How to Save a Life

As a nurse, I was given the opportunity to save at least a couple of lives during my career. I never had to talk someone off of a ledge or anything cool like that, but I did talk to a lots of depressed people and helped them try to find a reason to keep living.

That’s really the key to surviving a serious bout of depression. Not killing yourself. Suicide greatly decreases your chances of ever getting better. And it really, really messes up your family. Suicide is never a good idea. Talk to someone. Get some help. Do something!

Please.

When I was a nurse, I was certified in CPR. I think it’s probably a requirement for most nurses nowadays. I went through periodic recertification every year or two. And you need that refresher training, unless you do a lots of CPR. It was a skill I had to utilize only a few times in my career.

I think the only time that I may have saved someone with CPR was at the MVAMC. It was in the dead of night, of course. An old manic guy had collapsed in his room, and one of the other nurses discovered him laying on the floor, unresponsive. She called out for help, and all nurses on the floor went running.

If you don’t perform a lots of CPR, it’s kind of a tricksy thing. There’s a series of steps you’re supposed to follow, but in an emergency you tend not to remember them, and you can’t call a time out to check the manual. Adrenaline takes over your brain, and you just react.

This guy wasn’t breathing and I couldn’t feel a pulse, so I started chest compressions. And, I probably broke half of his ribs. That’s actually normal, especially with an elderly patient.

If you’ve never had a broken rib, or a lots of broken ribs, it kind of hurts like hell. And that’s probably what revived the old manic guy I was working on more than anything else. He took a deep breath, opened his eyes, and then punched me in the mouth, splitting my lower lip open.

Oscar Wilde was correct, again. No good deed goes unpunished.

I’ve unsuccessfully performed CPR a couple of times. Unlike TV, where everyone needing CPR survives and lives happily ever after, there’s about a 10% success rate in reality, and not everyone that survives lives happily ever after.

That’s why healthcare professionals have Advanced Directives and Living Wills, and 80% of us are DNR/DNI. If I collapse in front of you, just step over my body and keep on walking. I will fucking sue you if you even think about touching me.

I’m serious. I may punch you in the mouth.

I was a psych nurse, and there’s a little known fact about Psychiatry. The vast majority of our patients were sincerely depressed and suicidal while they were being assessed for admission. And the moment they learned they were going to be admitted, they were no longer suicidal.

In order to get admitted, you had to meet criteria. If you so much as whispered the S-word, you had to be admitted. And believe me, our patients knew the drill. Getting into the hospital was their primary objective. Their lives had gone to hell, and the hospital was their sanctuary and refuge.

There are many anxiety provoking aspects of psych nursing, but one of the worst is a patient that sincerely wants to kill themself after they’re admitted.

If someone truly wants to kill themself, they’ll eventually find a way. It’s true. I could suggest you talk to someone that committed suicide, but…

Our objective as nurses was to make sure they didn’t find a way to kill themselves while they were in the hospital. I had four patients take their lives while they were on my unit in my thirty years as a psych nurse, and it was a traumatic experience for everyone, staff and patients, every time.

I performed CPR on two of them, and I knew both times I wasn’t going to be bringing either one of them back. You don’t have to be a coroner to know when you’re looking at a dead person. They became organ donors, so they were able to help others in that regard. I do not recommend this method of organ donation, ever.

Life and death, they become part of the job when you work in healthcare. You win some, you lose some. You go on, or you quit because you can’t deal with it anymore.

But what if you’re not an healthcare professional? And you don’t have a lots of training? What if you’re just a guy riding your bike to work one morning? Then you might be my brother, Tom.

* * * *

My brother used to be a cook at the Perkins® restaurant in Sauk Rapids, MN. Like me, when I was I nursing school, he had a car that started about half of the time he wanted to drive it, and when it wouldn’t start, he rode his bike to work.

It must’ve been a morning that his car wouldn’t start, hence, the bike. And as he was pedaling his way to work, a panic-stricken woman ran toward him, screaming.

“Help! Help me! My son! I think he’s dead!” And she pointed toward a pickup truck in the yard, then ran to the house to call 911.

Her son was a teenage boy, and his head was stuck in the door of his truck, which was up against a tree in the yard. There’s a bit of a backstory to this. The boy was teaching his younger sister how to drive his truck. I’m not sure why they were driving in the yard, but it was Minnesota…

So, his sister was driving, and her brother was walking beside the passenger side of the truck, with the door open, giving her instructions on how to shift the manual transmission. I’m going to guess everything was going fine, until the truck got close to the tree. It was a really big tree.

