The patient was a 63-year-old man whose feelings of being unwell had been building for 4 days, and this was before anyone called 911.
By the time my emergency medical services (EMS) team arrived, his blood pressure was 198/110, and his oxygen saturation was 84% on room air. He was leaning forward in a recliner, working hard to breathe, and his wife, who had made the call, told the dispatcher he had a cold. She told the crew the same thing when they arrived, and while she was not lying, she wasn't painting the full picture. She did not have a better explanation for what she had been watching for 4 days.
The medication list alone took 10 valuable minutes to reconstruct. There were supposed to be seven medications. She knew the colors of the bottles. She knew that one of them was for his heart and one was for the water his body likes to hold onto. She did not know the names, the dosages, or the prescribing conditions. The bottles were in a bag somewhere, and we only found three of them before transport.
The patient care report that arrived with him described a general illness call with a history of cardiac disease, hypertension, and an unknown medication regimen. It was accurate. It was also, as a clinical document, almost entirely the product of what his wife had been able to communicate in a language that she did not speak; a language of chief complaints and medication names and symptom timelines that nobody had ever taught her to speak.
