1993, New York.
The elderly Filipino woman was shaking when she was brought by the EMS paramedic to Triage. Her eyes were shifty and anxious. She clutched my hand, pleading in silence.
“We picked her up at the airport. Her plane had just embarked from Brazil. The flight attendants noticed that she was very agitated and she was crying uncontrollably. It seems she’s traveling alone, but she would not talk to us now.” The EMS paramedic bypassed the other triage nurse and zeroed in on me, correctly guessing that his patient and I share the same ethnicity.
She was in her late 60′s, with grey hair, stooped back, and gnarly hands; she looked like anybody’s grandma. She looked so much like my own departed grandma. She held tightly on to her purse with tremulous hands, and her eyes filled up with tears. My initial reaction was to pat her shoulder in a gesture of comfort. As I rubbed her back, I felt her tremble. I wondered if she was having an emotional breakdown, but with her tachycardia and hypertension, I knew we have to clear her medically.
At that moment, two men in suits appeared and handcuffed “Grandma” to the stretcher. The narcotics agents informed us that “Grandma” was being suspected of swallowing condoms of cocaine, and as such, she had to be isolated from the general population. Their plan: to wait for her to pass the condoms. I prayed that the cocaine packets would remain intact. Rupture of the cocaine packets will result in massive intoxication, seizures, and death.
Her story was all too familiar. She was a drug courier, or a “drug mule”, or a “body packer”. But she was older than the rest of the couriers who had come to our emergency department. And in my part of the world, the couriers I’ve seen were from South America. None of them looked like “Grandma”.
In my naivete, I was not prepared to think of the possibility of my patient as a “mule.” As I looked at her in disbelief and disappointment, “Grandma” averted her eyes. She accepted the intravenous without any complaints.
“Why?”. Thrown off by my preconceived notions of a drug mule, I could not help but ask her. She kept her eyes closed, but tears ran freely down her wrinkled cheeks. I shook off my personal feelings against drug use, and proceeded to take care of the patient. I had asked the head nurse to switch my assignment so that I could take care of “Grandma”.
The hospital administrator had vouchered the patient’s property as we await for a judge to issue a warrant, but had consented for the patient’s cell phone to be turned over to the authorities. The property clerk showed me a picture of Grandma with her grandkids.
The agents were frustrated with the lack of information. “We need to find the people who contracted her to carry the drugs.” Their interviews with the patient were met with silence. She looked afraid; maybe she did not want to give any information for fear of repercussions.
The repressed moan did not escape me. The patient’s face grimaced in pain as she pressed on her stomach with her free hand. Alarmed, I yelled for the doctor STAT. The patient’s blood pressure was rising, and her heart rate was racing. She had not gone to CAT scan yet, but I was afraid that the cocaine packets have burst open.
“How many packets did you swallow, Grandma? Tell us please!”. The patient hesitated, but as she squirmed in pain again, she mumbled “Ten.”
The next few minutes passed in frantic preparations to bring her to the OR for emergent exploratomy. We were racing against time.
Just as the surgeons wheeled her out of the room, the patient turned to me and said, “I did it for my family.”
“Grandma” did not survive the operation. She had died because she wanted the money to pay for her daughter’s cancer treatment back home.
About the Author
Jo Cerrudo is the author of ED Vignettes blog. From the blog: “They say you need to be a special nurse to work in an ER. I am just someone who thrives on challenges yet perform with grace under pressure. I do my job to prepare the nurses to give the best and safest care to their patients.” Read more stories like this on ED Vignettes blog.