Shining through Suffering – Learning How to Cope with Sadness in EMS

Medic Trommashear, who writes great stuff has offered to co-post with me on this. You can check it out at her blog: http://lookingthroughapairofpinkhandledtraumashears.com/

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This morning the wife came home from her night shift on the ambulance and told me a sad story. During the wee hours of the morning she handled a rather nasty fatality accident. The victim, a 20-something male was walking home from a party on a dark country road and tragically, a passing motorist didn’t see him in time and the accident ensured that he’d never make it. Pedestrian vs. car accidents at high speeds have a way of doing that.

Sad stories like this are getting more common for her as she’s immersed herself fully into paramedic school and professional EMS in general. She’s been seeing sad stuff multiple times per week it seems. I can see that it’s wearing on her and I feel her pain. I have experienced it quite a bit myself in my own career and I continue to do so on a regular basis. Jumping into full-time EMS exposes a person to sadness on a level that can’t easily be prepared for. A person just has to jump in with both feet and not be afraid to feel the range of emotions that they’re going to be exposed to. It’s hard, it’s tough, and it’s one of those things a person just has to learn how to overcome if they want to make EMS a part of their life.

That’s the part that most people don’t get, I think. The part where you have to “Learn How” to overcome the sadness and negative emotions we’re faced with as EMS people. A common statement that lay people make when they hear that I am a paramedic is “Oh, I could never do that job and see what you see. I just couldn’t handle it”. Perhaps they’re right, but I would guess that anyone can train themselves to handle almost anything. My pseudoscientific opinion is that we develop our tolerance and our healthy ways of dealing with being exposed to such negative emotions on a regular basis through experiencing it and learning ways to function and feel happy afterwards. It’s harder for some than others and I can’t imagine that there is a single roadmap for learning it. It’s individual. Friends help and so does an understanding family. Good coworkers are great to observe and learn from as long as they realize their own humanity and aren’t simply trying to fool themselves out of bravado. We’re all human and I can testify that we’re all affected, no matter how thick our skin may appear.

Back when I was a new medic I was working a ton of hours. I mean, I worked a lot. I worked TOO much. I worked for days on end without sleep for multiple jobs. At the time, I felt I had good reason. I was attempting college for the first time, taking care of my recently deceased father’s businesses, and trying to sock away money to help my mother. I worked a full-time EMS job, a full-time hospital job, ran the businesses, and volunteered for a separate fire department and EMS agency. It was nuts. I would literally go for days without sleep. During that time it seemed like I was getting slammed by horribly sad calls. I felt I was surrounded by suffering and death. I was working at least two codes a week on average. Mayhem and madness seemed to rule the day. I was getting deeper and deeper and…

I was going nuts.

I was horribly, deeply depressed.

I almost went insane.

I was at my darkest hour when I found myself angry at anything that was cute or fun. Literally things like jokes, teddy bears, and Hallmark cards made me angry. I just couldn’t see how people could stand to look at that kind of stuff when there was so much suffering in the world. How frivolous! What a waste of time! It made me angry to think of anything that didn’t acknowledge the pain I was bearing witness to on such a regular basis. I was depressed and angry. I just couldn’t understand anything other than feeling the pain that the people I was taking care of were feeling. It affected my life, my work, and my human interaction. It was horrible.

Then I had an epiphany that changed my personality and who I am to this day.

Those who meet me know that I like to joke around. A lot. There are things that I take seriously however I do not personally happen to be one of them. My epiphany was that the stuff that was cute, fun, loving, friendly, and/or happy was all that actually did matter in life. We combat the bad with the good, the yang with the yin. I chose to pay attention to the comedy of life and downplay the tragedy. After that revelation, my whole outlook on life and my personality changed for the better. I had found that comedy, friendship, and love were the ways to live my life. Come what may, I can make a joke about it and that makes it ok. I laugh at inappropriate times and seek out the good in life. My life and career ensure that I’ll still have an onslaught of human tragedy thrown at me whether I’m ready for it or not but If I can actively seek out the positive, I may just end up ahead of the game.

