Chapter 26 - Grandma Maggie

Fernando Martins de Bulhões (aka St Anthony) was born in Lisbon, Portugal.  Saint Anthony is the patron saint of lost or stolen things.  The practice of praying for St. Anthony's help in finding lost or stolen things began when he had a treasured book of psalms stolen from him.  Books (this was prior to the printing press) were hand copied and very valuable items.  He was a Franciscan friar, who with his vow of poverty, did not have the resources to get another book.  A novice friar who had let the Franciscan's took the book and left.  St. Anthony prayed for the books return.  The novice who had left with the book brought it back and rejoined the Franciscans. 

Saint Anthony is invoked (and venerated) as the patron saint for the recovery of lost items and is credited with a ton of miracles involving lost people, lost things and even lost spiritual aspects of people. 

Margaret Gonzales Martinez (aka Grandma Maggie) was the consummate catholic and had a prominent statue of St Anthony in her bedroom next to her small kitchen.  When I was away, she turned St. Anthony to face the wall.  When I would come to see her, she would hug me and then go to her room to turn the statue to face the picture window.  A reward for the return of her grandson to her home.  We did not say I love you a lot to each other back then but that felt like I love you in the most powerful way.

"How many certified copies do you want?" the smiling clerk at County Records asked.

"Three, will work thanks" I replied as I watched her disappear into the back room. 

I have always purposely tried to not remember the day, month, and year that she died.  I don't tell anyone that I try not to remember this, even in print now, it sounds like hell.  Especially since she was such a large presence in my life then and now.  

The day she died was nothing compared to the life she lived for all of her 89 years.  She did not stop being a presence in my life on the day she died, she has remained with me.  I never had a specific day that I celebrated her, I have celebrated her a little bit every day whether I could see her or not. 

"30 dollars" the young clerk said when she handed over the death certificates. 

I thank her and take the envelope and sit with it in the Jeep for a minute.  I hate that my hands are shaking, and I did not even glance at the certificates the clerk gave me, to make sure it was her. 

I open the big manila envelope and pull out one of the certified copies.  Margaret Gonzales (Grandma Maggie), died on May 29, 1992.  I close the envelope and do not read anything more than that.  

Grandma Maggie was my internal compass for my head and heart for my entire life.  She had this amazing knack for letting me know how much I was loved, even when we were having tough talks about me and what I was doing with my life.  I trusted her and she was brutally frank with me.

When I would leave, she would hug me for a long time and make me wait while she turned Saint Anthony to the wall again.  She would give me a foil wrapped ball of coins that she would save for me and a couple of burritos for the ride home.  As I walked up the driveway, the last view I would have was her standing in front of the old gas stove, working on a stack of tortillas or lunch/dinner for Grandpa Charlie.  

At the nursing home, he daughters and son sat around her bed.  They took turns holding her hands and telling her how much they loved her.  I stood quietly in the doorway, not wanting to interrupt.  As everyone got up to grab a quick dinner, I told them I would stay with her until they got back.  

Even as she lay in the bed, she was a larger than life for me.  I was not there to tell her goodbye or to tell her that I loved her.  I only wished; I would have had the foresight to bring Saint Anthony here to her room to turn to the wall until I came back.

I did not talk to or hold her hand, I sat quietly by her bedside and the only thing I said was "I'm here".  There were so many days that I ate a warm tortilla with a huge chunk of butter quietly while she continued to cook.  When mom got back with her sisters after a quick dinner, I left to go home and take a quick shower and eat so I could come back and sit with her.   I touched her hand and told her I would be right back.  It did not occur to me to tell her that I loved her because I know that she already knew that.

Here is my public service announcement.  For everyone you love, you will always be one "I love you" short.  When your loved one is no longer in front of you, you are already one "I love you" short.  That holds true for beloved grandma's, kids, family, and friends.  It is one of those universal truths.

On May 29,1992 halfway through my shave, the phone rang, and I realized I was one going to be forever one "I love you " short for my beloved Grandma Maggie.  

I am sitting at the kitchen table at station 3, with the large manilla envelope in front of me getting ready to open it and read the entire certificate when I see the familiar green light come on overhead and hear the dispatcher's voice.

Beep, Beep, Beep Engine 3, Paramedic 4, respond to 1024 8th Street for an unknown medical.

I can hear Chris coming down the steps, along with Tom and Jeremy.  Everyone is quiet this morning as they are getting on the engine and into their gear.

"Engine 3 in route status 4" Chris, you grab the AED, Tom grab the jump kit, Jeremy you...."  
I am interrupted by the dispatcher.

"Engine 3, Paramedic 4, elderly female found this morning in bed, with no pulse and not breathing."

"Engine 3 OK" I say into the microphone.  Everyone is immediately focused on what we are being dispatched to 

"Jeremy bring the O2 kit, everybody gloved up with eye protection, we are about 5 minutes out."  I say over the headset to the crew.

When we pull up in front of the address, a worried looking woman in her 40's is standing in the driveway in a t-shirt and jeans waving at the engine.

"Leave room for the ambulance in front of the driveway, Chris you and Jeremy have patient care."

"Engine 3 arrival, this will be 8th street command, we will be investigating. "

"We found her in her room, I don't think she is breathing, and she is not responding at all."

said the woman, when I approach her.

"Take us to where she is " I tell her and we follow her to a bedroom in the back of the house.

She is motionless, lying in bed, with the covers pulled back.   The woman starts to walk towards her again and I take her lead her gently out of the room.  I ask her to waiti by the front door to bring the ambulance crew back to the room when they arrive.

