The "ghosts"...

[sarweim]

Someone else mentioned having their first code recently. I had mine a few weeks ago. Well, I guess technically my second, but my first MEDICAL code, rather than trauma from a major MVA. My first medical code turned out to be someone I know and considered a friend. I can still see his face as he was lying there, blue and looking surprised, with the eyes wide open. And his wife's face, with the tears and the fear... And hear his grown daughter's voice in my ear, "Daddy! NO! Daddy, wake up! GET UP!!"

I've been told everyone remembers their first code. Some people seem to have to think about it for it to come back up. So I'm curious, how long until those unbidden "ghost" images faded for you, to the point they only come back if you actually think about it?

I can tell you this - that experience has made me want to buckle down even harder in my EMT class (I currently "just drive"). And it also drove home, in my mind, how annoying it must be for friends and family to see these eager, excited "kids" showing up like they're there to play with a shiny new toy they found under the Christmas tree... But then again, I might have been the only friend of the guy there with a level enough head at the time to notice. *sigh*

 

[lampnyter]

Hmm ive thought about the code but i wouldnt say it bothers me that much. I shrug things off pretty easily when it comes to EMS.

 

[Akulahawk]

I remember most of the codes that I worked, including my first. They don't bother me at all. The reason is that I have come to the realization that no matter what modern medicine does, the best we can do is provide a good shove towards life. If it's the patient's time, there's nothing we can ultimately do to prevent that. I do my best to provide the nudge or shove and know that beyond that, there's nothing that I can do.

 

[Veneficus]

Codes are like exlovers, nothing gets you over the last one better than the next one.

I can still recall every detail of my first code, who was there, the name of the patient, the color of the carpet, the color of the couch.

However, there are codes I don't remember any details at all. Some I have forgotten about totally I am sure. Mostly for some time I only remember them if there is something significant, like an MVA with 2 pregnant ladies killed and the simultaneous crash c-sections in the ED.

For me the distance hasn't come from time but from volume.

Inevitably as the only medical provider in my family, when interacting with their friends, usually over dinner (which is not a problem for me, I can work a code and eat a pizza at the same time), somebody always asks what is the worse thing I have seen.

As if they want to know.

Usually I give them an anecdote of something that is a bit serious, but has a light humor side to it.

When discussing it with medical providers, the worst thing I have ever seen is honestly not an illness or injury or death. It is how poorly people treat other people.

The details of that I save for myself.

 

[Sassafras]

Honestly, my first code was surreal, but nothing over the top. We didn't save him, and I remember the paramour collapsing on the sidewalk in tears, but it doesn't bother me. I know we did the best we could. I know I would trust the people who were on my crew with my life and that of my children.

The one that gives me ghosts was a birth honestly. A blue baby with an incomplete OB kit and an exposure that was never addressed. Baby survived, mom thinks I'm a hero, but I sit wondering if I'm HIV positive now as a result. Or positive for some other weird disease. And knowing mom was unhappy with the actual hospital staff where she requested to be transported I live in fear of being summoned for the next 6 years.

 

[WolfmanHarris]

Remembering is one thing, being haunted is another. I have two places where I did some major, tragic traumas, that are both unfortunately along the route of my commute. Every work day, twice a day, I remember those calls. Just for an instant, and then it passes. Were it to stick with me or were I to feel stress or find myself having any stress related difficulties now, I'd seek some assistance.

Never forget that your family will likely notice stress related changes before you do. They're your canary. If needed turn to an Employee Assistance Program (EAP) through your employer, or through your doctor, or in a pinch (since it's a Canadian organization), contact the Tema Conter Memorial Trust at www.tema.ca .

Not saying you need it, I just didn't want to ignore the elephant in the room.

 

[vquintessence]

I agree with Wolfman; having "ghosts" is drastically different from reliving the scenario in the confines of your mind. Was this your first face-to-face exposure to death? Sometimes those can be the longest relived, leading to the most questions and reflections.

Has your sleep been poor or interrupted? Appetite? Those are the questions you need to ask yourself, and if the answer isn't clear-cut, then perhaps you should talk to somebody beyond an anonymous forum.

 

[Bullets]

i dont remember my first code, but i remember my second one every day i get on the truck.

