner exclaimed, not willing to miss a golden opportunity for a joke.

    It was true, the month of December especially was much busier than in years prior. As a volunteer, I had run 20 calls around the schedules of the paid staff, mainly in the evenings or during the night. 

    Setting the certificate on the desk, my mind wandered back to the chilly morning.

 

*    *    *    *    *

 

  It was about 7:30 on a Saturday morning. I was standing by the bathroom sink, talking to mom when my pager rudely broke interrupted the conversation. I went into my room and listened to the brief description the dispatcher gave. "1525 Back Mountain Rd, across from Vine Street, fall victim, possible CVA." followed by static. Whirling around to the door, I nearly ran into mom, who was standing in the doorway. "You going? she asked. Answering her question with a question of my own I replied "Yes, if you think it would be ok if I'm an hour late in the shop." A nod was all the confirmation I needed. After changing quickly into my uniform, I ran downstairs, grabbed my phone, ID, and keys. 

    I made it to the station 3 minutes after dispatch. As my partner drove out of the truck bay, I radioed the dispatch center to let them know that we were responding to the call. 

    A few minutes later we arrived on scene. Kneeling on the floor by the elderly gentleman, I began asking a few basic questions to check his mental status. A confused stare was all that answered my questions.   After a deeper assessment, it was evident that my patient was indeed having a stroke. The baseline set of vitals I got didn't make me feel any better about my patients condition. I was very glad when I heard the wail of the approaching medic unit a few moments later.

    Abby, the paramedic walked in and I gave her a brief report. "Let's get moving," she said. "I can't really do any more than you have here on scene. We can do more treatment during transport." As soon as the patient was loaded into the ambulance, the driver turned on the lights and sirens and we sped away to the nearest stroke center. 

    Even with the paramedic's treatment, the patients condition continued to decline. I called the hospital to let them know we were coming. The paramedic placed a call to med command to ask for further treatment direction. There wasn't anymore we could do. The hospital had the medication our patient desperately needed. 

    Screeching to a stop at the Emergency Department, my partners and I worked to quickly take the patient inside to meet the stroke team. "Go right to CT," the Dr. said as we rolled through the wide double doors of the EMS entrance. 

    The CT scan confirmed our diagnosis. Patient care was transferred to the ED staff, and after getting a few papers signed I loaded the stretcher back into the truck. There wasn't anything else to do at the hospital so we started up the ambulance and headed back to the station. Over the next few days, I wondered about the outcome of my patient. 

    The next time I went to that same hospital I got a pleasant surprise. "Congrats!" the ER nurse said with a grin as she handed me a brain pin and a TPA certificate.

 

 

It had been an involved call but I was glad to hear that the patient was recovering.

Last week I saw obituaries for 3 of my patients. All were patients I had treated in the past few weeks. Finding my "missing brain" was a nice reminder of a better patient outcome.