By Craig FauntLeRoy

The man was big. He had a strong square jaw and intelligent blue eyes that burned with a flame born of his heritage. He was the kind of man who could dominate a room with his physical presence and the force of his will. Even at this later stage of life, his massive build spoke of a power that demanded respect. In his younger days he would have been a fearsome adversary or a formidable friend. But on that day, over 30 years ago, he was in serious trouble.

I was driving for American Company out of Fresno. I had several years of emergency medical experience at Fresno Community Hospital’s ER, and had been working at American for a few months. It was back in the pioneer days of paramedic service when paramedics were generally trained and licensed by the county where they worked. Later I would be trained at San Joaquin-Delta College in Stockton, but that day I was the driver for my partner, Tim, who was the paramedic.

The man’s physician had called our company and asked us to transport him to Fresno Community Hospital. Our instructions from the physician were to, “not, I repeat, not, do anything. Just take him to the hospital.” The use of paramedics was in its infancy in Fresno County and some physicians were adamant about us leaving their patients alone.

The man and his wife lived in a small cottage about half an hour west of Fresno and a little north of the rural community of Kerman. When we arrived at his home, there was already a North Central Fire Engine in the front yard. North Central did not have paramedic service in the area then, so the engine captain was glad to see us arrive.

Entering the quaint home was like stepping into another world. Memories from a different place and time draped the walls of the living room: swords, knives, muzzle loading rifles, and old portraits framed in dark wood. There were several people in the dark cool room, some I would never forget, a few I would never know. Each played an important role in the images etched into my memory. The man we were to take to the hospital was sitting in a wide backed velvet chair. I could see tension around his eyes and a firmly set jaw. Even though it was cool in the home, he was sweating like he had just emerged from a sauna. His white T-shirt was soaked. At first I thought the tenseness in his face was set against pain, but I slowly became aware of a hint of something else. His wife was there, and a grandson. The man was talking quietly to his wife in a language I did not recognize. The grandson, who looked to be around 30, informed us his grandfather and grandmother spoke only Russian. The grandson would be our interpreter.

Tim quietly relayed to the grandson that this grandfather needed to go to the hospital. His doctor had called and was already expecting his arrival. The grandson repeated Tim’s message to his grandparents in a respectful tone of voice. The stoic, almost noble looking grandfather nodded and talked quietly with his wife. The grandmother spoke to her grandson, who relayed their wishes, “Grandfather realizes he must go to the hospital, but Grandmother says he wishes to wait for the priest.”

Tim asked the grandson how long it might be and was informed that the priest had already been called and was on his way. Tim looked directly at each of the elderly couple’s eyes and said, “That will be fine.”

I was beside myself with apprehension and nervously said to my partner, “Tim, this guy is in serious trouble. We’ve got to get him to the hospital.” Tim merely replied, “Let’s get his vitals, start him on some oxygen, then get him on the gurney and into the ambulance. The priest will probably be here by then.”

We approached the gentleman to move him to the gurney, but he refused our help. His wife said something to her grandson and looked at us with imploring eyes. The grandson interjected, “She says he must wait for the priest.” The grandfather’s face was resolute. I began to realize the powerful will that I had seen in his eyes earlier. Tim assured the grandson that we only wanted to get him on the gurney and situated in the ambulance so we could leave as soon as the priest had arrived. The grandson relayed Tim’s reply and after a quiet discussion between the man, his wife, and the grandson, we saw the look of agreement on their faces.

The grandfather flatly rejected our help getting onto the ambulance gurney. By force of will he slowly moved from the chair to the gurney. Once seated, his massive frame made our gurney look like a child’s wagon. We put the back of our gurney in a high upright position and started to move him toward the front door. As we started to pass through the home’s threshold he quickly spoke to his wife in Russian. She looked at their grandson and then to us with sad eyes. The grandson said something to her that seemed to reassure her slightly and then reminded us, “Remember your promise to wait for the priest.”

