The First But Not The Last

There are some things on this job that will never become routine.
Or, more specifically, there are things about this job that, should they become routine, ought to signal to you that it's time for a career change.
You can't check your humanity at the door the day you get your EMT ticket in the mail.
It's Ok for certain things to get to you. Hell, it's probably necessary. After all, what would it mean if there was nothing on this job that could tap into those parts of ourselves that contain empathy, sympathy and compassion?
What if we no longer had a well inside us that contained those things?
It would mean we had become less than human, automatons able to recite drug doses and perform various medical procedures but without that spark -- divine or otherwise -- that differentiates us from monkeys, who are also able to perform simple procedures.
In short, it's Ok to admit that some things bother us. It is in fact necessary to admit this.
That was the point I tried to make to the distraught EMT in the charting room.
We'd just worked together on what was her first cardiac arrest, a sentinel event for anyone new to EMS but made especially so because our patient was 2-months-old.
After we dropped our patient off with the code team I restocked the truck and went to the charting room looking for my partner, ostensibly to see if he needed help writing up the call, but really just to spend a minute or two with a medic I respect tremendously, commisserating about the sadness of it all before shaking it off and getting ready for the next call.
This is a strategy I've used to great success throughout my career.
The room was empty except for the EMT, who stood in the corner weeping. She was a little embarrassed to be discovered, but didn't stop.
I asked her if it was her first pedi code, and she told me it was her first code, period.
I assured her that she had performed admirably and professionally, and that there was nothing she or any of us could have done to bring that baby back; that we all acted as aggressively as we could, but that the baby had been down long before we got there.
I know the "research" about debriefing after rough calls is sketchy, and that there is a school of thought out there that says critical incident stress debriefing -- an automatic process that kicks in in many EMS systems after intense calls -- actually causes more harm than good by continuously re-opening psychic wounds among responders and not allowing time for healing.
I'm not sure what I think.
I've never taken part in a CISD session.
I don't say that as a critique of people who have, but I've never had a problem admitting to a partner after a bad call that there were aspects of the call that bothered me.
More often than not my partner has felt the same way.
And having those feelings out in the open, I so far have always been able to move on.
There are many former partners of mine out there who deserve thanks for the fact that I am not burdened by the occasionally horrific and often sad things to which I've been a witness.
I don't know if my little conversation with the EMT in the hospital charting room helped or not.
I know her partner, who I didn't speak to, ended up going home after the call, while this EMT did not.
I saw her again on a call, later that night.
A 35-year-old woman had walked into traffic on a busy street and been hit by a car.
The street lights were out and the woman lay in a crumpled heap in the middle of the road, her left leg mangled.
We worked by the reflected glow of emergency strobe lights off the wet pavement and the weak light of a half-dozen Mag Lights held by a surrounding phalanx of police and fire personnel.
I completed my assessment and was working on securing the patient to a long board when I noticed that EMT again in the circle of people caring for the woman, this time holding traction on the patient's head.
We completed c-spining the patient, loaded her into the ambulance and took off for the hospital.
I was in the back with the EMT but we didn't really speak, occupied as we were with caring for our injured patient.
But I couldn't help but think that the fact that she was even here with me in the back, doing her job, taking care of the sick and injured, was a good sign.
Her empathy didn't die with that poor baby.
It lived on, in the simple belief that she still had work to do and there was a worthwhile reason to be here, working in the back of a cramped ambulance roaming the streets of this beleagured mill city.
There is a name for such a thing.
We call it "hope."