Dealing with Death

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EPICMEDIC

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I have been afraid to broach this subject because I am considered the pinnacle of manliness at my service. I never cry publicly, refuse CISM, and lately have been drinking heavily. I see death too frequently. Every week its another story of someone we could have saved if we had been there sooner. This thought keeps me awake at night. I got into EMS because of the show "Trauma". Prior to that I had no EMS experience. I went in thinking that every call would be like the show. Just saving lives every call. Now, I cant even remember that last time I intubated someone successfully. Anyway, my worst fear on a call is pronouncing someone dead. The look on the face of the family, their tears, and suffering is too much. When I can sleep, I see the faces of the ones I could have saved. This tears me up to the point that I have developed IBS. Anyone have any tips or tricks to make this not affect you at all? Any help with sleeping trouble? I dont like pills as I am a recovering addict from Tylenol PM so something other than that would be great.
 
First don't refuse cism it's there for a reason. Second try and get-something going on outside of your job. Something non EMS related. Maybe volunteer once a week for a few hours at the SPCA or meals on wheels. Don't be afraid to seek help it doesn't show weakness it shows strength. Asking for help is the hardest thing a man can do. Physical activity is good too. Hit the gym, eat right and maintain a social life outside of work. Most of all vent. Either here or to your co workers. There a reason the manly types die young. It's because they bottle everything up till it kills them. Good luck

Just noticed you said you have been drinking heavily. Take it from some one who knows, alcohol is bad news. Try not drinking any alcohol for 7 days if you can't do it go to an AA meeting. Just sit in the back and listen.

Mike
 
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First, I'm not trying to be judgemental, but it's absolutely ridiculous you based your life decisions around a tv show. But, I really feel bad for you, because That's some pretty heavy stuff. Normally, I would tell you to try watching Oprah, but ever since she went off the air, I'm at a loss for coping. Dr Oz suggests psychics, but a lot of insurance doesn't cover it. Regis is practically dead so he's useless for advice, and the View only covers real topics like Casey Anthony (who knows a lot and handles it real well but might be hard to get in touch with) and menopause. What sort of public access religion shows are available in your area?
 
GoTowardsTheLight said:
First, I'm not trying to be judgemental, but it's absolutely ridiculous you based your life decisions around a tv show. But, I really feel bad for you, because That's some pretty heavy stuff. Normally, I would tell you to try watching Oprah, but ever since she went off the air, I'm at a loss for coping. Dr Oz suggests psychics, but a lot of insurance doesn't cover it. Regis is practically dead so he's useless for advice, and the View only covers real topics like Casey Anthony (who knows a lot and handles it real well but might be hard to get in touch with) and menopause. What sort of public access religion shows are available in your area?
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You forgot Ellen... I get lots of good advice from her!
 
GoTowardsTheLight said:
First, I'm not trying to be judgemental, but it's absolutely ridiculous you based your life decisions around a tv show. But, I really feel bad for you, because That's some pretty heavy stuff. Normally, I would tell you to try watching Oprah, but ever since she went off the air, I'm at a loss for coping. Dr Oz suggests psychics, but a lot of insurance doesn't cover it. Regis is practically dead so he's useless for advice, and the View only covers real topics like Casey Anthony (who knows a lot and handles it real well but might be hard to get in touch with) and menopause. What sort of public access religion shows are available in your area?
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bigbaldguy said:
First don't refuse cism it's there for a reason. Second try and get-something going on outside of your job. Something non EMS related. Maybe volunteer once a week for a few hours at the SPCA or meals on wheels. Don't be afraid to seek help it doesn't show weakness it shows strength. Asking for help is the hardest thing a man can do. Physical activity is good too. Hit the gym, eat right and maintain a social life outside of work. Most of all vent. Either here or to your co workers. There a reason the manly types die young. It's because they bottle everything up till it kills them. Good luck


Just noticed you said you have been drinking heavily. Take it from some one who knows, alcohol is bad news. Try not drinking any alcohol for 7 days if you can't do it go to an AA meeting. Just sit in the back and listen.

Mike
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I agree about hitting the gym, ive noticed your looking a little scrawny these days ;/
 
I went to NA for my tylenol addiction and that did nothing for me. Sitting in a room with all the low life people I take to the hospital did nothing for me. I have watched all the intervention shows and know about that kind of thing. For me it wont work though. I need some way at the end of shift to erase the atrocities. I cant stand seeing their crying, lifeless faces.
 
Nice to know that helping fellow providers is such a funny joke to you darkstarr.
 
Compartmentalize it. Leave work at work by finding stuff you enjoy in your off time besides hitting the bottle(s). I find hiking (alone) to be a great stress reliever.

Keep in mind, there is no "could have" in this field. It either happened or it didn't, whatever you're talking about. You got the tube or you didn't get the tube, you "saved" the person or you didn't. After a call, run through it with your partner, find your mistakes (if any), learn from them, and move on.

Like BBG said, take help from your CISD program, they were made for a reason.

Don't be afraid of broaching the subject with others in the medical field. They either are going, or have gone through the same :censored::censored::censored::censored:. Get it out there in the open.

PM me if you need someone to vent to, Brother.
 
