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Guernica
climber
s x sw
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Topic Author's Original Post - Mar 19, 2009 - 10:56pm PT
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Hi everyone! Long time lurker, first time poster here. I've always enjoyed the discussions here a great deal, but this is the first time I've felt compelled to initiate a thread.
I'm an EMT-B student a little over halfway through the program. I went on my first ride-along yesterday, and predictably, a couple issues surfaced. I'm really curious how you guys deal with the emotional, and dare I say, spiritual stress of dealing with such things.
Most of the calls were pretty tame, but there was one call that really left me thinking. We entered the patient's house and there on the floor was an unresponsive woman, bleeding out of her mouth and generally looking near dead, with a shocking amount of blood smeared over the walls and floor... however her family/friends (also covered with blood) were hysterical and just absolutely losing it. This I found deeply stressful and when I first walked in the house the horror struck me like a bad mushroom trip starting to wash over me... that only lasted a couple seconds and I was able to conduct myself in a professional manner (easy to do since I didn't have any real responsibilities), but it left me wondering if I'm cut out for this sort of thing.
I will certainly chat about this with my instructor, but I'm truly interested in what you all have to say. You've seen much, and I could really use some feedback!
Take care everyone.
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Reilly
Mountain climber
Monrovia, CA
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Mar 19, 2009 - 11:29pm PT
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Guernica,
Nice handle! I've seen the original, very moving.
I've done quite a bit of SAR. Like many things you do get hardened to it. That said I think most people have only so much 'in the tank' so I would encourage you to plan ahead. I saw a lot of people in SAR who seemed to be only in it for the thrill. The fact that you obviously care and are thinking about it tells me you'll be fine.
I would make one distinction between 'our' SAR and your urban duties. That is most people who come acropper in the hills are there because they want to be. Though the sad results may be the same I found it somewhat more palatable than people on people mayhem.
Best of luck!
Reilly
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Guernica
climber
s x sw
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Topic Author's Reply - Mar 19, 2009 - 11:58pm PT
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Thanks for the feedback Reilly! Perhaps someday I'll get to see the original Guernica as well. Anyway, that's a great point about wilderness vs. urban stuff... the plight of people going about their daily lives, maybe even in their own homes, and having a tragedy occur is very different from people who go on an adventure knowing the risks. I'll be doing my ride-alongs in a violent and drug-steeped little town (somewhere south of the colorado border is probably all I should write) so I can be exposed to harsh things quicker and hopefully, trail-by-fire style, learn quicker too.
Thanks again for the wisdom.
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Guernica
climber
s x sw
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Topic Author's Reply - Mar 20, 2009 - 01:01am PT
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Others?
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WBraun
climber
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Mar 20, 2009 - 01:12am PT
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The body is the vehicle and the owner is the driver.
You are the tow truck driver bringing in the broken vehicles.
The driver never dies, nor was he ever born. It just looks like that to our conditioned materially defective senses.
Doctors are just mechanics, they can't save the soul, they just try and fix the complex incredible created machines.
Bring em in and do your best ......
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S.Powers
Social climber
Jtree, now in Alaska
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Mar 20, 2009 - 01:17am PT
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I dont really know what to say here as I think we all develop our own way of dealing with the emotional stress. I have a little voice that tells me when its okay to cry, and i listen to it. I have cried on a scene with a grandmother whose 9 year old grandchild had just passed from away from a terrible respritory illness. I cried with her and we both appreciated it.
If your asking what happens to me when I get to a scene like yours, I kind of turn off the emotions that are not going to help me help other people. I am lucky, it just happens for me. When i get to a place where i can cry I do, and i talk with the others involved in the call.
Im still new to the EMT thing as well. If you really want some good answers I would PM TanSlacks, hes a real life hero, has dealt with the worst, and until proven otherwise is the golden model of what an EMT-P should be.
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bluering
Trad climber
Santa Clara, Ca.
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Mar 20, 2009 - 01:24am PT
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Werner hits a homer!!!
I have no idea about this stuff, just put into a very good context for people who do this stuff.
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Jaybro
Social climber
wuz real!
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Mar 20, 2009 - 01:25am PT
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Welcome Guernica
The EMT stuff is scary sh#t, that's why I gave it up and became school teacher.
Good luck!