No one should watch the work that needs to be done to save a life.  Normal courtesies are set aside and the difficult work that needs to be done can look disrespectful when it is your loved one laying on the floor.  You do not want to see your beloved mom or grandma undressed with a host of medical devices and interventions being performed on this person.

Chris is leaned over the bed and is checking her.

"No pulse, no breathing, she is warm - Floor"   Chris says.

Tom, Jeremy and Chris put the woman on the hardwood floor.  Jeremy already has the oxygen hooked up so he can bag her (breath for her) and is sizing her for an airway.  He reaches down puts his fingers under her chin and tilts her head back, making sure her airway is open.  Chris is cutting her nightgown off and working to put the pads on from the AED.  With the airway placed, Jeremy looks at Tom and gives her two quick breaths as he squeezed the bag.

"Starting CPR" Tom says and has positioned his hands on her chest to start chest compression's.  He looks at Jeremy who has the Bag Valve Mask attached so he can breathe for her.  They both know that breaths and compression's have be to be synchronized to be successful.  Tom has started chest compression's I am grabbing saline bag and preparing to drop a larger bore IV into her AC.

"8th Street Command" I need to tell the incoming ambulance what we currently have and are doing.  I speak into my portable handset.

"8th Street Command go ahead" The dispatcher says.

"CPR in Progress" The ambulance will know that we are actively working this patient and can more fully prepare for the patient care that is needed.

Doing CPR under any circumstance is exhausting.  The room seems warmer, and beads of sweat are appearing on Tom's forehead.  I am able to establish an IV and nod to Chris who is prepared to step in to do chest compressions for Tom.

"Paramedic 4 Arrival"  I walk out to meet the paramedic's and give them hand over report as they are getting gear and the pram out of the ambulance.  

"Approximately 70-year-old female, found unresponsive by son in law, warm to the touch, no rigor, no idea when she went down.  Oral airway in place, CPR in progress for 5 minutes, with Bag Valve Mask. high flow O2 and we are bagging her.  No known medical history, daugther is getting meds, and currently says she is not under doctors care."  The paramedic is nodding while I am talking to her.  

The paramedic assumes patient care and begins to direct the team.  

The next 20 minutes is a blur of activity, paramedics have intubated her and given advanced life saving cardiac care and meds. 

"Nothing, I got nothing" she says and at the end of another 10 minutes she says, "Stop CPR" and checks the patient very throughly one more time.

"I am going to call it" and she calls into the ER doctor to give a brief summary of what has been done. 

I cannot hear the ER doctor on the phone but after a brief pause, the paramedic looks down at her watch and says "08:02" and nods to everyone in the room.

"Time of death is 08:02"  She says and everyone kneeling on the floor working the patient stops what they are doing and looks over at each other,

There is a heaviness in the room.  There is the paper from the unwrapped meds, airways, and the 12 leads from the AED.  Exhausted firefighters are standing up and talking off gloves and wiping the sweat from faces.  A firefighter will be assigned to stay with the body until the coroner arrives.  The family will be told but not be able to be in the room with the patient, until the coroner gives the OK to do that.

Victim advocates that were placed on standby are now in route to the address to help the family deal with the exhausting steps that come next.  

There is nothing to say to the crew right now.  The work to save this woman's life by an engine crew and paramedic's has been nothing short of heroic.  And right now, it does not feel heroic at all.

We are in a bedroom at the end of a long hall.  In the time we have been in with the patient, family has gathered in the living room.  When we all start to file out of the room and walk down the hallway, it is very apparent what has happened, without ever saying a word

I see the woman who met the engine out on the road in the room and I walk over to her.  She looks at me, and tears start to roll down her face.  This is one of the hardest things I will ever do in the Fire Service.  I hold her gaze and walk over to her.

I want to tell her about the heroic work that everyone did to save the life of the lady in the room.  I want to tell her that for the short time she was in our care she was our mother, our grandma.  I want to tell her that the men who work tirelessly to save lives take the lives that are not saved to heart.

There are 10 ways to say a person has died and I need to be as compassionately direct as I can here.  She has to know the woman we are working on has died.  I need to tell her what happens next, I need to tell her about the strangers that will fill up her house and start the long process of healing.  

I look her directly in the eye and tell her that her mother died and that we did everything humanly possible to save her life.  The woman looks at me, touches my arm and I tell her I am sorry for her loss.  She reaches out to squeeze my hand, nods with more tears rolling down her face and says nothing.

The ride back to the station is quiet and we work quickly to restock all the kits that we used this morning.  It is mid-morning but I make a new pot of coffee because it feels like I did not get to have my cup of coffee this morning.  

I pour a fresh cup of coffee and start to open Grandma Maggie's manilla envelope. 

I feel strongly that Grandma Maggie was there with me today and did the thing she always did for me in life.  When I fell down in life and did not think I could get back up, she would firmly pick me up and point out the perspective I gained from the fall.  Most importantly, she would in her wonderfully direct way point out what people saw in me when I stood back up and resumed my path in life.  She loved to tell me that I was never lost but like Saint Anthony, I could from time to time end up staring at the wall instead of looking out the picture window.  She would hug me for a long time and tell me quietly not to stare at the wall for any length of time.

Margaret Gonzales Martinez (aka Grandma Maggie), was the consummate catholic and had a prominent statue of St Anthony in her bedroom next to her small kitchen.  When I was away, she turned St. Anthony to face the wall.  When I would come to see her, she would hug me and then go to her room to turn the statue to face the picture window.  A reward for the return of her grandson to her home.  We did not say I love you a lot but that felt like saying I love you in the most powerful way possible.

Today, for all the heaviness and that big manilla envelope in front of me, it feels like St Anthony is looking out of the picture window.