The Gift

A forty-five year old man lays slumped against the storefront of the Erotic Palace. He is out cold, drooling. He clearly has done some drinking from the smell of his breath. Doesn’t respond to a sternal rub. We take his jacket off so we can get access to his arms. No track marks. He is clutching a small box in one hand. We get him up on the stretcher and then into the back of the ambulance, and get him stripped down on the top. His pupils look pinpoint, but he doesn’t respond to narcan, which I give him in two doses, .8mg, then 1.2mg IV. His blood sugar is 244. He is tachycardic at 120. His blood pressure is fine. His respirations are snoring so I put in a nasal trumpet that slides in easily and helps with his breathing. In his wallet there is a non- driver’s ID card, and a mental health clinic appointment notice.

I look at the box, which sits by my clipboard now. There is a gift bow around it.

In the ER, I give my report, running down what I have done. The doctor and nurses ask many questions.

“The answer,” I say, “is in here.” I open the box and show it around.

A small diamond ring.

“It’s his heart.”

1 Comment

  • Anonymous says:

    I have started reading one month of these posts, both here and the other blog, per evening. I do it in spite of having very urgent and pressing things to do. But few things do I enjoy more than good, true, EMS stories.Of what I have read thus far, which would be Jan-April, this is by far the best of them all.My background is in a mental health-related graduate education. I just started in EMS. On a daily basis I am continually amazed at how well the education serves me.We were dispatched for a difficulty breathing call, history of breathing problems. On arrival, we met mom, dad, and the waif-like 16 year-old daughter that I first thought was not more than 12. She was such a little girl, so frail and so despondent.Mom was the most Present. Dad was doing his best to be the Strong Father Figure, but managed to do little more than put a thumb over the artesian well of fear inside him. This was very much Dad’s Daughter, despite mom being the liason.And the daughter: crying, history of asthma, uses an inhaler. Resps are pretty high: fast and shallow, with a bit of accessory muscle use. Hard to tell though, since she’s swaddled in clothes a size too large. She was at a funeral for a good friend earlier, mom says. It’s been a tough day.BP is around 100/70. I didn’t get the BP. That made me feel kind of stupid. I quit listening at around 110 thinking the ambient noise had thrown me off, the cuff wasn’t placed correctly, or I wasn’t over the artery. I’m not very confident about my BPs, especially in the rig, while driving. I try think positively, but it doesn’t always work.Mom wants to transport, but Dad doesn’t. We don’t argue with mom. It’s clear that we could talk dad into transport, but something about that just doesn’t feel right. So we leave her and daughter with instructions on breathing more deliberately, getting some fluids and food in her, and then going to the ED. In the rig, I turn to the other two medics and say, “That looked like a panic attack.” I’ve been checking the DSM criteria for a panic attack in my head, since I’m better at identifying mental disorders than medical disorders.The medics are quiet for a second. I’m worried I’ve said something really stupid, like maybe this was something entirely different.One leans to the other and says, “Not bad for the new guy. That was what I thought too.”I didn’t feel so bad about the BP.