I have never seen the original either, nor have I been to Spain.
I wonder if Cilley has seen it..
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Lynne Leichtfuss
Social climber
valley center, ca
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Mar 20, 2009 - 01:30am PT
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maintain composure, listen to your heart, do what yo been trained to do to the best of your ability, pray and try not to get too indifferent over the years. Balance.
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Ken M
Mountain climber
Los Angeles, Ca
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Mar 20, 2009 - 01:42am PT
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You actually made a factual mistatement, although unintentionally. When you said that it was easy to maintain professional composure, because you actually didn't have anything to do, that is wrong.
In reality, it is FAR easier to deal with things, when you actually do have responsibility. Many of us refer to it being like "throwing a switch" or "changing into our professional clothes". As time goes on, and we gain more experience, it becomes easier, and second-nature to make the switch back and forth.
"You" don't become affected by the experience, because "you" were not there. It is amazing how the human psyche is able to make this adaptation.
Even after years in ER's, I have no trouble with massive trauma....if I'm procedurally involved. However, if I'm just watching, it can turn my stomach.
You will know more about this as you go along, and it is amazing how adaptable most people are.
Good luck, and thanks for trying to help in this way!
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dirtineye
Trad climber
the south
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Mar 20, 2009 - 01:44am PT
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as a (now lapsed for obvious reasons) WFR, I would point out that you can easily become a WEMT, wich is a valuable person to have around when there is a climbing accident-- better than a city emt by far.
TO answer exactly what you asked, fortunately I have only had to deal with two angulated fractures, not compoundf thank god, and both were at a boulder field wiht real paramadics only 15 minutes away, so all I ahd to do was stabilize the injury by hand and try to keep the usual fools from doing something with good intent that would be very bad.
I had to hold an ankle that was snapped right at teh ends of the tib fib-- how it did not compound I really can't figure but the agony was bad enough for the victim as it was, and what we did was get a pad under her, whil holding the fracture imobile, and cut the shoe off ver y very carefully, find a pulse, check perfusion n the nails, and of coures absoultely the first words out of my mouth when it happened wee " call the paramedics". thank god for cell phones and boulder areas inside the city.
My reactions were, pretty much awe aaat tthe way the fracture looked, and trying to stay calme and keep the victim calm, and ward off the goofballs who wanted to move her. how I did this was to say, " look, 6 well trained guys who do this every day will be here in a few minutes wiht the proper equipment. we are not doing anything other than what we are doing now until they get here and take charge".
Afterwards of course it was different. once the paramedics had control I could let loose and realize the horror of what is a very serious and painful fracture, horrible to look at, ( I stared at it for a solid 20 minutes at least while imobilizing) and I felt pretty shaken.
Luckily this was the worst one I had to deal with. There was another accident at that boulder field that I am glad to have missed, that involved a lot of blood, brain damage, and kids witih no business on the rock 9not climbers, just kids goofing around at the park, took an easy way up to a 30 foot spot, were driking and smoking pot, and playing around) doing some really dumb things and paying a huge price, and I really am glad I was not there, because I was arriving as the paramedics were rolling him out into the ambulance, and he was totally unconcious and looked for all the world like he was a goner.
Like I said, I'm really glad I missed that one, cause it would have been at the limit of what a wfr can do, andwas much more dangerous than a fracture where the patient is still concious, with no head injury adn all that that adds to the fun.
Good luck, and I hope you are a climber who will become a WEMT along with your EMT.
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Guernica
climber
s x sw
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Topic Author's Reply - Mar 20, 2009 - 08:51pm PT
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Thanks for the heartfelt advice everyone. It is all absolutely helpful, and neat to have an image of the painting in the thread, thanks Jaybro. I knew you guys would have some perspective for me. And yes, WEMT is the next step I think... good call dirtineye. Thanks again and keep me apprised of any more thoughts on this.
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tom woods
Gym climber
Bishop, CA
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Mar 20, 2009 - 09:22pm PT
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the post above is right. right now you have nothing to do so that's harder, once they trust you, you get in there swinging no problem, especially if there is a paramedic.
like a lot if things in life, the first step is a dusy. after that you'll be fine.
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Ricky D
Trad climber
Sierra Westside
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Mar 20, 2009 - 09:57pm PT
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Rent the Nicolas Cage movie "Bringing Out The Dead" - if you feel a psychic connection to the main character - then being a Paramedic is probably not for you.*
*This advice from my brother, the paramedic in LA.
