By Carol Lindsay
I recently cared for a man who had tried to kill himself by hooking a hose to his car's exhaust pipe and feeding the carbon monoxide emissions through the window. He was in his gas chamber long enough to lose consciousness, but he didn't die. A neighbor found the man in the car, pulled him out, and called for help.
When the paramedics brought him to the ED, the suicidal man was wide awake and very unhappy to be alive. His belligerent and combative behavior got worse so we restrained him. As he struggled to free himself, he fought the restraints with so much force that the bed rocked. The man's anger continued to boil as I forced him to wear an oxygen mask, but fortunately for me, it caught all the spit he was trying to spray in my face.
He said it didn't matter how long I kept him restrained. "As soon as I get out of here, I'm going to shoot myself! I should have shot myself today!" No family or friends came to visit. I left the man under the watch of a police officer and went to care for another patient.
My new patient was 43 years old and had arrived by ambulance, as well. But unlike the man who had tried to kill himself, the new patient came into the ED quietly. One paramedic was performing chest compressions while another did respirations. The patient's distraught wife told us she had left her husband in the car while she went into the store. When she returned, she found him slumped over the steering wheel.
When I removed his jeans, a beeper fell to the floor. I handed it to his wife and listened as she explained her husband had cardiomyopathy. He was staying in our state while he waited for a heat transplant.
The beeper was to alert him when a donor heart became available. The man had tried valiantly to live; he underwent numerous surgeries and followed a strict medical regime, but all his efforts weren't enough to save his life. Nothing we could do would repair his diseased heart.
As I returned to the room of my suicidal patient, I could hear the dead man's wife crying as she spoke on the phone with their children. I had one patient who was so unhappy with life that he was under a suicide watch and tied to the bed so he didn't hurt himself. Just down the hall, I had another who tried so hard to live but lay dead.
My combative patient had become quiet. Through the widow's sobs, the suicidal man and I could hear the conversation she was having with her children in the next room. For the first time, we made eye contact. "Life is not fair," he whispered, "he could have had my heart."