Like a page from a book, dispatch sends us code 3 for a finger amputation. Grumbling as I roll out of bed while dispatch updates us–a 27 year old female at one of the local state-run group homes who intentionally put her hand in a garbage disposal. The grumbling increases. The staff at these facilities leave something to be desired and the patients usually are fine. This has to be an overreaction, doesn’t it?
As we round the corner inside the door, the scene is as expected–practically empty. One staff member sits with our wheelchair bound patient, everyone else seems to be missing, despite it being meal time. A quick once over leads me to believe there is no amputation, the annoyance sets in.
So I ask my patient “whats going on tonight? How come you did this?” I am completely unprepared for the answers that follow. My patient–a 27 year old paraplegic female who suffers from Bipolar disorder, severe depression, and a gamut of other psychological issues–literally just came from our Behavioral Hospital. The very behavioral hospital she has requested to be transported to several times over the last few weeks due to depression and serious thoughts of suicide.
The story goes like this… as a child she was sexually abused by her father, her brothers, and her uncles. Her father pushed her down a set of stairs leading to a mild Traumatic Brain Injury and complete paralysis from the belly button down.
The state put her back in this home where these ingrates continued to sexually assault, mentally abuse, and psychologically destroy her for the next 9 years. Finally the father is arrested for assaulting a neighbor’s daughter–when the story comes out again and the state takes her into their custody–only to be bounced from group home to group home, from one mental facility to another and back to the group homes. She has literally begged to be given inpatient treatment and the physicians say she just needs long term counseling. She is unable to do anything for herself–she cannot function without someone pushing her along. Not because she is physically weak, but because she is mentally broken.
She hurts because she has to actually hurt herself to get anyone to listen. I tell her we’ll get her help but she knows what that means. I will take her to yet another hospital where yet another doctor will push her back into the care of undereducated and overworked group home staff. All she wants is to feel safe. She wants to know that she can’t get out and THEY can’t get in–but no one will give this to her.
By the time we arrive at the hospital I know her story. I know enough to know that she needs this help. She knows what she needs, but doesn’t have the resources to do it herself. As I transfer care I take the doc aside and give him the story. I tell him how I think she is a genuine threat to herself and that her mental anguish is real–not like so many of the calls we go on–the ones that made me grumble as I rolled out of bed. This is the real deal.
– — –
Two months later the tones startle me awake. Code 4, Any unit in position, Cardiac Arrest to an address I am all too familiar with. Dispatch updates with a 28 year old female, unconscious, not breathing, her throat is cut.
My foot reaches the floor. My knuckles are white on the wheel. My partner looks at me and asks me if I’m O.K. I just drive faster. I walk in, the same deserted scene. The same deafening silence. I look down and know we’re too late. I let out a sigh, turn around and make the call.
I hurt because we failed.