It’s kind of difficult to imagine how something like this could actually happen, but the girl drove the truck really close to the tree–the passenger door of the truck was right up against the trunk of the tree–and wedged in between the door and the body of his truck was the head of the teenage boy, with the tree trunk as a giant doorstop holding the kid’s head hostage.

“His head was really fuckin’ stuck! His neck was caught between the door and the chassis and the tree. It was something so stupid even you couldn’t have done that!” Tom said, when he described the incident to me. “I tried to pull him out, but I couldn’t. So I ran around to the driver’s side. The girl that was driving was scared shitless. She was white as ghost. She had one foot on clutch, and the other on the brake, and her legs were shaking like crazy. Her brother was making all these weird choking noises, and his face was purple.

“I told the girl to shift into reverse, and she said, ‘I don’t know how!’ She was beyond freaked out, you know? She couldn’t fuckin’ move! The truck was in gear, if her foot would’ve slipped off the clutch, she would’ve chopped her brother’s head off, just like that.

“So I reached across her, and shifted it into reverse, then I lifted her leg just enough to engage the transmission to back the truck up. And when her brother fell to the ground, I reached in and shut the truck off, you know, so she wouldn’t run him over.

“I don’t know how long the kid had been stuck like that, but he didn’t look good. I mean, I thought he was dead. He wasn’t breathing, and his face was all purple and shit. I figured he needed CPR, you know, but I wasn’t gonna kiss him! So I just pushed on his chest, real hard, and then he started breathing again. And then he started looking better, and not all purple and shit anymore, and that was a big relief.

“I could hear sirens coming, so I figured an ambulance was on the way. So, I got on my bike and went to work. I didn’t want to be late.”

And that’s how my own bro became the Unknown Hero of Sauk Rapids. And he probably saved that kid’s life. I know his mother thought Tom had saved her son’s life. And his scared shitless sister did too.

I’m not sure if that kid ever tried teaching his sister how to drive again, but I doubt he ever tried teaching her by walking next to the truck with the door open again.

Tom wouldn’t stay the Unknown Hero. The next time he had to ride his bike to work, the entire family came running out of the house to thank him when they saw him pedaling down the road. They more or less adopted him as their official Wonderful Guy. A few years later when Tom almost got dead from a motor vehicle accident, they all came to visit him at the hospital.

* * * *

The accident my brother was in was because of something stupid Gary did while driving his car, and Tom was his passenger. Dan, Shorty and I would hear Tom’s version of the story, and Gary’s. Tom’s version won. And Gary was officially stupid, stupid, stupid.

Gary’s car was totaled in the accident, and his leg was smashed all to bits. He had to be put back together with metal rods and a lots of screws. He would spend close to a month in the hospital.

Tom had been hospitalized overnight for observation, and there didn’t appear to be anything wrong with him, so he was released the next day. I think it was a Sunday. I drove down to whatever little podunk town Tom and Gary had been in at the time of the accident to pick my brother up.

Tom and I were roommates at that time of our lives, and that would’ve been around January of 1980, I think. I had just started surgical technician school. We had an apartment across the street from the Vo-Tech.

A night or two later, my brother started complaining of severe abdominal pain, and his belly looked like a damn watermelon. I possibly helped save Tom’s life by recognizing his spleen had ruptured and got his ass to the St Cloud Hospital where he had emergency surgery.

Tom has never forgiven Gary for almost killing him to death.

But we all did stupid stuff back then, me and all of my friends from back in the day. Tom, Gary, Shorty and Dan. It’s probably more than a few miracles that any of us are still alive today.

Shorty almost killed me more than once, and he almost killed Dan to death and wrecked his motorcycle beyond all repair once. Dan almost got me dead at least once. I have no idea how many times I almost killed my best friends. You’d have to ask them. But we saved each other’s asses more times than any of us can count.

And that’s pretty much what life, and friendship, are all about.

To Sleep, Perchance to Dream

I don’t know what the problem is, but I’ve been having trouble sleeping ever since I retired. It’s not like I have a lots of stuff on my mind. The two most pressing problems in my current life are, Where did I put whatever it is I’m looking for? I just had it! And, where should we eat today?

This may not sound serious to you, but me not sleeping–it’s like Guy Fieri having problems with his appetite. It’s like Hillary Clinton not having problems with integrity, or Donald Trump not saying something stupid.

