Becoming desensitized- what's your story?

[Liv3r]

Hello, I'm an aspiring EMS, and I was curious about all of your personal journeys on not letting gore and all that get to you.

I was volunteering as a lifeguard last summer at a big camp. Big enough that there had to be EMS on site. I was eating lunch with a couple of paramedics one day, and they were talking about all the stuff that they've treated. One of them said that he'd treated probably everything in the wilderness first aid book at least once. From spinals to mortal wounds, to even an evisceration, apparently he'd seen it. He seemed really chill about it too. It didn't seem like those injuries bothered him at the time he was treating them or at any time. At that point I realized that him and I were very different. If presented with scenarios like that, I'd probably be pretty disturbed.

So this made me wonder: if an average joe stumbled across those injuries, he'd probably freak right out and never sleep properly for a month. This guy when I asked about it just laughed and said that gore isn't something that really bothers him anymore. My question is, when does that change happen; from being freaking out at the sight of blood to able to calmly treat injuries no matter how gruesome they are? Do you just have to always be ok with gore? Does it go away with training? Is that gross out factor still there but just set aside so you can focus?

How do gruesome injuries affect you, and how is it different from before you joined the medical profession?

 

[mgr22]

People have different capacities for "gore" whether they're in EMS or not. There isn't any standard break-in period.

 

[Aprz]

I feel like some people have to get used to it like me and my best friend. Although when off duty or watching a movie, we still gag, get scared, feel panic. In real life, we have a job to do, and don't really have time to think about it. One thing that is kind of funny is that is that it almost seems fake in real life. Like seeing a dead person in real life versus movies, movies are way creepier. An evisceration in a movie is guts everywhere while real life might be like a tiny yellow pink marshmellow or oversized noodle somewhat sticking out. Bullet holes look like cigar burns with very slight oozing. So something to consider is real life injuries, while real, tend to not look as bad as we would imagine.

I don't know about most people, but I tend to take other EMTs/paramedics more lightly. It seems like a lot of them like to dramatize what actually happened and make it seem like it was no big deal when really it was never big deal. When I was an EMT, there was one paramedic I worked with where he was notorious for being a black cloud, and actually watching him worked, he got the same type of calls as everyone else, but spiced it up. He would make things way worse than they actually were. I've seen some EMTs/paramedics working at theme parks or non emergency inferfacility transport steal stories claiming they ran a call when other people actually did. People want to sound cooler than they actually are and EMTs/paramedics are not immune to that.

 

[Liv3r]

People have different capacities for "gore" whether they're in EMS or not. There isn't any standard break-in period.

So I guess you just got it or you don't.

 

[RedBlanketRunner]

PTSD in emergency service workers. When rescuers need rescuing | Medicine Today

medicinetoday.com.au

 

[CCCSD]

You either handle it or not.

 

[VentMonkey]

You either handle it or not.

Um, we no longer think this way. If you need help, you can seek it out and get it.

The “Suck It Up” mentality has all but fallen by the wayside, and that’s ok. If you need help, or someone to talk to, it’s accessible.

 

[RocketMedic]

There’s no real requirement to “handle it”, EMS is simply a learned response to firsthand witness to terrible things.
Seeing burned bodies in a crashed vehicle was pretty horrible and unpleasant, but training takes over. So are lots of other things.
You’ll find that we tend to detach and depersonalize the worse it gets. The old lady with a broken hip is still a “person”, etc. The dead generally get relegated to “patient” in terms of our emotional involvement, and we tend to dehumanize and detach from people as a whole when their presentations are traumatic and disturbing. It’s a pretty common form of emotional self defense.

 

[RedBlanketRunner]

VFD I worked with had a near mandatory talk down session after traumatic incidents. Three fire chiefs, one mentality: don't send the crew back home with something bottled up.

 

[Peak]

When I think of the calls that have stuck with me, it isn't the gore. It's the CSAs, NATs, true peds psych (like under 10 and not a behavioral issue), young adults who have died and left families behind, et cetera. In fact the only ones I've actually lost sleep over had no gore to them at all.

What is going to bother one person is different that what might bother another. That being said it really isn't healthy to take this stuff home with you.

I'd be a bit cautious of the war stories. They are typically very embellished, and real professionals don't go around celebrating the trauma (physical or emotional) that other people have gone through. Whenever someone asks me what the worst thing I've ever seen in EMS/Fire/ED my response is "do you want to hear about a child abuse case or a sexual abuse?" That usually shuts them up pretty quick.

 

[RedBlanketRunner]

snip

 

[mgr22]

So I guess you just got it or you don't.

No, what I said is that it's hard to predict how long it would take you or anyone else to "get it." And there's no shame in not "getting it," or discovering that you'd rather do something else.