The phrases my fire/medic mentor told have helped me. "we didn't cause the problem. We respond to try to fix the problem". "when people are in over their heads and need help or don't know what to do they call us".

The first one is the one that has helped me the most with bad calls.
 
But thats what Im saying. We can save these people. If we only try harder. For instance, I work every pulseless patient, even trauma, hoping they come back. This is my way of trying to help. I cant help but feel worthless when they dont come back. I second guess myself thinking if I just did one more round of drugs, or didnt miss the intubation, or used the IO instead of 3 failed IV attempts that a father could watch his kids grow up. If I give up trying, I have failed.
 
For alot of patients no matter what we do they are gone. There are some patients where it's not worth anything to try to start CPR. Mostly with traumatic full arrests there is nothing that we can do. There is a point where you have to realize there is nothing anyone can do.
 
I was told in my class that everyone deserves a chance. That some trauma arrests come back with enough drugs and cpr. I just cant stand sitting back and doing nothing.
 
Maybe you could try working on your skills a little man, I know this is a tough time for you, but the truth is you'll have better success rates if you can give meds or control ventilation sooner. I've learned some good tricks over the years, feel free to pm me and I'd be glad to help if I can
 
EPICMEDIC said:
I was told in my class that everyone deserves a chance. That some trauma arrests come back with enough drugs and cpr. I just cant stand sitting back and doing nothing.
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Everyone deserves a chance when it's reasonable to save them. If you arrive on scene for a DOA x 3 days they are gone and it's not wise to start CPR.

If you get a MCI you have to leave the patients who are gone. You mark them and move on. You don't spend time doing CPR in that case because they are already gone and you could be doing something to save someone that actually has a chance. I know it sounds bad but when I get those kind of calls I don't view the patients as people. I view them basically just objects. It helps me leave the ones that don't have a chance

Yes some traumatic full arrests can be saved but it's hard to tell which ones have a chance and which ones don't. A normal full arrest call for us takes us out of service for at least 2 hours. So in the time frame of working that full arrest (with probably no chance of being saved) we could have ran more calls and helped someone who actually had a chance.
 
There are some of us...

who, by our very nature go the way of asking ourselves questions that a lot of others in EMS don't.

There are also those of us who, by fate or circumstances, get exposed to more of certain kinds of trauma in a month than a "normal" medic could expect to see in a ten-year career!

And THAT gets you thinking, or dreaming, or suspecting, or fearing (fill in the blank!)

...and THEN you start asking all these questions!

Would it be accurate to suggest your world got rocked?

It's part of the territory -- and this is the important part -- SOMETIMES!

This stuff shows up in waves, asks you to make some personal determinations or come to some understandings, and then move on. You can choose to move on with them or resist and deny and get stuck IN the morass.

Bottom line, it's all about facing what happened, expressing it, and SEEKING some sort of closure; something you can live with (which ain't crawling into a bottle!). It's about movement.

It's possible you signed up for something that moved so fast you found yourself in the deep end without your inflated Duckie! I'm not quite sure that the whole thing is real to you yet. A way out is to find safe times, places and people to express your experiences to and help you explore what this means to you personally.

Sorry, but it may be you're one of those people that get called on to really take a look at death so they can help others with it later.

Again, this may not be who you are or what happened or what you need, but maybe just taking it seriously, as you are to us, is a good enough first step. In this case, it's take what you need or what might work. Listen to what others here have to say.

Then, figure out something that works for you.

And oh yeah, I almost forgot; Please, tell us about what you learned!
 
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Im fairly certain my skills are up to par. i dont appreciate the personal attacks either. I saw earlier that you are a sgt at your service. Maybe you should take a look at yourself. I know that I am a ball of emotion right now. I know death is real. I see it almost every day. I work in the inner city and see people that could be saved. Logically, I know that a GSW to head in full arrest is not survivable. But its the thought of what if? What if i "call it" and he could have lived? On TV they always try. Who is to say that its wrong to care? Are you saying just because I service mostly low-income folks that we should just forget about them?
 
EPICMEDIC said:
Im fairly certain my skills are up to par. i dont appreciate the personal attacks either. I saw earlier that you are a sgt at your service. Maybe you should take a look at yourself. I know that I am a ball of emotion right now. I know death is real. I see it almost every day. I work in the inner city and see people that could be saved. Logically, I know that a GSW to head in full arrest is not survivable. But its the thought of what if? What if i "call it" and he could have lived? On TV they always try. Who is to say that its wrong to care? Are you saying just because I service mostly low-income folks that we should just forget about them?
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On TV they always try even when everything says it is futile because they don't need to be concerned with reality or evidence-based medicine on TV. As a paramedic, you should be concerned with evidence-based practice. It is wrong to "care" by trying to resuscitate someone when it is clearly futile and this has nothing to do with the fact that you're serving low-income people.

Most people who go into cardiac arrest won't come back. The drugs you give for cardiac arrest does not save lives and intubating these patients does not help either. That is simply the reality.

I'm always up for an EBM debate, but I know that you came asking for advice about serious problems you're having. I would suggest that you really need to seek professional help. Hopefully your employer has an employee assistance program. If not, then your family doctor would be a good first stop.
 
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