By Sean Eddy
When talking about the kind of work I do, people often ask me how I deal with everything that I see. I usually come up with some generic answer like: “Oh, we just get used to it after a while.” The truth is, I often wonder how I don’t deal with everything that I see.
Let’s take a trip in the way back machine ….
It was my second week of field training at my very first ambulance job. I had just celebrated my 19th birthday and my very first EMT-Basic certification. I was working in a rural farming community in Central California. At the time, it was the only ambulance service that would hire an inexperienced 19-year-old. We were dispatched to an “unconscious person” in the far reaches of our response area, way up in the mountains. By the time we reached the patient, he was showing signs of an imminent cardiac arrest. In other words, he was dying.
Shortly after loading him into the ambulance, his heart stopped and we immediately started CPR. After nearly an hour of driving, doing chest compressions, pushing cardiac medications and managing his airway, my preceptor made the call to terminate resuscitation efforts. He didn’t respond to any of our treatments and we had completely run out of Epinephrine and maxed out our dosages of every other possible drug to administer. The ER doctor granted our request to terminate and we stopped CPR. My preceptor and I were both pouring sweat and exhausted from all the chest compressions. We placed a blanket over the now-deceased man and sat back to catch our breath. My preceptor turned around, rubbed his hands in sanitizer, opened a cabinet, pulled out his lunch and said “well, now’s just as good a time as any”. I sat there in complete disbelief as he ate his sandwich. How could he possibly eat after what we had just experienced?
Now let’s fast-forward to a couple years ago…
I was working in rural Texas during a bad ice storm. We were dispatched to a vehicle collision on a long bridge on the outside of town. It took us almost 20 minutes to get on scene due to the ice and traffic. An off-duty volunteer firefighter had witnessed the collision and was giving us updates over the radio. He told us that a small SUV has slid head-on into a UPS truck right in the middle of the bridge causing a multi-vehicle pileup. He informed us that he and the UPS driver were doing CPR on the driver of the SUV and that there were “a few more patients” still in their vehicles. We arrived to find CPR being performed on a middle-aged woman on the middle of the icy bridge. Only now, a few family members had shown up and were helping and shouting at us to “hurry up and help.” I told the firefighter to keep doing what he was doing until I got back.
My partner and I split up and checked the other vehicles. It was bad. We had three very critical patients and a few with minor injuries. I walked up and told the firefighter to stop CPR and come help me with the other patients. I immediately received a simultaneous “WHAT??!!?” from everyone that was trying desperately to resuscitate the lady. I tried to quickly explain that we had three critical patients that needed immediate attention and still had a chance of survival.
The conversation went something like this:
Firefighter: “You’ve got to be kidding me! We’ve been doing CPR for over 20 minutes!”
Me: “I know, but I have one patient with a critical head injury that needs to be intubated, another with a tension pneumothorax (collapsed lung) and an entrapped patient that’s going in and out of consciousness.”
Firefighter: “But isn’t the stopped heart more critical?”
Me: “Look, we can’t do anything about that. We have three patients whose hearts are still beating but need immediate care to keep them that way.”
Patient’s Family Member: “The only one without a beating heart is YOU. You’re taking away any chance my aunt has at living.”
I brushed off the comments and continued toward my partner who was working with bystanders to get one of the patients out of the car. I knew I had no other ambulances available and no helicopters would dare dream of landing anywhere near our scene. I was stuck.
The family members of the deceased patient continued to do CPR until a police offer finally stopped them. They shouted at me, called me a killer, and threatened me with everything from physical to legal action. I did my best to ignore them and work on treating my patients and getting a second ambulance.
It was another 20 minutes before a second mutual-aid ambulance showed up. We loaded up all three patients and headed to the nearest rural hospital. Unfortunately, there was no reasonable way to make it to the nearest trauma center due to closed roads and traffic. We dropped off the patients, cleaned out our ambulances and cleared the hospital.
Most “normal” people would have spent the rest of the day re-living what they had just experienced. Not me … I wanted breakfast. We headed to McDonalds, grabbed a quick sandwich and headed back out on another call. It wasn’t until later that evening when I was taking a shower at the station and getting ready for bed that I realized that I had just completely brushed off that morning incident like nothing happened.
I looked in the mirror and asked myself the question that I had grown quite fond of asking over the last 10 years: “What the hell is wrong with me?”
We try to explain away our lack of emotion all the time. We say things like, “You can’t get wrapped up in emotion with this job or you’ll just go crazy.” But I can’t help but wonder if we’ve already gone crazy.
