Excerpt from FRESH AIR with TERRY GROSS ©2016 NPR
Interview with Kevin Hazzard, author of A Thousand Naked Strangers: A Paramedic's Wild Ride To The Edge And Back
GROSS: A lot of people have do-not-resuscitate orders. And if you're working with somebody in a nursing home or a hospital, you have easy access to those papers. But somebody could have a DNR and have cardiac arrest at home. And they might be alone; they might be with people who don't know whether they have a DNR or not. So what are you supposed to do as a paramedic when you're in that kind of situation where you don't know?
HAZZARD: Cross your fingers. I mean, if you think about it, Thanksgiving - you can't even get all your family members to agree on whether they want fresh or canned cranberry sauce, right? I mean, the simplest decision in the world, and you will get four brothers who will fight to the death because they all have a different opinion. And then, add to that now that decision is what to do if mom drops on the floor. And a lot of times, it kind of depends on who the first person is to arrive, whether - you know, does she live with one of the sons who wants her to be revived? Does she live with one of the children who doesn't? You know, even if there's a DNR that has been signed, oftentimes people can't find it. So then you have to say, OK, we don't have, technically speaking, a valid DNR, so we have no choice but to work. And the family will get angry with you, and say, no, no, no, that's not what she wanted. But you can't prove to me that's not what she wanted. And how do I know that you don't have a sister who's on her way right now who knows that there's no DNR, and who's going to come flying through the door and wonder why we're not doing anything? And I actually got stuck in a parking lot one day. We brought a - it was a man. We brought him out, his wife was with us. You know, they were elderly, and she was beyond being able to talk to us just because she was in such a panic. She said, call my son. So we call her son, and the one son said, he's got to be worked. And the other son, who lived down the street, was adamant that he not be worked, and there was a DNR, the wife just was incapable of finding it, understandably. So we're in the parking lot, and the son pulls up, and he's blocking our ambulance. And he's screaming at us to stop doing what we're doing. We're literally doing CPR on a man in broad daylight in the morning, and he's saying, stop, stop, stop, I have the DNR my hand. What do you - I mean, there's no class that prepares you for a moment like that because now you have to decide, do I leave this guy in the street? I mean, how do I take him off my stretcher and put him back on the floor. You know, it really puts you in an awkward position.
GROSS: Yeah, what did you do?
HAZZARD: Well, we took him because again...
GROSS: You took him to the hospital?
HAZZARD: ... How does it look if - we did, we took him to the hospital because how would it look if an ambulance walked a dead man back up to his apartment, dropped him on the floor, and then walked back down. And, you know, there's people watching. At some point, optics come into play, you know, and you have to say, look, there's no way that we can just dump this guy on the floor. You have to be able to see why that's not good for your father. And usually, people, you know, can be reasoned with. But it's - end-of-life decisions are so tricky, so tricky, even when they shouldn't be.