# worst call of my Career.



## DitchDoctor44289 (Mar 24, 2012)

Ok guys, ive been an EMT-I for almost a year now in a Busy Metro department. Friday night I had what i consider my worst call ever. Ive seen alot of dead people and alot of bad Trauma but this one was differant. This scene has stuck in my head since i walked in the room. Im wondering what some of yalls coping mechanisms are and any advice on getting past this? Any help is appreciated.


----------



## STXmedic (Mar 24, 2012)

Do what I do. Bury it deep down inside, pretend it never happened, and go for a run.  

Or you could do it the right way and talk about it with somebody.

If you've got somebody close to confide it, have at it. If not, we're all here to help fellow EMTs, so let it out here. I'm sure somebody here has been through something similar and can really offer some helpful advice. We've all had those calls that really shake you or hit close to home. It's not at all uncommon.

I've got a few calls that have really stuck with me as well. Can remember every detail as vividly as the nights they happened. Just remember that it wasn't your emergency, you made it home alright, and you did everything you could do. 

As slice said, see if your company has a CISD team that you can talk with, also.


----------



## SliceOfLife (Mar 24, 2012)

Sorry can't help you I have yet to see something that sticks with me for more then a shift.  I guess my tough areas would be kids or really really bad elderly neglect and I just haven't seen any bad cases like that yet.  Try talking to the other people who where on scene.  Does your service have some PTSD counseling?


----------



## DitchDoctor44289 (Mar 24, 2012)

The problem im having is it was a suicide of a patient that i had known for a couple years. And it was a shotgun in the mouth. Ive just never seen anything like that. It was just tough.


----------



## SoCal911 (Mar 24, 2012)

Family members calling 911 for no reason because they think the patient is weak or something... However the patient has no complaint...happens at least twice a day.


----------



## SoCal911 (Mar 24, 2012)

Ugh -___- I totally posted this in the wrong place.


----------



## Anjel (Mar 25, 2012)

DitchDoctor44289 said:


> The problem im having is it was a suicide of a patient that i had known for a couple years. And it was a shotgun in the mouth. Ive just never seen anything like that. It was just tough.



You may not get over that. It is way worse because you knew the person.

Just remember there is nothing that you could of done. We are all here for you, but you can't let it get you down. Just strive to save as many as you can to make up for the ones you cant.


----------



## DitchDoctor44289 (Mar 25, 2012)

Thanks, im gonna just try to make peace with it. Just takes time i guess.


----------



## WolfmanHarris (Mar 25, 2012)

With time it should move from an open wound to a scar. I can still vividly picture my worst calls, but with each passing month the response to them becomes less and less and the time I spend thinking about them shorter. 

Right now, when it's fresh, take care of yourself. If work is making it worse, tap out for a day or two and focus on the rest of your life. But don't feel you have to stay at work or take time off because, do what's right for you. 

Recognize when you can't cope and seek help. The stigma of help comes more from us not wanting to admit "weakness"; but that's crap. Get the help early and don't let it fester. 

I wish I could share the letter I have from another medic who attempted suicide as a result of PTSD but while it was released semi-publicly, I wouldn't feel right reposting it. We're all human. 

In person or online so many providers have faced the demons. You have support; use it, that's what everyone's here for.


----------



## DitchDoctor44289 (Mar 25, 2012)

I really appreciate that. I think i will see about some Critical Incident Stress Debriefing. Just to get it off my chest and out there. Thanks guys, excellent advice it helps


----------



## DrParasite (Mar 25, 2012)

I can recall the two worst calls of my career.  #2 involved a maternity (eww, the grossest thing to begin with), but in this case, the head started to come out, and went back in.  and it started to come out, and went back in.  at which point, I asked my partner "that's not supposed to happen, right???"  additional help was called, ALS and the supervisor, and we drove really really fast to the ER.

probably the worst involved a family of 4 who were hacked up by a then unknown person.  Mom was missing half her arm, half her wrist, unconc and bleeding, 4 year old was stabbed down her collarbone (and surprisingly calm and not bleeding), baby was slashed across her face, and the other daughter hid in the closet.  It ended the career of 20+ year veteran (she transferred to billing and never stepped foot on an ambulance again), and to this day is probably my worst call ever.

