Dealing with Chronic Stress

My first encounter with real death was on my EMT internship. The ten hours I spent at an inner city hospital in Brooklyn, New York set the stage of my life to come.

Basic Training

My first encounter with real death was on my EMT internship. The ten hours I spent at an inner city hospital in Brooklyn, New York set the stage of my life to come.

I sat in the busy ER, ignored and bored, as most EMT interns. The permanent ER staff went about their business and avoided me whenever possible. It was not that they were rude, as I would later learn from experience, it was just that they had little time to deal with some inexperienced and non-certified healthcare provider. It was an interruption of their routine. It was an intrusion on their lives. It was a slow night and the last thing they needed was to make small talk with a complete stranger. I was there for one shift and chances were that our paths would never cross again. They wanted me to sit there, not play with the patients, not hurt myself and at the end of the 10 hours say, "if I don't see you again, have a good life."

Since I picked a particularly slow night, a knack that I have never been able to duplicate, there was very little staff. As I sat in a large chair meant for ambulatory asthmatics reading my prep test manual, my eyes closing for the hundredth time, the room started to get noisy.

What I later found out was a very green crew brought in an elderly woman in cardiac arrest. They were doing CPR and bagging her with a BVM, both crew members drenched in sweat. The ER doc looked over at me and yelled, "take over."

Take over what, I thought? Somehow, my body made its way to the gurney and started to do chest compressions, just as I learned on the manikin. After a few thrusts, I heard the crunch of bones snapping. "Oh Lord," I thought. "What did I do?"

The ER nurse sensing my distress and my inexperience consoled me, stating that broken bones are quite common, especially in the elderly. After what seemed like an hour or so, about 30 seconds later, the ER doc noticed that this particular human being had dependent lividity. I even noticed that she was purple on one side. The doc proceeded to pronounce the patient and mumbled a few unkind epithets at the crew.

Not fully understanding why we stopped doing CPR other than that was what the doctor said to do, I looked at the patient's open eyes. With my hands slightly shaking, I closed them as gently as I could. The ER nurse, recognizing that I was green around the gills, insisted that I go out and get some fresh air.

It was at that moment that I decided that EMS was probably not the job for me. I did not want to lose the battle of life and death again. It was for someone else to fight and win or lose.

Advanced Training

Somehow, I became an EMT and helped fight other battles with life and death. I think what helped was that the battles were not fought alone. I had great partners. However, I had been lulled into a false sense of security.

Anytime we think we got it figured out, God or the fates smack us in the back of our heads. The minute you say, "I never miss an IV line," you are going to blow the next vein. The minute you say, "I'm a great driver," you are going to bang up your vehicle, etc., etc. The long and short of it is God, the fates, reality and life humble us.

I, like many other EMTs had the stubbornness to continue because of our teachers. All good men and women, none perfect, some better than others, each and every one, people doing God's work, helping to ease the suffering of humanity. Each dedicated on some level to make the world a better place.

Much later, as a paramedic student once again on my internship and anticipating taking state, local and national exams, the bottom fell out. I questioned my choice of professions.

A young woman, walking out of her office, collapsed and died. We brought her back for a while but despite the efforts of a team of doctors, nurses, medics and EMTs, she never came back from the dead. I just didn't get it! She was in relatively good health, in her twenties and had her whole life ahead of her. Why in God's name couldn't we get her back? What made her different from any other patient who I helped treat before? Why did she matter more to me than the other patients that came before her?

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