 

[Summit]

VFD I worked with had a near mandatory talk down session after traumatic incidents. Three fire chiefs, one mentality: don't send the crew back home with something bottled up.

How very 1980s debunked CISD style mando debrief luckily nobody does that anymore... I hope

 

[DrParasite]

You either handle it or not.

The “Suck It Up” mentality has all but fallen by the wayside, and that’s ok. If you need help, or someone to talk to, it’s accessible.

I don't think that was what he meant by "you either handle it or not." there is is no easy way to desensitize yourself to what you see, however you can either handle it or you can't. There is is no fixed time or way to "get used to it" which will work for everyone.

I worked with one medic who spend 20 years on a truck, and after one really bad call (it was really really bad, they shut down our ped and adult trauma ER for CISD following it) she never stepped foot on a truck again. Others have walked quit on the spot. I know some who quit after less than 2 weeks on the ambulance; they realized it wasn't for them, turned in their ID and never came back.

Some people can handle what they see, while others can't, and those that can't generally don't last in this profession. This isn't the "suck it up" mentality, this is reality, where this job isn't for everyone for one of many reasons. There is no shame in admitting that this isn't for you, or you can't handle it, or that a call is bothering you; but at the end of the day, you either handle it or not.

 

[CCCSD]

Um, we no longer think this way. If you need help, you can seek it out and get it.

The “Suck It Up” mentality has all but fallen by the wayside, and that’s ok. If you need help, or someone to talk to, it’s accessible.

Great to see that members can’t differentiate between suck it up and you either can handle something or not. Next time, ask the source. I NEVER said suck it up.

Humans can either handle something psychologically, or they can’t.

 

[StCEMT]

Families have been what made patients "real" to me. Otherwise, the ones people would consider bad I haven't gave a second thought about because I'm usually trying to cram 10 minutes of work into 5 and just have bigger things to focus on. Doesn't mean I don't have a respect for the situation that happened to someone, but half of them I probably couldn't tell you what they looked like by the next few days.

 

[KingCountyMedic]

I agree with CCCSD. You either are able to do this job or you move on to something else. There is absolutely nothing wrong with starting out in EMS and changing your mind and getting out if it bothers you. I think that is a healthy move. I also don't think CCSD was saying "suck it up buttercup" look at prior posts and you'll see none of that kinda crap from them.

I'm going on 30 years on the job and I've seen a lot that I'll never forget unfortunately. I don't share "war stories" especially with new people. Some folks can handle the visual but the smells get to them and vice versa. I had a partner that could go on just about any call you can imagine and be fine but after losing a parent every elderly patient really hit them hard and made the job damn near impossible.

The most important thing is knowing when you need to talk to someone and following through and talking to someone! If you are just starting out just do your best and learn from everyone. The gore is going to be there, it's a fact of life, don't dwell on it. One of my first Instructors told me when I was starting out to always tell yourself "Whatever happened isn't my fault, I'm just going to try to do my best to help this person" and that's always helped me get through the bad ones.

 

[RedBlanketRunner]

Self assessment is absolutely critical, but is something that cannot be taught since it is so subjective. One often doesn't realize one's limitations until it smacks you in the face.
Ernest Gann put it rather succinctly: "Within each man dwells a lesser man whose presence stinks in the sun." -Fate is the Hunter

can handle the visual but the smells

What entertainment centers/stupid-izing tubes need is an olfactory channel. See how well those trivialized violence shows and videos fare when you smell a crispy critter or someone turned inside out. Melted plastic mixed with charred flesh. So pervasive it seems to get into your SCBA mask; better than Ipecac for the newbie rescuer.

 

[VentMonkey]

Great to see that members can’t differentiate between suck it up and you either can handle something or not. Next time, ask the source.

Sure thing, way to keep your composure BTW.

@DrParasite, I get that there’s a difference. And yes, most will either walk away, wash out, or won’t even bother entertaining the idea of public service knowing good and well it’s something they probably can’t stomach.

To the OP, anyone who carries on the way you suggested these “seasoned” providers did is probably masking some things of their own.

Also, this is certainly some of the better advice on this thread:

I'd be a bit cautious of the war stories. They are typically very embellished, and real professionals don't go around celebrating the trauma (physical or emotional) that other people have gone through.

If it’s something that interests you, give it a go. If it doesn’t work, it doesn’t work. But providers like the ones you’ve described are indeed hardly seen as professionals, and are historically poor clinicians.

 

[Tigger]

VFD I worked with had a near mandatory talk down session after traumatic incidents. Three fire chiefs, one mentality: don't send the crew back home with something bottled up.

The absolute last thing I want to do right after a rough call is talk about it with people I don't choose. Doubly so if they weren't present. Some things I would rather just go home with and come up with my own strategy for.