To my wife, I love you. Hopefully you don’t end up where I have been… but I’ll be here for you, come what may. I understand what you’re going through and I love you for this any many, many other reasons. Always.

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You may want to read one of my most popular posts. It’s an older post of mine where I explore what I call “Splashed Sadness”. It’s along these lines. We EMS people have to deal with a lot. Never be afraid to share it. Don’t hold it in. Get it out and learn how you can cope with it because there’s not a one of us ain’t human.

“Splashed Sadness – A look at Negative Emotions in EMS”

Or “Reflections on an Easter Morning” – another post about a bad call.

Also, don’t forget to check out Medic Trommashear’s co-post on this. You can check it out at her blog: http://lookingthroughapairofpinkhandledtraumashears.com/

(Note: I’ll link to the post directly when it’s up)

  • Hilinda

    I found both this and your “splashed sadness” post to be helpful. You’re right, people need to learn to deal, not just fall in and hope they can deal. I’ve found a variety of coping mechanisms, some of them joking about things, others more introspective. I have learned not to splash sadness outside of those who have also learned ways to cope, and who can hear the stories and learn from them. Because some things had become “comfortable” for me, as ways of processing, I wasn’t fully aware of how uncomfortable they still were to some.
    There are three of us in my family who are involved in EMS, and one who is not. The one who is not really, really doesn’t want to hear about ANY of it, and who can blame him? The rest of us are able to be there for each other, and look out for signs of not coping well, which is very helpful. This would be a very hard thing to navigate alone.

  • Janicel719

    I found your post informative for those that maybe new to the idea of dealing with death and dying. I, myself, hold a position where death is a constant. In fact dealing with death and the family and friends that are affected by it is my entire job in a nutshell. The key in this line of work is to find a way to separate yourself from the situation around you but yet keep your empathy for those that are looking to you for answers that you may or may not be able to give them. In other words while you are on scene and in the moment do not become emotionally involved. Understand you have a job to do and stay focused on that and that alone.
    I understand to some this may sound cold and crass, but please know that this is coming from a mother who has held a SIDS baby while it’s mother said her last goodbye, a wife who sat and held the hand of another spouse while they told me that now they were all alone in this world. These things are not easy and I don’t think anyone could ever become accustom to these types of calls, however as your post states there are things that we can do to cope.
    For me if it is a bad call concerning a child; I come home hug and kiss my children, tell them I love them, and then I take 5 or 10 minutes to myself to just let it out. For other calls it is a huge help to have others that understand that mode of thinking whether it be EMS, law enforcement, or even someone who works with the county coroner’s office.
    I think the biggest thing is to understand that death, whether expected or not, is a part of life and to try not to take it personally or make it your own tragedy.

  • Anonymous

    Joy and pain are flip sides of the same coin. If you succeed at insulating yourself against the one, you deny yourself the ability to experience the other.

    I figured this out a long time ago. The only thing worse than feeling sadness is not feeling it, and remembering a time when you could.

    Humor helps us cope without shutting the door on our humanity.

  • http://twitter.com/EMTGoose Brad Buckler

    Chris, thank you for writing this. It will no doubt help me on my first bad call.

    ~Brad
    @EMTGoose

  • http://www.publicsafetydegrees.com/paramedic-to-rn.php Olmedic

    Chris, great article. I don’t think a lot of EMTs/Medics realize what they are getting into, when it comes to this level of stress. It is taught in school, but nothing can prepare people for stuff like this, until they actually experience it. The daily “grind” starts to weigh on people after a while and leads to burnout. A good friend of mine write a great article about how to cope with this sort of stress in EMS. http://www.publicsafetydegrees.com/articles/ems/coping-with-ems-stress.php. My wife and I were also both paramedics, so I can completely identify with your blog post.

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Chris Kaiser aka "Ckemtp"

I am a paramedic trying to advance the idea that the Emergency Medical Services can be made into the profession that we all want it, need it, and know it deserves to be.

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