Woulda, Coulda & Shoulda For RD

RD does not stand for research and development. It is the initials of a friend, a friend recently lost to cancer or as my emotions backed by my brain want to say lost to chemo and radiation. I never physically met this man or his wife, yet we are and were friends. I consulted them on nutrition and wellness. I tried to help, I wanted to help more and had that sense prior to offering my assistance.  RD was an inquisitive man that asked me questions and poked at my answers, he challenged me, yet as I find out, made changes around his home because of me and spoke of me to his wife, now widow, I was honored to find this out.

I get asked odd questions when people find out about my varied background. When paramedicine becomes the topic of conversation, I get asked what is the ‘grossest’ thing I have ever seen or done. It is here that I ask them to define gross, you see my definition was twisted by fifteen years in EMS. I could tell you about the 14 year old boy I successfully intubated after he had been pile driven into the ground by a crane that broke and shattered most of his C-spine. Sexual escapades gone wrong and landed in the back of my bus, or the horrific motorcycle/car accidents, the list goes on and on.  I remember these things explicitly, yet they do not make my list of ‘gross’, I did my job, I did it well, there was nothing I could have done differently or better for those patients.  You see my definition of gross is gross systemic negligence whether real or perceived and in the stories I seem to need to spill here, it is perceived, a perception fueled by woulda, coulda and their friend shoulda.

A call that haunts me to this day is a suicide, a triple attempt, and he got it right the third time, he was my patient the second time, not first or the third, the second. This young man was handsome, I am not ashamed to say, and from my position had a bright future. He was a religious kid from a rule community, we connected, and we talked about cows. He had been in a facility when I picked him up, being ‘watched’ for suicidal behavior. He took an air vent cover and slit his wrists, that was how I ended up in his life.  You have to be in a lot of emotional pain to do what he did.  He did this because of shame and guilt, he on his worldly escapade accumulated a $4,000 credit card debt and did not feel that he could ever go back home because of this sin and irresponsibility. I took good care of him, I did no harm; however when we got to the ER the doc that was assigned to him was known for his crass attitude about suicide.  He did his job too, he stitched him up and sent him back to be ‘watched’. I don’t remember why this kid did not get mental help in the ER, but he didn’t and I didn’t specifically request, hence my shame to this day. This kid was isolated and was not getting any support at the facility he was in, this is what he told me, and I believe him to this day, it was not the first time I had heard this complaint about this facility.  He was shut in a room and ‘watched’. Two days later while I was on duty another ambulance was sent after him, he had hung himself with his shoestrings. This is my definition of gross, no one did anything wrong, we were all just too busy, the cards just did not fall right.  It was his time, is what I tell myself.  I learned from that though, I never left another suicide with that doctor without a social service consult, or any other doctor for that matter.  It made me more aggressive about protecting my patients from the ‘system’. Now after all this, I can get into why I am telling you this, RD.

Cancer does odd things and creates odd bonds.  I am a medical anthropologist specializing specifically in cancer and even more finely tuned to breast cancer.  I met RD in a cancer alternative education group. He was crass and crabby, we hit it off, frequently exchanging aggression toward the ‘man’. RD was ex-military and I have some history there too, but that is another blog for another day. I thoroughly enjoyed correspondence with this man.  I was honored when he asked me to consult nutrition for him, he said he was feeling better, I began communicating with his wife and then she sent me the kindest message telling me he was gone. I got a severe case of woulda, coulda, shoulda all over again.  Why didn’t I volunteer sooner, why didn’t we connect sooner, why, why, why! He served his country, was devoted to his wife, his kids, and he was my age.

Now you may be thinking that I have gone soft, after being a hard as nails paramedic, but I got another email tonight from RD’s widow, I hate calling her that by the way but I am respecting their privacy here and have no better way to describe her. RD had been given up on, radiation and chemo had failed, I thought he and I had failed too. But here is the kicker and why I can’t sleep tonight, his tumors had significantly shrunk.  He was on the right path, it was just too little too late, this is gross for me, the fear of gross negligence of the too little too late and the ghosts of woulda, coulda and shoulda.

I did not think I had theme in my blogging yet I do, it is time. Time, the illusive ideal of having it to squander, that there is more where that came from. I have become more dedicated in the last year to myself and yoga as a daily routine and I believe one of the greatest lessons that meditation has taught me is how to expand time, how to make more of what you have and how to cherish this moment RIGHT NOW. Take your time and cherish it, none of us know how much we have.


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