NOBODY Sees What WE See

     On an old episode of Law and Order Special Victims Unit, Detective Olivia Bensen asked a former member why he left the Unit. He replied, "Nobody sees what we see." The same can be said about EMS providers. Nobody sees what we see.

     On rare occasions, we get to see people at their happiest, such as a successful emergency childbirth; however, more often than not, the call for medical assistance is for illness or injury that cannot be controlled by family members. In these situations, parents, mothers, fathers, siblings and close friends are in panic mode. For the most part, they think the worst. We are taught that in these cases we must be the model of calmness and professionalism for the concerned family and, of course, to the patient.

Containing Our Emotions
     When caring for the patient with a grave illness or serious injuries, we often know from experience when death is imminent. At these times, we keep an even voice and calm face, and answer their questions honestly with reassurance. We see injured, sick or dead children, or torn flesh and broken bones from auto accidents, and, through it all, we believe we should not let our emotions show. We think we must contain our feelings and not let them out. We believe we are not allowed to cry.

     But what should we do with our emotions? The day we took the EMS job, we swore we would never take the job home. We don't want to appear weak to our partners, and we feel we must always be the stoic caregiver. We often handle our emotions with humor, never talk with our spouses about our assignments, and, of course, we never cry.

     Well, I can tell you that I have cried many times. I have to release my emotions in order to continue with what I do. When we work so hard to save a life and find out our efforts have failed, there is a tremendous letdown--a feeling of failure and frustration. No one can go from such an adrenaline rush to total frustration without feeling emotion. And it does not need to be about death. It may be something you have seen many times before without any effect.

Look Out for Each Other
     Several years ago, we were called to a scene where domestic partners had argued and fought with a knife. The fight continued for approximately 45 minutes before the calls for help came in. When our ambulances arrived, the home was literally wall-to-wall blood. It was one of the bloodiest scenes I had ever seen in over 40 years of service. After we handled our patients and made our transports, we returned to our station, where I noticed one of the younger EMTs sitting on the rear step of the ambulance with his head in his hands. I went over to talk to him, and he kept repeating, "I never saw so much blood." I talked to him for over an hour, and several other EMTs came over and tried to reassure him. We talked about the successful care we had given, the injuries that were sustained, and how we had handled them quickly and efficiently. We critiqued the call as we restocked our rigs, but apparently we were not successful in debriefing our friend and partner, as he left the service three months later. He was never again the same. I was disappointed that he left, but I was also disappointed that I did not help my friend get through his situation. I could almost see in his face the need to cry for his patient. What I really wanted to do was put my am around him and tell him it was all right to feel the way he was feeling.

Protect Yourself
     We must realize that we are first human. We take all the necessary precautions to protect ourselves physically, but do we take precautions to care for ourselves emotionally? How many volunteer organizations actually schedule critical incident stress debriefings? How many professional caregivers do not seek counseling because they don't want a record of it in their personnel file? How many of us are too macho to admit we actually have these feelings? I can tell you with certainty that you would not be in EMS if you did not have those feelings.

     If you have a call that brings you to your stress limit, don't be afraid to ask for help in dealing with your emotions. It doesn't make you a weaker person; in fact, it will help make you stronger and help you handle the next stressful call. You owe it to yourself, your family, your profession and your next patient to seek the help that will allow you to continue. Talk to your coworkers. They understand, and may even have the same feelings but are embarrassed to talk about them. If you open up, you may help them do the same. Professional help is available from doctors and counselors. If you are so inclined, speak with your priest, rabbi or minister about how you feel. Describe how you were affected by what you saw and what happened. Remember, you are still bound by the rules of confidentiality, but what you saw and how it played on you needs to be discussed.

     Your services are valuable, and you are a valuable asset to your service. Many people count on you, and many more will rely on you in the future. You love your job or you would not be doing it. Stay strong and stay healthy, both physically and emotionally.

Nathan Connizzo has been involved in EMS for the past 43 years. He has served as both an administrative and line officer for his local fire department rescue squad. He has more than a dozen CPR saves and three childbirths to his credit. He now serves as an EMS instructor and safety consultant.