The Wrong Wife
Our most heroic efforts sometimes yield unexpected results. No medical drama on the streets is more galvanising or more disorganised than resuscitation from cardiac arrest. Crowds, hysterical relatives and unfamiliar circumstances can be distracting, and it is also an opportunity for my personal Evil Genie to take advantage of haste and confusion to play his tricks.
In the late summer of 1977, my young family and I were returning from Europe on Wardair, Max Ward’s charter airline that was eventually swallowed by Canadian Airlines. Since they had served good food and free booze on our transatlantic flight I was in a mild state of foggy fatigue. We queued up for customs inspection at Winnipeg’s International Airport, shuffling our feet impatiently as the grim faced customs officers methodically searched the suitcases of the pensioners in line ahead of us. The tremulous, perspiring old lady just in front of me should have caught my attention, but the August heat provided sufficient explanation for her perspiration and my mental lethargy. Just at the exact moment that she heaved her suitcase onto the counter, she collapsed, folding up into a small forlorn heap at my feet. That immediately ended my lethargy. Five years of teaching CPR triggered the instinctive response: “Are you all right? Can you speak? Does anyone here know CPR? Call 911 for an ambulance.” I followed the prescribed steps, opening the airway and checking for breathing, but I knew she was in cardiac arrest. A crew-cut young man, who I later learned was a North Dakota state trooper, slid onto his knees beside me and we started methodical two-man CPR: one-one-thousand, two-one-thousand…….five-one-thousand – breathe. I swear that the customs inspector continued to inspect her suitcase as we sweated on the floor to save her life.
After what seemed like eternity, but was actually less than twenty minutes, a Winnipeg Ambulance Services crew arrived. In the zeal of the moment I had no intention of leaving her fate in their hands alone and into the ambulance with her we went, both the State trooper and me. Just as the crew had secured the stretcher, a small bald head timidly appeared at the ambulance door and a querulous voice interrupted us: “Is that my wife?” I had neither time nor patience to deal with this distraction. My response, “Does she look like your wife?” was answered uncertainly, “Yes, I think so.” “Help him into the front seat of the ambulance and let’s get going.”
In the ER, thirty minutes later, it was obvious she was not going to make it. Asystole was unresponsive to bicarbonate, adrenaline, calcium, and, for good measure, several attempts at defibrillation. This was my hospital, my domain, my colleagues, and we were a smooth functional team. We had had a few successful resuscitations from prehospital cardiac arrest and we did our best, but his was not to be one of our saves. Reluctantly we stopped and I went to find the little old man.
Informing the next of kin is never easy but there is a standard formula, even when you’re exhausted. Find a quiet room, sit down, hold his hand, and break the news as gently as possible. “It was her heart, cardiac arrest. We tried our best but we couldn’t start it. Yes, she has passed away. Yes, of course you can see her just as soon as the nurses tidy her up a bit.”
I thought about my family, forgotten and marooned at the airport. For a minute I sat dejectedly at the nurses’ desk, waiting for a chance at the telephone to call a cab. Anne, the charge nurse, was on the phone, listening but not talking. Then she cupped the phone in her hand and turned very slowly towards me. “Dr. Tweed”, she said, “I hope I’m hearing this wrong. This call is from the security services at the airport. They’ve found a woman in a wheelchair, a large, loud and very angry woman, and she’s looking for her husband. And what she’s threatening to do with him when she finds him should not be repeated by a nice girl like me. It seems they’ve also found a somewhat senile little old man who’s lost his wife.”
Let me digress for a moment. This story was told at a dinner party in Bahrain, twenty years later and half the circumference of the globe away. We were being hosted by Tom and Casey O’Leary, now in Edmonton. I had known Tom as a resident; he had finished his anaesthesia training in Winnipeg a few years after me. But the anecdote was really for the amusement of others, American friends who had been regaling us with tales of their own mishaps. Over the intervening years I had not repeated this story often, at least not until I thought that the principals would all be dead and the story had been long forgotten by everyone but me.
“Yes”, Tom said, “I remember that case, I was covering emergency that day. Before I joined Anaesthesia I worked as an ER doc. After you stopped the code and talked to the old man I took him in to see his wife. He cried and kissed her cheek, held her hand for a minute, then said he wanted to be alone.”
Anne must have gotten the response she expected. I was numb, dumbfounded; my first reaction was hope it was a hoax. How can a day turn out so badly? You just try to do what is right, what you’ve been trained to do, and the whole world conspires against you. Meanwhile, Anne, ever resourceful as ER Head Nurses must be, checked his and her identification. The dead lady was definitely not his wife! Who is to tell the old guy and how can one explain such a fiasco?
Back to the quiet room, holding his hand, speaking slowly, carefully choosing my words. This was not a task I had practised before. “I’m sorry, Mr. Brown, for upsetting you so, but how could we know? The lady in the ambulance, yes, that lady in the other room, who is dead. Well, Mr. Brown, you see we’ve made a mistake. We don’t think that lady is your wife Mr. Brown. In fact, Mr. Brown, we’re sure that she’s not your wife. Your wife is at the airport Mr. Brown. She’s at the airport, very much alive, and she’s looking for you.”
He sat quietly for a moment or two, saying nothing. I didn’t know if he had heard, or understood, or was about to collapse himself. Then a little tear slipped out of the corner of his eye and ran down his cheek. I left before I confounded my folly further.