The tree is glittering with a hundred lights, the presents have been unwrapped and the kids sprawl around the room playing with their new treasures. Comforting, familiar smells waft out of the busy kitchen as preparations for the mid-afternoon luncheon are nearing their conclusion. Grandma sits quietly in an armchair, dutifully collected from her nursing home as with any major holiday. She observes the busy scene before her, lost in thoughts and memories and wishing she were more a part of their everyday life. Nevertheless, she has resolved to enjoy the companionship today before being dropped back off at her sterile, impersonal little room.
She sits and waits patiently, not wanting to be a bother even as her stomach starts to grumble. It has been many hours since her 7 am breakfast, and her normal 11 am lunchtime has long ago come and gone. As she watches and waits, her head starts to drop and her eyes begin to close. "Don't wake Grandma!" her grand-kids are admonished as they get loud in their holiday excitement, but the correction is unnecessary as she doesn't even flinch when a new remote controlled car is driven into her foot. She slumbers peacefully on.
The turkey is done and carved, sending its wonderful aroma through the house as the family begins to collect around the table. The gravy is thick and rich, the vegetables perfectly tender and the wine is poured as Mom sends a cousin over to wake up Grandma. "Auntie! Auntie! Grandma won't wake up!"
The picturesque Christmas scene is rudely interrupted by two cold, hungry paramedics trooping in the front door, knocking the wreath askew with our bags. I take in the scene, the wonderful yet untouched food, the seemingly sleeping little old lady tucked away in the corner, the wide-eyed children and worried adults. We run through our physical assessment as our questions begin, but nobody seems to know the answers. "What medical conditions does she have?" Blank stares. "What medications does she take?" Blank stares. "How long has she been 'asleep'?". Nothing.
Her blood sugar comes back at 1.7 mmol/L, understandingly so. It is close to 3 pm and apparently Grandma is a very hungry diabetic, confirmed by the medication list a relative has found in her purse. My partner starts an IV and we give her dextrose, waiting for responsiveness to return. She slowly, very slowly, starts to come back to consciousness, but is now showing a pronounced facial droop. Christmas dinner has now been thoroughly ruined and we leave the family's guilty tears and angry accusations behind as we package up semi-conscious Grandma and disappear into the cold, gray day.