CISD were called for both ALS crews, the other BLS crew, the Ped's ER, Adult ER, and trauma team.  and Since my unit wasn't invited (we had a non-emergency transport to handle), I was very close to quitting on the spot as a result, and  I had some choice words with the supervisor.  afterwards he asked me if there was anything he could do, and I still remember my response: "I could really go for a beer right now."

To be honest, alcohol typically is one of those things that you don't want to mix.  But I always found that having the entire shift with you, all sharing a drink and talking about what happened can help time heal all those newly opened wounds.

And that's my non-official, based on my own experience only, way to handle the really bad calls.


----------



## firetender (Mar 25, 2012)

One of the things that probably caught you off-guard was that over the couple of years you tended to that person, you somehow got connected. You shared a series of meaningful moments with that individual, it doesn't much matter if they were good or bad the thing was that person was REAL to you.

With most of our patients we are at a distance from the very start; we don't know them at all and, let's face it, they're a problem to be solved. But after repeated exposure, we get to know them as fellow human beings. Things change when that happens and it's nobody's "fault" or error.

So we let down our guard a little and get burned. First of all, I'm glad you're feeling what you're feeling because you're still feeling! That's what most turn off; they de-sensitize themselves to suffering. I'd say to the suffering of others but it just doesn't work that way, when you de-sensitize yourself to suffering it means your own, too. 

You got stuck with pretty grizzly image, that's for sure, and OUCH! that hurts! You can't turn away from it but it WILL fade away on its own. One way to accelerate the process is to take some time to make that individuals' life of value.

You can fixate on the injustice to him and you both or you can take the time to learn more about suicide and listen to what that experience is teaching you so maybe you can be of more value next time around to someone in similar pain. (Sorry, but you probably will have another round of this if you're in the biz long enough.)

Look, I don't want to "show you the way!" but I do want to get you to thinking of how you can turn this around and make it another tool in your Bag of Tricks. I'm challenging you to make this make you a better medic. It's accumulating experiences like this -- if you use them instead of getting used up by them -- that allow you to get really good at this game and benefit a whole lot of people; and you don't have to sacrifice your soul in the process. What is this teaching you?

I hope one thing is obvious to you; the guy (my assumption; women just don't use hardware like that!) assessed his current situation and determined taking his own life was what he wanted to do. He exercised choice, and choice is so sacred even God doesn't mess with it-- if you need a metaphor to work with. Suicide is certainly one of the ways we exit, that you can't deny. 

My point is you got to see one more of the things people do to accelerate their leaving the planet. How many more of your patients are committing slow suicide? This is what people do and your job is to lessen the damage around it. In that way this is no more or less important than any of your calls; it's a lesson.

And what would it be like if medics took the time to sit with each other, listen to stuff like this as if it was important, and share what they experienced and learned openly? Just a few people setting a time and safe space for such discussion could save a lot of broken hearts in EMS.

PM whenever about whatever!


----------



## Veneficus (Mar 25, 2012)

DitchDoctor44289 said:


> I really appreciate that. I think i will see about some Critical Incident Stress Debriefing. Just to get it off my chest and out there. Thanks guys, excellent advice it helps



Before you do that, keep in mind CISD is shown to make things worse.

Personally I would go with firetender's advice, but I think what is bugging you is the suicide of a person you knew, not the specifics of the call.

You may want to see a professional that deals specifically with that.


----------



## Ackmaui (Mar 25, 2012)

Veneficus said:


> Before you do that, keep in mind CISD is shown to make things worse.
> 
> Personally I would go with firetender's advice, but I think what is bugging you is the suicide of a person you knew, not the specifics of the call.
> 
> You may want to see a professional that deals specifically with that.



I disagree completely with your comment about CISD. I have been to some of those meetings. One for a 3 year old that was murdered by her mother and the other was for a 7 year old who drowned. They were a big help and I would use them again.


----------



## Sasha (Mar 25, 2012)

Ackmaui said:


> I disagree completely with your comment about CISD. I have been to some of those meetings. One for a 3 year old that was murdered by her mother and the other was for a 7 year old who drowned. They were a big help and I would use them again.



It isn't his opinion. Their are studies done that show CISD is more harmful than helpful.


----------



## Ackmaui (Mar 25, 2012)

Sasha said:


> It isn't his opinion. Their are studies done that show CISD is more harmful than helpful.



