I had an interesting personal transition at work last night, and I can't figure out if it's for betterment and self-preservation at work, or just the result of seeing too much bad shit.
We went out on a code (cardiac arrest) of a larger late-middle aged gentleman last night in asystole ("flat line", generally a very. bad. thing. Yes, I am the Martha Stewart of EMS). Quite amazingly after going through the motions, we got a pulse and blood pressure back (something I was not entirely expecting with this particular patient), and off we went, lights and sirens, our driver swerving and tossing us around in back, to the hospital. Pt, self and other medic, and a cornucopia of volunteers swarmed the gurney into the trauma bay, and there I gave my report, methodically, like a robot.
See, one thing that I really, truly suck at is that I'm NOT a robot. This is not a quality normally rewarded in EMS. But there I was.
"Pt found _____. Pt in ______. Pt had a history of ______. Pt intubated, monitor suggested ____. I gave epi, atropine, epi, _____ cycles CPR, pt went into __________. Vitals now _________."
And that was when the doctor asked me an unexpected question: "What is the patient's name?"
For the first time in my career (my business motto might be "thumping the dead since 1994!") I did not know my patient's name. I knew where I could find the best pulses, what size his pupils were and how they were (or were not) reacting, his approximate airway size, his weight in kilograms, his blood glucose reading, his changing cardiac rhythms, even how much carbon dioxide was emitting after each ventilation from his lungs, but I did not know his name. In the few minutes I had deep intimate contact with the very insides and workings of this man, I was a cool observer of parts, plumbing, flow, rhythm, but I did not know his name. This is wrong.
So I told the doctor his name was "Bruce". It wasn't, but I felt like at the very least he deserved a name, and as soon as his records were found, I would (and did) correct him.
I've waited well over a decade for this moment. So many of my calls have gone like this: Gunshot wound to the head/ "does he have children? Where are they? What will they look like when they hear the news?" Pulse rate of 20/ "His wife looks like the kind of person who likes to cook muffins". CPR being initiated/ "I wonder if he is aware of this virtual beehive of people trying to save him, willing him to live". Airlift on standby/ "wow, he drives a purple Buick. Who drives a purple Buick?" 16 gauge IVs started bilaterally/"amazing how blood looks in the dark of night with only a flashlight, like liquid silk". Yes, I actually think of these things, and they are they very things that stay with me and sometimes keep me up at night. I don't remember grotesque bloody features, I remember the potted plant so tenderly care for in the messy room of a suicide. I don't remember the contours of the dead baby, but can't escape that I wanted so badly to hold him with tenderness so he would have at least been held once in love and reverence. I have longed for this moment of passivity, of urgent self-removal.
Last night, I slept soundly. 4 hours felt like 10. When I woke up this morning, I did not think of the family waiting for the latest news in the hospital, only of the mountain of paperwork and ECG's and forms that needed to be turned in before the shift ended. It wasn't until I got home, with the sun warming my back in the frosty morning and my dog barking with excitement, that I thought of this man and his family. Not of his rhythms, pulse, and medical conditions, but of this father, husband, son, and wherever he is on his journey today.
He taught me a lesson. I'm glad that the ghosts seem to not poke and prod at me as much anymore while I am in the role of conductor/ ringmaster/ paramedic. But I must never, ever forget that the blood flowing, the body on the floor, the line on the monitor- this is a person. We are so privileged to be invited in, unwelcome but necessary, to these moments in people's lives-- this is a burden and a gift.
With my few hours of quiet while Zane is at school today, I should take a nap, but the sun is shining outside for the first time in days. I think I'm going to go out there and tackle the yard again as a form of meditation. I think I'm going to write this man's name in some freshly tilled soil, then rake it over, and decide whether the beets or garlic want to live there.
Goodbye, "Bruce". You are somebody.