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TradIsGood
Chalkless climber
the Gunks end of the country
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Mar 20, 2009 - 10:01pm PT
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Expect to see a lot of calls of the diminished mental capacity type.
Depending on where you are, you may just be their taxi service.
Good luck with it.
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tom woods
Gym climber
Bishop, CA
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Mar 20, 2009 - 10:08pm PT
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I loved bringing out the dead, good flick, not understood by a lot of people.
With your new, job, you'll get it, hooray.
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TimH
Trad climber
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Mar 20, 2009 - 10:38pm PT
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To paraphase something from an old episode of M*A*S*H:
"The thing they taught me in command school was that Rule #1 is people die. Rule #2 is you can't always change Rule #1."
(As I sit in the fire station, wondering how many more OD's, shootings, stabbings, MVC's, let alone the odd sick person, I'll be dealing with before shift change.)
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Robb
Social climber
It's like FoCo in NoCo Daddy-O!
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Mar 20, 2009 - 11:08pm PT
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You're going to see the worst that mankind has to offer and be elbows deep in it. Been in & out of it for almost 30 years now. Of the people I've known in the business, some don't seem to be the worse for wear & some are now AFU in the head from what they've been involved in. Hard to say until you're really in it for a while.
Like Werner & Rad said, when you're in "pro" mode, you just run through your abc's et al & don't think too much about it because you're busy doing your thing.
PS: ER humor can be a great help, but be careful who's around as it can be very offensive to some.
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pip the dog
Mountain climber
planet dogboy
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Mar 21, 2009 - 12:22am PT
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Guernica,
i think the simple fact you asked that question in this or any public place shows the beginning of a very good EMS head.
i much agree with Ken M that when one is truly focused and truly busy in the middle of a world of bloody chaos, there is little if any emotion. it's when you have nothing to do, or worse yet don't know what to do, that your guts churn and your thoughts torment you.
~~~
early in my training (not all that much, a bit past what you are working on now, that and many years ago) -- when i was just ballast along for the ride, i focused on watching every technical thing the best pros did, and precisely how they did it -- every teeny detail. that and how they talked to the patient, and everyone else at the scene. afterwards, at an appropriate moment, i would ask them about anything i didn't understand. the most and best of them are very generous teachers. the rest are easily identified and ignored.
when you can walk away afterwards knowing in your gut that you did the best that you could possibly do, peace comes easy. OTOH, if you walk away thrashing in your head "if only i had..." peace comes very slowly, sometimes not at all.
~~~
as such i worked very hard to "become a machine" -- a machine that could do the right things (within my skills) fast and without a hiccup of emotion. true, on occasion i'd walk off alone afterwards and puke and shake and cry. but only afterwards. and even those moments inspired me to work even harder at becoming a better "machine". understand that by 'machine' i don't mean less human, i mean more effectively human when on the spot.
~~~
finally, i myself have this theory, developed over years, that much of how one responds when the poop really hits the prop is wiring, genetics. i've many times seen very cool headed, mature, and focused people collapse when things got really ugly. i've also seen quite a few people with relatively little experience or training focus like a laser and get things done fast and right without so much as a gasp or a shudder. i can't explain why that is. but i have seen the pattern enough to be certain it is so.
and that is ok too. none of us choose our genetic wiring. some i trained with choose to move easily into related fields like hospice care or MRI tech work or the like. others are now the kind of 'LAS' wizards that i hope show up if i ever end up suddenly very broken.
stay with it. keep asking the right questions. and remember you will forever have a world of excellent options if you decide that the front line is not for you. you might also find that the front line is precisely the right place for you. give it time.
all good things,
^,,^ (michael)
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johnboy
Trad climber
Can't get here from there
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Mar 21, 2009 - 12:43am PT
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Do you like a challenge?
Some of the better ones I've worked with just rise to the task at hand, the nuances and visual aspects are mentally pushed aside and the job at hand takes priority. Its afterward that the morbid details take a reality grip. That is also when the numbness to whats just unfolded is conveyed. Getting hardened with time is unavoidable and inevitable.
In the long haul, trauma in infants or people I know well are my hardest runs to deal with.
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