When the dispatch is for a welfare check, person hasn’t been seen in two days, mail piling up in the box, newspapers on the front steps, strange smell, etc., my interest is piqued. What will we find when we get there? Sometimes it is just an empty house or apartment, and the neighbor says yes, she left on Thursday to visit friends in Maine, or the ambulance took him in on Monday. Sometimes we find a patient who has fallen and been unable to get up, moaning and lying in their feces and urine, and we carefully clean them up and wrap them in clean sheets and take them to the hospital, perhaps treating them for dehydration on the way or giving them pain medicine if they have broken their hip. Often, though, we find a dead bodies — bodies in varying conditions from warm enough to try to resuscitate to cold and stiff to decomposed. We find these bodies in various positions – from eyes closed, head resting on a comfortable pillow, blanket pulled up to their chin in a well-made bed to naked and sprawled on the floor with a table knocked and a trail of black bloody emesis behind them that never made it to the bathroom. I have found bodies hanging in the closet, bodies slumped over the wheel in a garage with their car running, bodies in pools of blood still clutching their shotguns to a body clutching a more personal instrument of manhood, dead eyes still staring into a porno mag. “Died coming and going,” my partner remarked.
I have found bodies with syringes in their arms, found them with their wrists slashed in a bathtub, found them clutching inhalers and clutching phones, and found them with their cold flesh nibbled on by rats and in one case, their face half eaten off by their dog.
I have found people I knew, an old sports coach, a woman I talked to on the street, even an old partner who rode next to me in the ambulance. I have found them young and old.
I have discovered bodies in hoarder’s houses, dead under a fallen pile of newspapers and I have found them in the immaculate rooms of the obsessive compulsive with their kitchen cabinets filled with perfect rows of Campbell’s Tomato Soup.
Sometimes we are alone when we find them, often we are with an apartment superintendent or neighbor with a key. Sometimes the family arrives. We stand over the body, attach our monitor wires and run a strip of asystole (flatline). We announce the time. Sometimes if there is no one there with the information, we look around for identification and for medications or other evidence that might help us figure out what happened, something to write in our report beyond the basic: pulseless, apneic with rigor mortis and dependent lividity (no heartbeat, not breathing, stiff with blood pooled by gravity). Sometimes we find suicide notes.
I often look at the scene and try to piece together their final hours, their final moments. Was their death peaceful or terrifying? Was it quick? Was it slow? Did they know this was their end? And how did they come to be alone?
I am one of those who believes when you are dead you are dead and gone. But I do wonder sometimes if, in that world that others believe in, if the departed are watching us, and I wonder, if that is so, what they are thinking. I try to tread gently in the space where their time on earth came to an end. I try to be respectful.
I wonder what the scene will be like when my time has come. I wonder who will stand over me?