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Grady Medic - Tales from Atlanta: "We Don’t Talk About Dying."

Updated: Nov 8, 2023

Bowen Homes – Atlanta, Georgia

Large beads of sweat made slow, steady lines down the man’s face, pausing only to fill creases and wrinkles of his face on their passage toward his T-shirt. The pressure from within the walls of his chest made it hard to catch his next shallow breath. He thought to himself, “I can’t win here.” Shallow breaths weren’t enough to catch any air, and taking a deep breath caused him to cough up a white foam. Gripping tightly onto the wooden arms of his chair, he whispered to the bald man squatting before him. “Mister, I think that I’m dying.”

In truth, he was dying from untreated congestive heart failure pushing fluid out of the blood vessels into the air spaces of his lungs. Each milliliter of liquid was quietly covering the internal surface area of the lungs desperately needed to bring in oxygen into his starved body. As the man’s anxiety increased, the need for oxygen to the heart and other vital tissues was more in demand. As the demand for oxygen is increased and not achieved, anxiety increases. In the simplest of terms, the patient is literally drowning in his own fluids. This is a vicious cycle of increasing demand and diminishing supply that kills quickly if allowed to continue uninterrupted.

Bill Marbury looked the older man dead in the eye and smiled. “Sir, we can talk about Braves baseball. We can talk about it being a nice summer night. We can talk about almost anything that you want to talk about. We don’t talk about dying. Nothing good ever comes out about talking about that.”

Assuring that the oxygen was flowing as fast as possible, Bill placed the oxygen mask over the man’s face. “Now, this . . . This is going to help your breathing.” Tapping the man’s chest, he said, “You have a lot of fluid built up in your lungs. I’m going to see if I can make some magic happen and clear some of that up for you.” With a knowing eye, the cheerful medic said, “It looks like you’ve been out of your medicine for a while.”

The older man nodded in agreement. Bill chuckled as he lifted the oxygen mask to slip a small white tablet under his patient’s tongue. “Now, this medicine is called nitroglycerin, and no, it’s not the same thing that you see blowing stuff up in the movies. However, it is going to give you a massive headache.” He shrugged at his own observation. “Nothing is perfect.”

Bill reached into the drug box to remove several syringes of medication. “On the other hand, I’m also going to give you some morphine. That will help with the headache and make it easier to breathe.”

As his partner taped down the IV flowing into the man’s arm, Bill injected the drug into the slowly moving stream of IV fluid. Satisfied, he said to the older man who sat uncomfortably before him, “Give it a minute and that stuff will slow down that pain in your chest.”

Inserting the needle of another syringe into the line, Bill leaned over to confide in the man. “This is Lasix, and it has one big downside that I need to warn you about. You are about to pee like you never have peed in your life.” Once the medication was injected, Bill laughed as he said, “Just think of it as I’m just draining that swimming pool inside of your lungs.”

Whether it was the medic’s running humorous commentary, the narcotic, or both, the elderly man mustered a smile. “It’s easing up. I’m almost catching my breath now.”

Glancing at the nearby cardiac monitor, Bill watched as the sinus tachycardia dropped steadily down into a normal sinus rhythm as all the medications began working together. The rattle from the doorway behind him alerted the Grady Medic that the Atlanta firefighters had brought in the stretcher from his waiting ambulance. With a smile, Bill pointed back to the awaiting stretcher. “These fine gentlemen are going to help me lift you onto that bed. Here’s the deal. We want you to simply sit there and do nothing, which is what I would be doing if I was at home. Right now, however, I just want you to kick back and relax.”

Not wanting to try speaking, the man gave a weak nod of understanding to the paramedic. The chest pain was down to a dull throb, and he could take a deep breath without coughing. He reached out to clamp his hand onto Bill’s wrist. When the medic looked down at him, he said the only words he could muster in the moment to the medic. “Thank you.”

Grinning from ear to ear, Bill Marbury helped the firefighters lift the man from the chair toward the stretcher. “So, how do you think the Braves are going to do this year?”

Still an ever-cheerful individual holding a dynamic control over events unfolding before him, Bill went on with his education to a Physician’s Assistant delivering anesthesia to patients in an operating room.

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