A Post As Inevitable As Death Itself

You'd think that, for a person as obsessed with death as I am, I'd write about it more.

I mean, I write a lot about other peoples' deaths, but I kind of shy away from writing about my thoughts about my own. I guess that's because it hasn't happened yet. Or maybe because I'm just too scared.

A few days ago, someone was talking to me about my time as a practicing EMT. She asked me if any of my patients ever died in the ambulance. In just over a year-and-a-half on the street, I am still relieved to report that nobody ever died while under my care, not even the spindly little grammaws who were definitely at least gently tapping on death's door with their brittle fingernails.

"No, no one died on me," I replied, "but plenty of people threw up."

That reminded me of one particular patient who did plenty of throwing up in the back of the ambulance with me. He was an elderly gentleman, very sweet and kind. His first name was Jacob, and he was being discharged via ambulance from the hospital to a long-term care facility. During the ride, he vomited four or five times. I would clean him up and the half-full basin rested on the vinyl bench seat next to me as the contents sloshed around uneasily with every Northeast Philadelphia pothole. He was extremely good natured and repeatedly apologized, which I told him was nonsense. I would take his pulse every five minutes or so, and it was steady and regular, though a bit weak. He had good color and wasn't in any distress.

I leafed through his discharge packet, which contains vitals from his hospital stay, nurses and doctors' notes and observations by the various therapists who visited with Jacob. He had been in the hospital for pneumonia and was having lots of difficulty keeping food down. He was on thickened liquids and had been upgraded to oatmeal just this morning, all of it was now in the pink emesis basin.

When my partner and I plopped him into his bed at the long-term care facility, I gave report to the nurse who accepted him. She, like many nurses, barely listened to my report. I mentioned that he vomited several times and should be kept upright to avoid aspiration. She turned her back to me, the universal sign for "Go Away" and so my partner and I walked out with our clipboard and her signature. Just like when you receive a package from Fed-Ex.

"Should we have taken him to the hospital?" I asked my partner as I opened the rear ambulance door to put the throw-up basin in a biohazard bag.

"Why? Because he lost his lunch a few times?" my partner asked.

"I don't know. That was a lot of throw up."

"Don't think so much," he told me. People are always telling me that. "Come on," he said, "let's get you some coffee, you'll feel better."

The next day, we were summoned to the hospital again and the obese nurse in the yellow scrubs who used to enjoy razzing me stopped us in the hallway.

"Hey, that sweet fella you took yesterday died this morning. I thought you guys should know."

"He did?" I asked. I immediately felt awash in guilt and sorrow.

"Yeah, they rushed him in late last night. Shame."

This was the only patient I had transported that I had heard passed away, though I'm sure others did. I could not shake the feeling that I was in some way responsible for his death, that, if we had taken him emergently to the hospital instead of the care facility that he would have survived. Of course, throwing up a couple of times does not constitute an emergency, but what if you're a frail old man being discharged from the hospital with GI issues, pneumonia and you're an aspiration risk? Is it an emergency then? My partner didn't think so, and he was a paramedic with many more years experience than me. But I couldn't stop thinking about it-- couldn't stop second-guessing myself. Fortunately, I was already one week into my two-week notice when I received the news about Jacob. I don't know how much longer I would have stayed on anyway.

I remember the night that my father's father passed away. He was dying slowly for some time in a nursing home in Australia. My sisters and I were watching "The Hard Way," starring Michael J. Fox and James Woods. We were laughing our asses off in the basement when we were called upstairs into the living room, long the arena of choice for family disputes, debacles and other assorted get-togethers. It was nighttime, pitch black outside, and all the lights in the living room had been turned off. My mother called to us, so that we could follow the sound of her voice, and told us not to turn the lights on. She and my father were on the sofa and he was sobbing, a sight that we were not allowed to see. His Abba was gone, and it was too much for even this old soldier to bear. He held each of us to him and clutched us with his big, awkward hands as his tears got on our arms and clothes.

Now, years and years later, I cannot bear to be at their house in the dark. When my wife and I go over for family dinners, my parents enjoy sitting at the dining room table or in the living room as the sun sets without switching on any lights. As 8:30 or so nears, and it gets a little too dark, it always prompts an uneasy,

"Jesus, can we turn on some fucking lights in here, please? What is this-- a goddamn strip-club?"

I make it into a joke because I have to. I don't want to be in the dark in my parents' house again.

Death's funny-- well, the way you think about it is, at least. I used to fear dying and being mourned and remembered and missed by no one. This, I feel, is the single greatest impetus behind the human animal's desire for fame. Now that I have a wife, I dread death because now there is someone who will mourn, remember and miss me, someone who will most likely, statistically, be left behind. She is the vegetarian in this relationship, after all. And I consume dubiously-coated processed meat.

I don't think that I obsess about death the same way I did when I was a little boy. I used to think about it constantly. It would keep me up at night. The entire night. For days on end, I wouldn't sleep, convinced I would not awaken if I let down my guard. I think I was the only third grader in the Western world with deep, dark purple circles around my eyes. Ironically, as I've aged, those circles have not increased, they've gone away. I sleep soundly through the night, more often than not. I've learned how to be happy in the moment-- somewhat. Though I still catch myself thinking about death, usually at very inopportune moments. Like when the Mrs. and I are having a cuddle on the couch, I'll think about it. Why does a love like this have to end? Why was it ever allowed to start if it has to stop and tear the remaining one of us apart? How and when will it happen? Usually, I'm able to quickly rid my brain of these thoughts and get back to the snuggle, but it always comes back. While we're watching a movie, while I'm walking the dog, while I'm brushing my teeth-- it comes back.

At the dentist last week, I was told that one of my bottom wisdom teeth, that I had previously thought was totally bone-impacted was poking through the gum. The dentist told me I had to get it seen to.

"I know it isn't bothering you now," he said, knowing the cavalier attitude I take towards dental issues, being a notorious appointment-postponer, "but this is an eventual problem. Down the road, maybe when you're in your seventies, you'll develop an small little infection down in there, maybe pneumonia will set in, and that'll be it."

"So, basically what you're telling me is that I'll be killed by my wisdom tooth?"

"Well, maybe," the dentist replied. "Maybe."

Through the paths that I've chosen for myself, I know that my demise will probably not be glorious or newsworthy-- I won't be going down with the shipwreck on the shores of Bermuda, I won't be slain while trying to apprehend a dangerous felon, but I don't think I want to be felled by a fucking toothache. I mean, I realize I'm a bit of a loser, but that's pathetic.

I used to go to my mother with my fears about death, and she'd tell me to stop it.

"If you spend your entire life worrying about death, you'll never get to enjoy life," she'd advise.

"But it's scary," I'd say.

"I know it's scary. But you won't be so scared all the time if you'd stop thinking about it all the time. Cut that shit out," she'd wisely conclude.

While I haven't cut that shit out entirely, I think I'm at a point in my life where I can balance my enjoyment of life with my inevitable thoughts about death.

See, ma? You can have it all.

As long as the lights stay on.