" I realized that my training was useful in less than ten percent of the calls, and saving lives was rarer than that. After a while, I grew to understand that my role was less about saving lives than about bearing witness. I was a grief mop. It was enough that I simply turned up."Bringing Out the Dead is a perfect example of a paramedic who is "burnt out" in public safety terms, in medical terms Frank Pierce (Nic Cage's character) is a classic, albeit highly dramatized for the film, case of PTSD. He had ran too many calls, had tried to wring out that grief mop one too many times. The years of hiding his feelings coupled with the lack of that adrenaline rush that comes with a save to give his life meaning, he is left to battle his demons. His particular demon was named "Rose," an asthmatic he was unable to save, becomes the standard barer for all those perceived losses he is unable to mourn. We call it being "Burnt Out," the inability to have any empathy. It's not that we don't care about our patients, we just simply cannot take any more, our mop is soaked and there is no way to wring it out.
The role of Public Safety falls into this category all too many times. The combined amount of human suffering and tragedy that we are exposed to is only compounded by the perceived machismo of the position. Showing emotion is often viewed as a sign of weakness and is preyed upon by the collective group. As always, there are exceptions, most often pediatrics. It seems to be the only time when emotion is not weakness, but expected. The same isn't true for the countless other tragedies, for those you are expected to "suck it up and move on."
For years, I followed this formula. Pushing all the fear and guilt of the "lost" saves into a dark recess of my mind. I would find outlets where I could, dark humor and nightmares were my two normal weapons to combat the feelings when they crept up. Insomnia became constant, only to be quelled by medication (both self and prescribed).
My "Rose" came in the form of a 10 year old boy. He happened to be wearing the same shoes I had just bought my son. Prior to this run, I had been comfortable as seeing my patients as their respective conditions. I could trick my brain into seeing a broken bone, a stroke, a heart attack as just that, the person who had suffered these ailments didn't exist. That wasn't your father, that was a full arrest who needed to be intubated and medicated. I followed my protocols and treated each problem in order of it's severity and life threat...until this child. I jumped into my normal role, he was a cardiac arrest that was more than likely caused by a respiratory problem. I needed to get him intubate and oxygenated...I inserted my laryngoscope blade and looked up to get my tube, that's when those Thomas the Tank Engine shoes came into view...I continued on my mission. I had been successful and had a return of circulation. I was walking on air...I had a save. One who had an actual chance of walking out of the hospital. Yet, his shoes stuck in my mind, I would relive this run over and over again, every night he would meet me in my sleep. I thought if I went to see him, to see that he was getting better it would help quell this temporary problem. I met his mother, I saw him on the ventilator with my tube still in his trachea, providing that all important oxygen. Yet, this only worsened the nightmares. It all came to a head when I heard the news of him dying. He was to be released, and suddenly took a turn for the worse. His death marked my first experience with that flood of emotion breaking loose from the dam I had built. Years upon years of tragedy I had held in broke loose with a force I had never experienced.
I took more and more ambien, trying to knock myself out and patch this hole...and it worked for a little while. The problem is, self medication never works. We need to change this broken dynamic. We need to realize that in our field there are no walls, we are alone in a sea of human suffering. We have been called to be islands of refuge in this storm, and we need to let their be strength in showing emotion.
I'll end this diatribe with this thought. We all have a calling. For those of us who chose to run towards the chaos instead of away from it, we have to realize that it comes with a price, more often that price is our own piece of mind. So take on that grief, be the mop, but before you become saturated, turn to your friends, your coworkers, and show that their is untold strength in empathy and emotion.
