House of Cards

One of my best friends who has been my mentor my entire career ran a call this week that undoubtedly will change his life. Setting: a family gathering in the front yard where an eight year little boy is playing. He runs out into the street, with his father chasing him and telling him to come back. Suddenly, from around the bend comes a car, that doesn’t see this child, and hits him.

I don’t think it’s respectful to tell the details of the call, and in any case, it isn’t my place because I wasn’t there. And I am certainly not trying to capitalize on someone else’s pain, but it does make me think about all of those times I came home from work frustrated with “the system”, heartbroken or just flat-out crying from the senselessness of it all.

There isn’t one call that sticks out for me that haunts my dreams. I never was one to get caught up in the overall picture. In order to block out the tragedy, I focus on the task at hand. For example, I once had an EMT-Basic partner run a pediatric seizure call with me. I had to start an IV on this 4 year old while she was actively seizing and it took me two tries, but I got it. My partner later said: “I don’t know how you stayed so calm and got that IV. I would’ve been scared to death.” Now, I am not trying to inflate my ego or make myself into a Paragod that I obviously am not. The point I am trying to illustrate is this: I knew I needed an IV and all I saw was the arm. The child, her seizure and her frantic mother all faded away. I focused on the arm, and nothing else mattered. Because I am able to do this, I can block out horrendous injuries that people suffer and if I have to treat that injury, I try to focus on that and block the person out. It’s a broken leg, just a broken leg, like there isn’t a person on the other end of it. It sounds heartless, and it makes me look like I don’t have empathy; on the contrary, I am deeply connected to my patients. But when it comes to tragedy, I have to separate the two.

I am a heart-sleeves person. I envelope the pain of others and I want to ease their suffering. Our job is to intercede: between life and death, pain and relief, grief and resolve. Being an intercessor is the most amazing part about this job, methinks. When we are on a call, we may see the most amazingly painful thing someone has ever gone through and we are lucky enough to be the person they turn to for comfort. We hold their hands, hug them, wipe their tears. We are there for some people at the end, whether it’s too soon or not. We see the way force is applied to the human body, we see accidents, crimes, hate and anger. We see every rotten thing human beings can do to each other, intentional or not. We are there to pick up the pieces, to intercede on behalf of the victim, or their family.

We reassure people on every call, no matter how miniscule it may seem to us. We walk in, professional, with an air of confidence and we smile at them. Our patients may think that this is a huge emergency, but we portray the attitude of: “I’ve seen this a thousand times before.” And they are relieved. We do this because, inherently, we all have a humanity streak. There is humanity in compassion and it is our compassion for others and not our technical skill that makes us good clinicians.

Joseph Butler said: “Compassion is a call, a demand of nature, to relieve the unhappy as hunger is a natural call for food.” And so we go. We go to these disasters, not knowing what to expect and not anticipating the emotional burden we will face. We go, in my mind, like warriors: bow-chested, strong-jawed and erect and we stand in between these people and their individual darkness. It seems less than altruistic, certainly, fantastically dramatized versions of a sometimes thankless job. But…is it so far from the truth? And if it is, what harm does it do to romanticize this evil if it gets you out of bed in the morning for a repeat dose?

We are left battle-scarred from careers spent watching, protecting, interceding. We have nightmares, though there are those of us who won’t admit it. There are people we tried desperately in vain to save, there are circumstances we struggled to prevent. We sometimes feel alone, because the events we witness are not things we want to bring home to our families-we don’t want that evil to pervade our house. We cry for them and mourn them, just as their families do. Their faces may blur for some of us over the years, but we do remember. And if we think hard enough, we can remember that punch-in-the-gut feeling we got when we first surveyed whatever mess we had been called upon to handle. We never forget them and we never let them go.

And so, on the phone with my mentor, I comforted as best as I could from far away. He is the best Paramedic I have ever known and I would trust him with my life. I believe, I told him, that there is a reason that child died and that he was the Medic. One day, the purpose of this will be clear. Will it make my friend a better Paramedic? Will he go on to teach, with renewed vigor, the young faces of this industry and train a person who is so inspired that they will save hundreds of lives? Or will this tragedy be for the molding of the child’s father? We aren’t to know the plan that’s in store for us, only that we trust in that plan and the tests we are given that make us who we are. There is solace in that.

After I hung up with my friend, I said a silent little prayer for him. When you have been in the field for any length of time, you have amassed quite a collection of human tragedies, like a hand of "Go-Fish":
"Do you have any senseless death?"
"Boy, do I!"

I know how he feels, how we all feel in those times of helplessness, when the deck is stacked against you and you are working feverishly for a result that will never come. What we have to strive for is the resolve to carry on through that call that threatens to break us and the strength to survive that call when it is done.