I've seen terrible things as a paramedic. The worst isn't what you'd expect

Taking an elderly man to hospital while knowing his wife would probably never see him again is the job I’ve most agonised over

What’s the worst thing you’ve ever seen? Ask any paramedic and they will have been asked this question many times over in their careers. I’d never given myself time to properly think about the answer, until recently.

Is it having my fingers in the back of a teenage boy’s brain as my colleague and I lift his limp bloody body into a bag after he had flipped over his new car on a dark country road?

Is it looking upon a small, wafer thin, dead child curled up on her Cinderella duvet after drinking her parents’ medication that they use to help with their addictions?

Is it the elderly man whose closed curtains had gone unnoticed by his busy neighbours while he lay decomposing into his own carpet?

It is none of these.

My answer starts at 6.10am one morning many years ago with a callout to an elderly man who is struggling to breathe.

We arrive at a slightly neglected bungalow where a frail elderly figure limps slowly to the door and greets us with an apology – she didn’t want to bother us. Her husband is slumped in the front room. I know he is not well and he needs to go to hospital. Mavis*, the woman who answered the door, is visibly shaken on hearing this news but she finds solace in starting preparations for her beloved husband, Bert, to leave for hospital. He needs clean pyjamas and a toothbrush, and after fondly rubbing his chin, he will need his razor too.

I give Bert some oxygen and start to think that if we don’t get him to the ambulance quite quickly he will collapse. Mavis returns tearful with her husband’s belongings. I talk to her to try to convey the seriousness and urgency of the situation. Bert is stoic in his responses, telling his wife he will be fine, but he is kind too, reminding Mavis of how much he loves her. Mavis is proud, they have been married for more than 60 years, she says, as she ambles away again.

I look around the room at faded photos of many generations of their family. Bert tells me they are all dead now, even their son who died young. I talk with him and reassure him that we will be going to hospital soon. She is the love of my life, he says, between tiring breaths; there has never been anyone else. I remember his soft slow words perfectly and the telling look in his eyes – he knows he is not coming home again. I worry that we are taking too long. Bert needs to be in hospital quickly; I don’t want him to die in my ambulance.

Mavis is elderly and frail herself, and accompanying her husband to hospital isn’t an option. I worry there is no one to come to help her when we are gone. My haste to get Bert out of the door and to hospital is abruptly subdued by the realisation that this is most probably their final moment together; they are about to say goodbye to each other for the last time.

I try to convey the gravity of the situation to Mavis. I think she finally understands when her eyes fill up. She limps back towards Bert, who is still protesting to her that he will be fine. Her hands cup his cheeks as her small stooped frame leans forward to give him a kiss. I pause momentarily, trying to be invisible, and then ask quietly if we can go. Mavis delicately flattens Bert’s hair to one side of his head, smiles at me and nods her head. I ask Bert if that is OK and he smiles and nods too.

Bert died later that day and I spent a lot of time wondering what happened to Mavis. I knew that I had cared for Bert and looked after him well, but I had deserted Mavis, I had left her all alone. I toyed with the idea of visiting her to check up on her. This felt right in many ways, but wrong in others too. I didn’t know what to do. I had prioritised Bert’s care but in doing so neglected what Mavis needed. I was left feeling I had failed her in many ways.

When thinking about my answer to the “What’s the worst thing you’ve ever seen?” question it didn’t take me long to remember this job, even though it happened many years ago. It is the job that I most agonised over. It is the job that stayed with me for the longest time after it was over. You might think it can’t be the worst thing I’ve ever seen, but it is definitely the worst thing I’ve ever felt.

I never did go back and check on Mavis.

*Names have been changed

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