She was 94, frail, but still mobile with the assistance of a walker. She had called us with a nosebleed that she couldn't get stopped. She lived in a large, 2-story farmhouse that stood on what was obviously previously a working farm, but was now a housing development.
When we arrived, it looked like a small massacre had happened in her home, with blood all over the floor, the walker, the bed, even across the room. She removed the tissue for a moment, and the blood squirted across the room. I was the preceptor on this call, a situation that doesn't happen too often. The probate member rightly decided that this lady needed the hospital yesterday, and started making preparations to hustle her down the hill to the waiting ambulance. While he was moving furniture, I took a moment to look around the room. It was the living room, but obviously had been transformed into an all-purpose room at some point. There was a bed, a couch, a desk, a table, everything she needed was in that one room.
The patient interrupted my musing, stating nicely "you know, I really don't want to leave, do you think all this fuss is really worth it?" The probate member immediately starting listing all the reasons why she could bleed to death if she decided to stay. After politely listening to him, she turned to me and stated "I just don't want to leave this place, for I'm afraid I'll never come back". She turned to survey the room, and look out the window at the mountains visible. "I was born in this house, I raised my 6 kids here, I had 2 kids die here, I lost my husband here. I just want to come back here, and die peacefully here one day. Sorry, you all are nice, but I don't want you to come banging in as I'm in the business of dying".
The probate was lost at this spiel, and started trying to quickly load the patient onto the stretcher. She paused for a moment, "wait a minute, young man, I need to grab my pocketbook." He was impatient, found the pocketbook quickly, and then hustled her onto the stretcher. By now the bleeding had finally slowed, so the urgency was less, but still the probate hurried her. I held up my hand for a second, and he paused. She was crying now, and softly told me "I love it her, all my kids live in the neighborhood, they don't farm like I used to, but they all have good jobs. Can I come back?" I held her hand for a moment, and reassured her that most likely she would be home before dark.
At that moment a massive figure appeared in the doorway. I instinctively ducked, for he had come in silently and I had no idea who he was. "MOM! How are you?" he gently called out, as he moved in to hold her hand. She turned to me, "this is my oldest son, and he comes over and cooks and cleans for me, allowing me to live her". He was gentle and carefully with her, and even tried to help us carry her out of the house. He reassured her that he would be at the hospital to pick her up "just as soon as I get some decent clothes on". We locked the door behind us, and gave her the key. When I climbed in the ambulance she was crying again. She caught my hand, pulled me close, and whispered around the tissues "Thank you for listening to me dear, I really do go on a bit about the house, but I'm getting older and if something kills me, let it kill me there". She patted my arm, smiled, and sat back.
Later in the day, I heard the ER got the bleeding to stop and sent her home in the care of her son. They commented on the care he takes of her, and her love for her family and her house.