I Am So Screwed Up

I found this post that I had written about a year ago that I never shared with you all. To give you a little background, I wrote it the morning after I got home from a rough shift on the ambulance. We were called out in the early hours of the morning, about 4 AM, for a cardiac arrest. When we arrived, our patient was truly in cardiac arrest. We did everything we could to resuscitate her but were unsuccessful. Because we had a really good idea when she went “down” (lost her pulse and stopped breathing) – and it was only a few minutes before the fire department arrived and began resuscitation efforts, we were determined to work the code for a while. However, as we progressed through the code, there were certainly signs that pointed to the fact that we were not going to get her back. After about two hours of resuscitation efforts, I pronounced her dead. As I was writing my patient care report, I started thinking how screwed up my mind and my thinking is toward death. And that’s where this starts…

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I admit it. I am screwed up. I came to this realization this morning about 6am as I pronounced a patient dead.

Death. This word, this idea, is something many people refuse to think about…until it happens. It is a taboo subject. And, quite honestly, can be a very difficult subject to think about. As a Christian, I understand and realize that people who have accepted the free gift of salvation from God will, one day, leave their earthly body. I know this will happen. I know they really never die. Because of God’s mercy and grace, they (and we) live forever in the presence of God without hurt, pain, sickness or death. Those who do not accept this gift will not have the benefits that Christ’s death brings Believers.

So, what’s the issue?

Because of this job, I look very differently at death. This morning, as I (and my coworkers and fire fighters….I couldn’t begin to run this type of call alone) was working on this 50-something year old, trying to resuscitate her, I knew it was hopeless. This patient was gone before we even arrived. Later, after my partner and I returned to the station and were beginning the long process of restocking our equipment and completing a mountain of paperwork that accompanies this type of call, I began to think of how “easy” it was for me to say: “yep, they’re dead and we’re done trying to fix it”. I did find it almost scary that I didn’t have the urge or desire to work harder. I felt like it was a non-human response to the situation. I should care. I mean, people trust me to take care of their loved ones. They put them in my hands to bring them back from the jaws of death, as we so often joke around. How did I let myself become so callous to the thought of death?

In thinking about it, I am certain it was not an active choice I made, but rather one to protect myself and my “thin skin,” so to speak. I am a sympathetic and empathetic person. I care about my patients. I care about the families of my patients. I hate the idea of causing them pain. I dread the thought of telling someone that their loved one has died. It is so difficult to do, especially when the death was sudden and unexpected, like this person that I mentioned above.

I feel like I have developed this attitude to keep myself protected. Unfortunately, I have dealt with a lot of death during my time on the truck. I have worked many cardiac arrests, and spent countless hours on the subsequent paperwork, restocking and cleaning that follows these events. I have had many more cardiac arrest dispatches that we did not work because the effort would have been completely futile, and we knew this from the start due to the obvious signs of death. And with many of these, I had to talk to the family. I had to tell them what was going on. And, if we stopped our resuscitative efforts due to the inability to regain circulation, I had to explain to them that their loved one was dead. Often, that meant I had to be the shoulder they cried on. I had to catch them as they collapsed to the ground (because they refused to sit when I asked them to before I told them…). I had to try to offer words of comfort to the grieving husband, wife, mother, father, son or daughter. I had to be strong.

If you don’t know me that well, then you are probably unaware of the fact that I can cry at the drop of a hat. And in sad situations, particularly if other people are crying, I can very easily start. Perhaps this is why I convinced myself it was okay to become, at least internally, insensitive to the subject of death. Outwardly, I still show compassion to these people who have just lost someone they love so dearly. It is a difficult time for them, for sure. And the last thing they need is some coldhearted individual coming to them and saying, “Well, they’re dead. Sorry about that. Bye!” But the last thing I need is to get completely caught up with every patient and their family. If I did that, I would have been out of this job within a year due to the emotional exhaustion that would come with it.

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It has now been a year since I wrote this and a lot has changed. Even though I am no longer in this field, I feel like it’s still as true as ever. My attitude toward death appears to be completely screwed up in the eyes of a lot of people, including myself. Dealing with the death, itself, is easy (relatively). I could handle that pretty well for most of my patients. It’s dealing with the family that was the difficult part.

I look at this as another way that those of us who have been or are in EMS and the fire department are just “special”. We have had to handle situations that most people never dream of being put into, and often times our only “training” for how to deal with these extremely delicate situations and issues is on-the-job training (talk about a stressful way to learn). We have to learn to make the best of them and continue on. We can’t take a time-out for ourselves to stop and re-group, particularly in the middle of a call. We have to keep going. So, we learn to deal with things differently than the general public does. And that makes us seem strange.

Please don’t think of us as strange or weird or coldhearted. We love the job we do or did. But it’s a tough job to have. And in order to keep at it, we have to learn to deal with very difficult things. (Think about it: you only deal with these types of situations when they personally impact you. We still deal with them on a personal level like you, but we also have to deal with them on a much larger scale and many more times a month and year than you, the general public, do.) If we couldn’t do that, every mental hospital would be full of medics, fire fighters and police officers due to the things we have seen. So, be patient with us. And understand that our way of expressing sadness or concern may not be “normal” but it is how we have learned to do it so we can do our job.