“You can’t make them any more dead.”
This is what the older EMTs always told me in an attempt to bolster my confidence and prepare me for the worst. It was my first night as the leader of my ambulance crew at the age of 16, responsible for my patients on the worst day of their lives. Ready or not, I jumped into action at the sound of the alarm, unsure of what was to come.
As I approached the scene, I went over the procedures in my head. Walk, do not run, from the ambulance. Be confident and instill a sense of order and control. Perform rounds of stimuli to the patient to assess her condition — she was non-responsive and static on the kitchen floor. Seal a bag-valve mask to her face to assist her breathing; my actions now completely controlled my patient’s breathing. Everything was going according to plan. I felt exhausted but elated that my training had paid off. I directed my driver and junior EMT as we breathed for the victim and began compressions. Once she was stabilized, we would transport her to the hospital and hope for the best.
I was trained to work like a machine, blind to the tragedy and horror occurring in my periphery. Getting the patient to the hospital safely was my job, and failure to do so was something I never considered. As I made orders and performed interventions on my patient, I found comfort in my knowledge of the procedure and the fluidity of my performance.
Then, things start to go terribly wrong. My patient started to aspirate, her airway closed, and my ventilations were no longer effective. My worst fear was coming true: She was flatlining. Seconds felt like hours as my team worked to see if there was anything more we could do. She terminated. Someone’s mother, aunt, sister or spouse was dead. There was nothing left to do. I had failed.
No one, especially a teenager, should ever have to witness this degree of trauma. But I did so by choice. I was part of a select high-school-run EMS organization in Darien, Connecticut. Just a few months after joining, 14-year-old high schoolers are sent to the front lines. Since freshmen and sophomores in high school don’t often have experience with this level of grief, they often don’t know how to cope with the stresses that accompany it.
This was my first time witnessing death at my hands. I couldn’t help but blame myself for my patient’s death. I spent countless hours reviewing the details of that night to see if there was anything I missed or should have done differently. After much reflection, I realized that the odds were stacked against both me and my patient when I arrived on the scene that night. I did my best to change the odds in her favor and fought to save her life.
After this fatality, I led a CISD, or Critical Incident Stress Debriefing, for my crew that served largely to help objectify the scenario and allow crew members to discuss their experiences throughout the call. As the highest-ranking crew member, I was tasked with protecting and caring for the well-being of my crew, so through this CISD we discussed our emotions throughout the call and what each of us had seen. I had taken part in CISDs before and had experienced the healing effects that openness and discussion had as I grieved the losses of past patients. Allowing young adults who have experienced trauma to be open about their emotions and look at the call objectively is a major part of the healing process.
Despite my efforts, nothing on that fatal call went as planned. I failed to save my patient’s life, and in my opinion, failed as an EMT. Still, I also learned that one failed call does not make me a failure as an EMT — or as a person. At times, failure is inevitable and the only thing I can ever do is to give it my all. I take great pride in all the people that I have helped since that tragic night. From falls to fractures to fatalities, I am there when people need me. Being an EMT has given me a new perspective on failure and death, ready to face the challenges that come my way both on and off the ambulance. “You can’t make them any more dead” may be true, but sometimes, you can keep them alive.
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