Trauma Queen

I am not a trauma junkie. I, in no way, live from adrenaline rush to adrenaline rush. I like calm, organized, controlled trauma. I like walking into a room, knowing the plan, being in control, and having faith that I can use my training to fix any foreseen and unforeseen complications. I do not like chaos.

Trauma, at least in my experience, is chaos. Inevitably, there is always a mess of bodily fluids, instruments, and varying levels of certification vying over the life of the trauma patient. Often, communication is lacking. Usually, everyone, no matter there level of experience, has already entered panic-mode and cannot be called back throughout the duration of the call. This is my experience; this is how every major trauma I have ever run has turned out. This is why I hate trauma.

I wasn't made for it. Adrenaline just makes me jittery and irritated. I don't get high from it.

And, yeah, some times some seriously cool shit happens in major traumas, but how often do we get to spend a second to really take it in? Most of the time, in a true emergency, we assess, package, transport, try to assess again after IVs and intubations and drugs are pushed and fluids flowing, but then we get to the hospital and the patient is transferred and it's doubtful you'll ever know the outcome or the treatment or what really happened anyway. This is my experience, and I prefer the little traumas. The, "I accidentally tore off my toe" or the "I got my hand caught in the table saw." The minor ones, the controllable ones, the ones that, when we get there everyone is mostly calm, communication hasn't failed, and we can chat with the patient and examine the wound and find out the real story. Those ones make my day. Not gun shots to the brain and stabbings to the kidney and cars going eighty into trees. I don't like chaos.

This last shooting wasn't exactly chaos, but it was the straw that broke the asthmatic EMT's back. Me being the asthmatic.

First of all, he wanted to die. He actually took the bullet and shot it into his brain. He just...didn't quite get the result he wanted. He used a very small caliber and shot it into his mouth with an upward trajectory. It lodged somewhere near his temple or so we assume, since he had a giant bulge there. My x-ray vision's on the fritz, so that's my best guess.

So, we get called out there because this guy wanted to die, and we think--because, naturally, we have no real information until we get there--well, he probably succeeded. But when we get there, we hear fire is with the patient and it's possible they are doing resuscitation. But we don't know anything for sure, because there are no cops, there are no fire personnel anywhere near where we had to park. We are getting our info from bystanders. Bossy ones at that.

So, we have to grab our gear and hike. Because Mr. Suicidal run out into the woods. Where? We dunno, we can't see anyone or anything. And we can literally get zero info from dispatch, who keeps telling us "fire is with the patient". Okay, great job Radio, now, where is the patient?!

Into the woods we go. Or rather, into the woods we slide. And, me, out of shape thanks to the EMS diet and lifestyle--I blame no one but myself--carrying fifty pounds of equipment, arms full, I land on my elbow and knacker my whole arm. But, I don't know this yet, because my adrenal glands have started working and all I feel is the jitters.

When we finally locate, patient is boarded--although, silly fire, they forgot the collar so he isn't entirely immobilized--tubed, and stable with an IO in his tibia. We hook him up to our monitor and chat for a minute about how to get him back to the truck. Nobody has any plan, no one has a single idea, no one wants to carry him out. All the while, I start to get seriously wheezy.

We decide we have to carry him, because, you know, it's an emergency, which leaves me with about seventy pounds of stuff to carry while fire and my partner four-point the backboard. (It was at this time that I yelled at the sheriff's deputies to make themselves useful, to which they kindly obliged.)

About fifty yards into the trek back, my respirations are at maybe sixty, I can barely speak, and my brain is starting to panic. Terror pretty much overcame me. I honestly didn't know if I was going to make it out of those woods. I was furious.

If I had dropped, if I hadn't calmed myself down quicker, if I didn't make it...I mean, would anyone have helped me?

And, I know the people on scene, yes absolutely they would. My partner would have dropped the patient, literally, and cared for me. But, my brain was full of adrenaline and I was panicking and I doubted it. I actually feared for my life.

That is the second time since I started in EMS that I have felt that way. And the last time? My service swept the incident under the table and handled our care, as the victims (my partner and me), so poorly both of us are still baffled by the situation. So, how am I supposed to feel? Well, I tell you, in the aftermath I was furious. Today, I still feel very much the same.

Luckily, I was able to slow down when we hit a chained gate and had to cross under the chain one person at a time. I helped Bonnie under, which helped me clear my head, then handed over the bag and crossed under myself. And then I almost all-out ran to the truck, unlocked it, and grabbed my inhaler. I saved my own life, because I still could, and I wasn't sure what would happen if I couldn't anymore.

Of course, it was severe, but it probably wasn't as bad as it felt at the time. But what it was, for certain, was unnecessary.

If I had had more detail before going into the woods, if I felt more confident in my service, maybe I would have brought the inhaler or wouldn't have panicked in the woods. But, we shrug these little things off and say, "that's EMS". I think that's bullshit. Maybe I just wasn't made for this world. And maybe that's just a-oh-fucking-kay.

I've never been an adrenaline seeker. Never gotten high off of getting high. Fuck, I hardly even drink, and I never get drunk when I do. I am solidly and wholly introverted, and I like it. Maybe EMS isn't for me. Maybe, some of us need to run the traumas while the rest of us study and learn the everyday procedures that too save lives. I guess that is who I'll be. It doesn't make me weak, or a pussy, or a loser. It doesn't make me any less of a care provider or bad at medicine or slow on my feet. It just makes me different. I can knock out the emergencies with all the skill and swiftness of the best EMT, but the joy I get doesn't come from the urgency or the rush or the high. It comes from knowing I am qualified to handle any and all situations, and I handle them well. Even if I inherently don't like them. I like a job well done, and I can get that WITHOUT the communication breakdown, literal mess to clean up, and overwhelming scent of panic when I walk I to a room. (And don't tell me everyone enjoys a job well done, because I know medics who are very poor at the skills, but still feel great after a serious call, even if they fucked it up, because they are high on the chaos. Also, they usually don't know they aren't skilled and fucked it up. I think that helps.)

(Interestingly, I do like CAs. Mostly, I think, because we have the opportunity to be calm and function as a team--if all the members are clear headed--because, hey, we can't kill 'em. Most of the arrests we run are by the book and very organized. It's the rooks and the medics who lack skill that seem to panic when they see a recently dead guy. Those arrests, with the skill-less or the inexperienced? I don't like those ones either.)

(For those of you who love the rush, who live for trauma, and who find joy in chaos, here's to you. You can have it. More power to you.)

I will never, ever regret what I have seen and learned in EMS, my experience is invaluable and will be highly useful for the rest of my life. But, it looks like my time with EMS is almost over.

I did get a job at another service. I'll be doing forty-eights every weekend. We'll see how I like it, but even then it will be temporary. I'm going to follow my bliss. I am going to stick with surgery.

And, in the meantime, if I can't take it anymore and have to get out, I'll go be a waitress.

Hey! TGI Friday's is hiring.

I've only got eleven months left.

Also, I just really hate the woods. Fuck.

Cut, Suture, Close