I didn't say it was his opinion..I said I disagreed with his comment. I also said it helped me, and it did. I really liked the team that came over and they were very helpful.


----------



## Veneficus (Mar 25, 2012)

Ackmaui said:


> I disagree completely with your comment about CISD. I have been to some of those meetings. One for a 3 year old that was murdered by her mother and the other was for a 7 year old who drowned. They were a big help and I would use them again.



It is not just my comment, there has actually been research published on it.


----------



## Dwindlin (Mar 25, 2012)

Ackmaui said:


> I didn't say it was his opinion..I said I disagreed with his comment. I also said it helped me, and it did. I really liked the team that came over and they were very helpful.



This is not meant to sound facetious at all, and I am very glad that CISD helped you, but I see this type of thing all of the time and I just want to say that anecdote != evidence.  You will find outliers in everything, but the literature shows overall CISD does more harm than good.


----------



## beantown native (Mar 25, 2012)

I say just try to bury it. CISD didnt work for me at all.... I ran a call in 1991, where a guy put a 357 to the side of his head.Worst part is he did it with his 2 twin sons about 2 years old with him on a full motion water bed. Here we are 20 plus years later and I could tell you every detail. Biggest thing for you to do now is just talk about it with colleagues and friends, And KNOW that it is what it is. There isnt much you could have done, and you did what you could. Remember your friend from a year ago. Lastly... dont be afraid to cry, even if you do it in the dark alone... It will help. So sorry you had to see it.


----------



## exodus (Mar 25, 2012)

Get real therapy if you decide to do it, not CISD.


----------



## RanchoEMT (Apr 4, 2012)

I've seen a couple of things that have hit pretty close to home, wilst working.  Ive seen people who were in nursing homes waiting to die, drop their pulse while i was palpating. Ive seen a man die infront of his family in his kitchen, who MINUTES prior was alert and oriented and telling us we were great. Ive seen an :censored::censored::censored::censored::censored::censored::censored: pass by our ambulance on the fwy going about 90mph on a bike, and about a minute later we drive upto a crash on the side rail, he had become a lump of mashed up human with brain matter coming out of the cracks of his helmet. Ive seen young people, my age, dressed up for a party ejectated out onto the freeway with no chance of living a normal life again. The scarring on the tree they hit will always be there looking back at me when i drive past it. Ive responded to calls near or on the way home.  Ive responded to houses were i once walked by coming home from school, only to find horrible horrible experiences in them. Ive cried after a girl (me and my gf's age) called 911 becuase her BF was passed out in bed one morning and unable to wake him. Because he was dead. She asked us why we(The Ambulance) were leaving and i didnt have the stomach to tell her. Ive seen some stuff.... But one of the worst things that im never gonna be able to forget is when a girl whose boyfriend ran her over in attempt to kill her, himself and her unborn baby because she wouldn'tget an abortion... This may not sound SO bad, but i knew her from highschool. The closer you are to the patient the more loss your going to feel. There's a difference between a body and a person. The full arrest with downtime prior to our arrival is not worth remembering. The full arrest with a guy whose talking to you, tells u his name and repeats your name back is personal, that is a loss. Not much talking after that call i remember....

Anywho, just dont bottle all of your sadness, fears, anger, and questions up.. If u feel u cant talk about it without tearing up, that means u need find someone u dont mind crying infront of and let it all out.


----------



## EMTBHillbilly (Apr 6, 2012)

My philosophy is: It was going to happen.  And if it was going to happen, somebody had to be there to deal with it.  If that somebody isn't me, who then?  I try to walk away glad that it was me who was there to assist.  So far, so good.  It's all part of why I do this job.


----------



## medicnick83 (Apr 7, 2012)

I think the best way to deal with things is to talk about it.


----------



## ITBITB13 (Apr 7, 2012)

Hey guys. I've only worked for a private IFT service & independent stand-by company, so the worst trauma I've seen on the job is a broken arm. I just got hired by a 911 company, so I know I'll be seeing/involved in a lot of traumatizing stuff. My only fear is something hitting me as hard as the OP. Anybody have any advice on preparing/managing these things for a 911 newbie?


----------



## RocketMedic (Apr 10, 2012)

Its not your emergency. Be proactive and avoid the bad life choices that put a lot of our patients where they are.


----------