I don’t usually make political references, but I used to facilitate a lots of groups, and one of the things I used to examine was how people tend to stereotype things. Now, stereotypes rarely stand up to rigorous examination, except this example: Are all politicians crooks? And everyone always said, Yes! It was true every time.

So, now that I’ve retired, I can’t sleep. Well, it couldn’t have happened at a better time. If I failed to sleep and I had to work the next day, it would surely effect my performance. I’d most likely run out of gas sometime in the afternoon, and probably sputter to the finish line.

Now that I’m retired if I can’t sleep, I can take a nap any time during the day I finally feel tired enough to actually doze off. It doesn’t have any impact on my productivity because, well, my entire lifestyle has changed. My boss is…me?

Well, technically, my wife’s the boss, then the cat. But they’re pretty easy to please, especially the cat.

Back in my nursing days, I had a lots of bosses. Administration. Management. Supervisors. Co-workers. And finally, my patients. I used to let some of them think they were my boss. It made life easier for everyone. And not all of my many bosses were easy to please.

One of the most common complaints by unhappy patient/bosses was this: I can’t sleep!

As a nurse, you have options. You can do nothing. Tell them to back to bed, stop trying so hard. Relax, you’ll fall asleep. This is generally seen as an inefficient response by the patient.

“I tried that! I’m still awake! That’s why I came out here to talk to you!!”

I would always ask my patient/bosses what they did when they weren’t in the hospital. Smoke. Drink. Take a pill. Yeah, well, we can’t let you smoke. We sure as hell can’t let you drink. Which pill did you take and what dose?

Benadryl. Ativan. Klonopin. Valium. Xanax. I don’t know. The green pill. You never knew what you were going to hear.

If there was a med order, I would dispense meds. The unhappy customer would take his or her medicine and go back to bed. Most of the time it was as simple as that. If there wasn’t a standing order, I could call the POD, Physician On Call, and usually get an order because I had a teacher that taught me how to get what I needed from almost any doctor.

It probably stands to reason that most of these urgent calls for sleeping pills occurred at night, right? Because that’s when it always happened. And I had a different name for the Physician On Call. In my terminology, POD stood for Prince/Princess of Darkness. As odd as this might sound, most of the docs I called in the middle of the night liked that term. Some of them identified with it. And you can get almost anything you want from the Prince of Darkness.

So, there was this guy at the MVAMC. Edison. He was an older guy, late fifties, early sixties. I can’t remember if he was depressed or schizophrenic, but what I can remember is he was the guy that couldn’t sleep.

I worked a rotating Day/Night shift at the VA. During the time in question, Edison was a patient on my unit, and I was working a stretch of nights. He was generally a quiet guy, kept to himself; makes me think he heard voices now. Because he couldn’t sleep, Edison didn’t even try to pretend to go to bed. He sat up in the lounge listening to whatever it was his voices had to say.

Edison didn’t complain about his insomnia, well, not at first. I offered him meds, but he declined. He said meds didn’t work. He just sat in the lounge every night for maybe four or five nights.

Edison started coming up to the nursing station. He still wasn’t sleeping, but maybe he’d try some meds. And that’s when the problems started. Edison wasn’t lying. Medications did not work.

I called the Prince of Darkness, he gave me an order for Trazodone. It’s an antidepressant, but it has one helluva sedative side effect. We used it for sleep all the time.

Didn’t do a thing.

Next night, get an order for an extra dose.

Didn’t do anything.

Next night, Edison says he hasn’t slept at all during the entire time he’s been in the hospital. I have to admit, I didn’t believe him. No one can stay awake that many days straight and not go crazy, or in his case, crazier, I suppose. I got a higher dose of Trazodone, plus a repeat dose if needed.

Didn’t do a thing.

We tried other meds as the nights progressed into Week Two. Haldol. Benadryl. Combos of Haldol and Benadryl. Add Ativan. It didn’t matter what we did, the meds did nothing. Edison asked me to get a big hammer and hit him over the head with it. I told him we already tried Maxwell’s Silver Hammer, and it didn’t do squat.

At some point in time around here I had a night off. Maybe two. I didn’t have any problems sleeping on my days off. When I went back to work again it was for another stretch of nights.

As for Edison, it was allegedly Night 11 of no sleep at all, day or night. I wasn’t the only skeptical person when it came to believing Edison’s claim of total sleep abstinence. No one did. We all figured he had to have gotten a few minutes of sleep here and there.

