Fog

I transported a patient today that suffered from severe Alzheimer's with dementia. While I've transported and treated patients with this disease before, never had I spent two whole hours with one of them.

Alzheimer's is probably the worst disease out there. Don't get me wrong, cancer and AIDS and diabetes and other diseases aren't any less debilitating, but what Alzheimer's does to a person is a bittersweet tragedy. This particular patient was a woman, and for her privacy, I'll simply call her Mary.


Mary had once been a registered nurse herself. As I disconnected and reconnected tubing from the hospital equipment to my portable units, I wondered how much she could remember of doing exactly what I was doing now. She watched, her brow slightly furrowed, as if she were focusing intently on my hands. I felt slightly nervous, seeing how agitated she became when we moved her onto the cot. The attending RN gave Mary a washcloth, explaining to me that Mary was "usually okay, as long as she has something to play with or fold or something." Right, got it.
We got her into the rig without incident, and as I placed ECG leads and secured the blood pressure cuff, she was pretty restless. She calmed down a little as we got going, and soon her attention bounced from one object in eyesight to another. I handed her one of the tourniquets behind me on the bench seat. Tourniquets are stretchy bands we use to make a person's veins 'pop' out when starting an IV. I've given them to kids before to play with, and as far as I could tell, that was basically the mental level she had. She fidgeted with it, a look of concentration on her face as she tried to match the washcloth and tourniquet edges. The tourniquet was longer, and this seemed to be a problem. I paused in writing my report to get another set of vitals. Mary was still pretty focused on the tourniquet until the blood pressure cuff began to inflate. In an effort to soothe her, and get an accurate reading, I took her hand and held it in both of mine. Not in a restraining way, mind you, but a calming one. Suddenly, Mary looked into my eyes and smiled. It was a big, broad, coherent smile. She reached up with her hand and touched my cheek. Her hand stayed there for a moment or two. "You're a lovey," she said. I almost cried. Then, just as quickly as she had come around, she faded away again. Her hand slid off my face and her gaze shifted back onto the cabinets in the ambulance. Her fingers searched and again took hold of the tourniquet and washcloth, manipulating them, folding them, over and over.
The rest of the ride was much the same. Every few minutes we'd make eye contact and she'd smile. It seemed like she kept trying to remember me from some time long ago. I knew we'd never met before, but since she couldn't remember ten minutes ago, she searched my face for her memories. Her eyes teared up a couple times, not really crying, just that moment before the tear falls, when the liquid is hanging on the ledge of your lower eyelid. She'd laugh at things she'd say, things I couldn't understand for the most part. I'd laugh with her, though, and she'd laugh even harder.
She'd ask me where we were, and where we were going. I kept the answers as simple as I could. Most of the ride was spent just keeping her hands busy. She folded and unfolded that washcloth about one hundred times, intent on the folds being even. I watched her eyes as she folded, looking into a fog that seperated her from the world I knew.

We made it up to the receiving facility without any problems and transferred her care to the staff there. I wished her luck as I departed, and for a split second, she knew me. "You're a good kid."

Then she patted my hand and sank back onto her pillow. I turned away quickly, not wanting to watch the fog roll back in...