Science can be black and white. “B” happens because “A” happened first. As professionals it is easy to understand the way things happen the way that they do. That being said, do we discount the benefit of faith in our practice all too often? Every once in a while we are confronted with a case that we cannot logically explain. There is no apparent cause and effect for the patient and it seems impossible to explain. On the other hand there is several instances where there had to be some form of divine intervention to prevent death and dismemberment.
I talk a lot about the CISM process and its actual (experienced) benefit. Without that process I probably would have been in a different place than I am today. Now before you go cracking about the “Hug-Me, Hold-me Squad,” understand that is the viewpoint of the person who doesn’t care any more. You can put on the “tough as nails” exterior but you know that when push comes to shove you still have a heart.
CISM is awkward. We don’t like talking about our feelings, especially with each other. It is one thing to talk about what is obvious, the care we provided. When we dig deep down into our chests and expose the tiny cavity known as our heart, shit gets ugly. REAL QUICK. In order to control the whirlwind of issues that will come up, we approach CISM from a “wham, baam thank you ma’am” perspective. Keep it quick, dirty, and leave a trail of doubt in your path.
When done properly, CISM is proven to be the most effective tool to deal with the problems that can haunt you from helping people. I am writing this article for two reasons. First, I was inspired by the idea of faith and its role in CISM from this article http://www.emsworld.com/features/article.jsp?id=17910&siteSection=4, found on EMS WORLD. The second reason I am writing this article is to tell you my first hand experience with a CISD Meeting.
Now is when I get to tell a story. I try to stay away from war stories, frankly because they annoy the hell out of me, but this is relevant. Let’s go back to the summer of 2006. I was just cleared to work as an EMT-Intermediate at the time. I was working one of my first shifts cleared on a warm summer evening in the big bad City of Springfield. I can remember the taste of the Tony’s (Boston Rd) Pizza that I was eating. Dispatch came over the air and sent us to a call on the other side of the city. Initially it came in as an infant with a laceration.
I casually finish my bite of pizza and store it properly so that I can revisit this occasion at a later time. We begin responding down the winding streets of the “outer belt” section of Springfield. Dispatch hails us again, “Dispatch 411 – ETA for PD?”
“411- we were coming from Central Post, about another 3 minutes out.”
“Dispatch 411, message received. Per PD they are going to be transporting from scene and are looking for an intercept location.”
Puzzled I reply “ahhh – received Dispatch. Tell them we will meet them at the corner of Centennial HWY and Winter Ave.”
My palms get sweaty, I have been working a lot of hours due to my new-found hourly rate. I was probably over doing it.
We turn the corner onto Centennial Hwy and we are now about one block away from Winter Ave. We can already see the hue of blue LED strobe lights. I pick up the mic, and blurt “Dispatch, 411, 411 is on scene.”
I wait for a second and hear a “last unit,” simply come over the air. Out of frustration I throw the mic and get out of the vehicle. Here is where the haze begins.
I approach the cruiser, and see an older male (presumably the father) holding the toddler in a blanket as if he were swathed to keep warm. I take the child from the father in my arms. My partner and I climb into the back of the ambulance. I leave my paramedic partner to get back on the radio.
“Dispatch, 411 calling. Requesting BLS Driver Priority 1.”
“411 be advised, closest unit is out in the meadow post. ETA 15 minutes.”
I scream “Fuck it, PD is going to drive.” Oops, did I have the mic keyed?
Standing next to me was a supervisor from the police department. He pretty much ran me over trying to get to the driver’s seat. I got back into the vehicle with my partner and we were off to the local trauma center. I opened up the blanket for the first time and can just remember sitting back and going “oh shit.”
The patient had bilateral femur fractures, bilateral tib-fib fractures, gloved evulsion of both feet, and an amputated 1st digit on the patients right foot. I didn’t even know where to begin. I applied as much bleeding control as I could. Before we knew what was going on, we were pulling into the hospital and the patient stopped crying and started to become unconscious. As if this call wasn’t already bad enough right?
Our arrival at the hospital was like that of a movie star. There were cameras, other officers, and other fellow paramedics as well. We make our way down the hall to the trauma room. We transferred care, and I walked out side. It was at this point that I began to feel reality again. I opened up the back of my ambulance and stared at the mess that was that call. Not really thinking straight, I thought…
“man, I wish I finished that pizza.”
A walk landed my about 75 yards away from that ambulance and at the entrance to the hospital’s heli-pad. An officer from the city approached me and began to make small talk. His superior was not far behind him. They both asked if we were okay, and gave us both a hug. It was a simple gesture that had a profound impact on me to this day. Let’s put all the bull shit aside. When shit hits the fan, we are here for each other.
I remember thinking to myself, “I am completely fine. This is something that will pass in a day or two.”
We went back to base, “on-scened” a roll-over with ejection and one unconscious. No big deal. I can’t tell you what I did on that call, because frankly I had no F*cking clue!
At the base, there was a CISM team waiting in the office. I had no idea what CISM was supposed to be. I thought it was just a bull shit way for people to get out of the rest of their shift and take a couple of days off. So, of course I didn’t take it seriously. We talked, laughed, cried, got angry so on and so forth. The CISM team members were more than supportive about giving us their contact information and knowing that we weren’t alone in dealing with this.
Fast forward a few weeks and many hours of missed sleep. I was irritable, nasty, and very quickly approaching “burnt-out.” Definitely not good for someone who is only two years into the profession at this point. I got a bitch slap from my friends and got my butt into gear. Talked to a professional and worked out some long-standing issues I had. Forgive me for not going into detail, I just want to keep that out of it.
Do I still have your attention? Okay, good. If you scroll all the way back up to the top of this post, you will see that I started it based on faith. Whoever your God may be, he/she/it/they can often give you a deeper understanding of why things are happening. Even if that understanding is that you’re not meant to understand. In this case, thankfully the kid survived. He had obviously go thru major therapy but last call, I was told he would be just fine. I will never know if this was because of, or in spite of what I did. All I know is I got to play a role in the big plan.
I am certainly not here to preach to you as providers. We all know that we get into this profession to help each other. I am opening this part of my life to you, my fellow public safety personnel, so that you don’t forget that in the process of caring for everyone else…you still need to care for yourself.
Feel free to comment, let me know about ways that you deal with the stresses of “the job.” It is always interesting to hear about other people’s stories.