I couldn’t stay awake that many days in row. I’d nod off for at least a few minutes, if not more, especially between 3:00-5:00 AM. It wasn’t called the dead of night for nothing. That two hour timespan was a killer for me. If I could make it through those hours, I could make it through the night.

It just so happens there’s a threshold/drop dead timeline when it comes for how many days you can survive without any sleep whatsoever.

Anyone want to guess how many days that might be?

I returned to work, and there was Edison, still not sleeping. Also there on this night was my nursing bud and all around best friend, Paul Anderson. This was going to be a great night, I thought.

Edison was becoming more vocal in his claim of not sleeping, not even a goddamn five minute catnap, for Christ’s sake! His voice was starting to incorporate a kind of annoying whining tone.

I checked his medication record. He’d already received everything he could for sleep. I gave him a couple Tylenol and a shot of Maalox, and encouraged him to lay down and try to relax. Edison whined as he walked down the hallway, but he didn’t go to bed, he went back to the lounge.

Paul and I had a great time that night. We told jokes and said funny stuff. And we were working with Gail Sebesta, an uniquely talented LPN who could run with the wolves, and by wolves I mean Paul and myself.

The night seemed to fly by. We were having a minor great time inside the nursing station. I looked at the clock. It was almost 3:30 AM already! This was going to be the best night ever. And that’s when Edison came up to the nursing station.

“I still can’t sleep!” he kind of whined.

“Yeah, I know. The problem is, I don’t know what to do about it.”

“Can’t you call the doctor?”

“Sure, I can call him, but then what? Edison, I’ve gotten orders for enough meds for you to put this entire unit to sleep for a week. I’m pretty much out of suggestions. You guys got any ideas?”

“Hey, Edison.” Paul said. He went through the Mark’s a good nurse and he’s done everything he can think of speech. Maybe more medication wasn’t the answer. It hadn’t seemed to have been very effective so far. Paul was a master of redirection, and when that didn’t work, he was a master at setting limits. All I had to do was sit back and relax.

“But I haven’t had ANY sleep in almost two weeks!” Edison cried, his voice was more whiny, and he was getting louder.

“It’s more like eleven days, isn’t it?” I thought that sounded better than two weeks.

“No. That’s not possible.” Paul disagreed. “It’s physically impossible for you to go that many days in a row without any sleep. Your brain will automatically shut down all by itself.”

“Mine just shut down right now,” Gail added. I laughed. Edison did not. He got louder.

“Why won’t anyone believe me?!? I haven’t slept since I came in here! I. Can’t. Sleep!!”

Other patients were coming to their doors to see what was going on. This was suddenly becoming a nightmare. No night shift nurse wants to take care of a bunch of cranky people at 3:45 AM.

“Hey, bud. Can you turn down the volume a bit, you’re starting to wake everyone else up.” I said.

“I DON’T CARE! I CAN’T SLEEP AND IF I DON’T GET SOME SLEEP SOON, I’M GONNA DIE!!”

“Hey, Edison!” Paul jumped back into the fray. He voice was stern. “You’re gonna have to trust me, man. No one has ever died from a lack of sleep.”

There are moments in every life when everything happens in slow motion, right? Have you ever felt that?

Paul finished his pronouncement. Edison started making these strange creepy-croaky noises in the back of his throat. His eyes rolled back inside his head, and he turned a kind of beet red color. He fell to the floor without even a hint of muscle tone or control. He landed face-first with a smacking sound like unto the sound a beaver makes when it smacks its tail on the water.

“Holy shit! Call a code!! Gail said, running for the crash cart.

There was a phone right in front of me. I called the Operator as Paul went flying by me to try to save the life of the man he’d just assured there was no way he was going to die.

And then everything became a blur. We started CPR, the Code Team flooded onto the unit and took over. But despite Paul’s promise, Edison was DRT.

I haven’t been awake eleven straight days, so there’s no chance I’ll die from Terminal Insomnia. My condition is probably a cumulative effect of all the profound changes I’ve gone through lately that have upset my sleep pattern. Life seeks equilibrium. We’re usually the cause of most of our own turmoil. It’ll all balance out again, soon…

I usually try to wrap these vignettes up in a nice, neat bow, and add a moral or something. But what do you say about a guy that was telling the truth, only you didn’t believe him, and then he got dead? My gut had no extrasensory messages for me, and my head was telling me that guy was full of it.

Maybe Gail summed it up best as we were walking off the unit when our shift was over.

“This only goes to show me what my mother told me as a little girl is true.”

“What’s that?” I asked. Paul wasn’t talking.

“Never trust a man that says trust me.”