The situation started moving from almost surreal to oppressive. All of my experience and training cried out that we should be getting our patient to the hospital as quickly as possible, but the resolve of the grandfather, grandmother, and grandson had become an iron triangle. It would not bend, it would not break. Moving him out of the gentle shadows of the small cottage into the bright sun, I had to shade my eyes against the intensity of the light. As my vision adjusted, I saw even more clearly the determined set of his jaw and tense manifestation of his will shining from his eyes. Picking him up to put him into the back of our ambulance I sensed more than saw the only flickering of fear I would witness. He spoke firmly to his grandson, who echoed what was more command than request, “You cannot leave until the priest gets here!” Tim assured him that we would not leave. I began to feel more helpless, an observer to events that were moving in a direction that made no medical sense, yet remained beyond my influence.

Once he was in the ambulance my apprehension surged. Tim took one look at me and said simply, “It will be OK.” I did not share his opinion. My medically trained mind shouted to me “We should have been to the hospital by now!”

The captain of the North Central fire engine had remained supportive but in the background. He approached Tim and asked, “Do you need us to stick around?” Tim replied, “Listen, thanks for being here. It does not look like we will need your help, so why don’t you go ahead and get back in service.” The captain nodded and gathered his crew to leave. Remaining, we were souls caught in a world of stark contrasts, shadows and light, past and present, needing action yet frozen by the power of our contrasting demands. Time had become suspended in the tension that remained.

Eventually someone said, “Here is the priest.” I turned and saw an old heap of an automobile pull into the front yard. Emerging from the old car was a middle-aged man with a dark beard, wearing blue jeans and a soft cotton shirt. I was confused; this did not look like any priest I had ever seen. Suddenly the realization came to me: They are Russian Orthodox. Tim was in the back of the ambulance with the elderly man, so I met the priest half way from the car and said, “We really need to get his man to the hospital.” In my voice I tried to reflect the medical seriousness of the situation. The priest merely looked at me and nodded saying, “I got here as quickly as I could.”

Turning to follow the priest I sensed an amazing change in the people in the yard. The grandmother—tense and worried, almost hostile before—was relaxed and gentle. The grandson who had been caught between the two worlds of his grandparents’ wishes and the medical communities’ system, changed in front of my eyes. His shoulders changed from square and rigid to soft and rounded, his arms now hanging loosely at his side.

Walking with the priest to the back of the ambulance I was to encounter an even more remarkable transformation. We had closed the back of the ambulance doors to help keep the inside cool in the afternoon sun. I opened the doors and the priest stepped up on the back bumper. Once again I was awed by the sight of this giant of a man, this chieftain of old, seated in the soft shadows within our ambulance. When I first opened the doors, his expression remained tense; his eyes stern. Then, with the dawning recognition of his priest framed by the bright sunlight, the first hint of a smile rose across the man’s lips. The priest exchanged a few words in Russian with the man and then turned and spoke a few words to the family. When the priest turned again to face the man he had produced a Bible and some sort of shawl he put around his own shoulders. The priest uttered a prayer in Russian, stepped into the shadowed compartment engulfing the man, spoke briefly with him and then returned to the back bumper of the ambulance. He held his hand up toward the man as if blessing him, softly recited another Russian prayer and then walked back to the grandson and grandmother. The grandson looked at me and said, “You may go now, and thank you.”

I turned to shut the doors and saw a different man sitting in our gurney. The eyes that had been tense and willful were now soft and accepting. The jaw was relaxed and at peace. The change, subtle but dramatic, had happened so quickly I had to take pause before I fully comprehended it. The cottage and people, the ambulance and its crew, were all the same individually, yet everything was different. Turning to walk up to the driver’s seat I caught the grandson’s eyes.

“Last rites,” he said, “the priest gave my grandfather his last rites.” The grandmother looked at me with sad, knowing eyes. She would not ride to the hospital with her husband. Pulling out of the yard and looking through the rear view mirror I caught a last glimpse of the small party of people from another world as they turned and slowly walked back into the cottage. I knew beyond all doubt I had been wrong.

We got him to the hospital. I called a nurse I knew the next morning to see how he was. He had died the night before. “There was nothing that could be done,” she said. I knew with certainty she was wrong. Much had been done sitting in the bright sun in the soft shadows in front of a small cottage just north of Kerman.

I would be with many more, both young and old as they made that passage, but my view of our role in that pilgrimage between shadows and light, life and death would never be the same.

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