It was a bad month, multiple MVCs with trauma, some bad codes, nasty injuries, multiple water rescues, drownings, all the bad stuff that can happen in the ocean. It all came to an end on a thursday, at 1014 hrs, sent to 14mo old U/R found a mom doing CPR on her 14 mo daughter, coached by Comms, Scooping and running as the paid FD and medics pulled up, police escort, ER Staff, color of the carpet, the toys on the floor, the show on TV, every tiny detail.

We got lucky, she got lucky, we all got a save. I think about how well we performed, me and the medics on the same page, acting without saying anything, the three of us just clicking. its the call that saves me when we deal with the BS, i think about her

 

[MS Medic]

Sorry to hear it was someone you know. That really sucks. Under normal circumstances, I would tell you that time and more calls will eventually fade the memory. All I can tell you is that I hope it will and that you have my condolences.

 

[Shishkabob]

Really, the thing I remember most vividly about my first code was just how damn hungry I was after it. Starving.

 

[DarkStarr]

all my codes (well, the few ive been on) have been elderly patients who put their best years behind them, yet, somehow, the family felt necessary to try to squeeze a bit more life (aka pain and suffering) out of them.

 

[sarweim]

No changes for appetite, sleep, etc. So I'm not really feeling stressed, per se, about it. Though for a few days I wondered if I had more experience and knowledge, would it have made a difference. It wouldn't have. He was gone when we got there, and the CPR and efforts were largely for his family to see us trying. Probably taking longer because it's someone I knew? My dogs and I used to walk the rail trail to the Dunkin Donuts, get a Coolata and a cup of water, and then hang out and talk with him and his wife for HOURS about mostly nothing. He could really talk your ear off!! And it was completely out of the blue, it's not like he had any known illnesses, (even to his family) to precipitate it.

My first "dead guy" was that MVA guy. Blood everywhere, brains. The flight nurse and medic actually rode in the back of my rig, because he was too bad to fly. But I wasn't working on him. "Just" the driver. It left me feeling a bit of surreality that such a big event in someone's life can happen like that, and the rest of the world continues on, not even knowing. But that was it.

So, yeah, I guess it must be the closeness of the patient (friend) and the closeness to the patient, and the fact that I was actually helping work on him.

 

[Bieber]

I honestly don't remember too much of my first (field code), or actually any of my first in hospital code. My first field code was my fourth patient on the first day of my internship, the lady was ghost white and only stayed conscious for about two seconds after we stepped into her house before she coded. I remember we picked her right up and threw her on the cot and then I intubated her in the truck. I do recall my preceptors asking me what drugs I wanted to give throughout it. My last call that day was a massive head injury motorcycle ejection, he died shortly after we got him to the hospital.

The codes don't bother me, and to be honest I forget them fairly quickly after they've happened. I was fortunate as a student to have had five codes throughout my internship, including two field saves and one of them being a clinical save neurologically intact.

Sarweim, I wouldn't beat yourself up about it. Did you provide competent care? Did you screw anything major up? You said the CPR efforts were probably taking longer because you knew the family? Honestly, we shouldn't be transporting blues so if you spent more time on scene then that only increased his chances of survival. But in the end, medicine is an inexact science and emergency medicine is still very helpless against the enemy it's up against. Bad things happen, we try as hard as we can but sometimes it's just not in our control.

 

[Veneficus]

one of them being a clinical save neurologically intact.

Those are the only kind that count

 

[sarweim]

Sarweim, I wouldn't beat yourself up about it. Did you provide competent care? Did you screw anything major up? You said the CPR efforts were probably taking longer because you knew the family?

Nope. The length of our CPR efforts was purely based on waiting for additional resources. My partner and I were BLS, first on scene, and we started CPR as soon as we got there (called the code before we even got out of the rig). Big guy, so we couldn't load and go on our own, and needed to wait for ALS, anyway. Once on the truck, the medic said he'd have just pronounced him there if he'd gotten there first, "But it's probably better for the family this way, to see that you tried..."

Honestly, we shouldn't be transporting blues so if you spent more time on scene then that only increased his chances of survival. But in the end, medicine is an inexact science and emergency medicine is still very helpless against the enemy it's up against. Bad things happen, we try as hard as we can but sometimes it's just not in our control.

*nods*

I talk to my partner that day about it, and my captain, and some of the other people who showed up to assist. I've gotten several, "You get used to it" comments. I guess I will, with time and more experience. On the other hand, I'd like to not turn out completely jaded, either!

 

[Smash]

God, I have trouble remembering what I did last week, let alone years ago! I certainly don't remember my first code.
I grew up in a small town and have had to work people I knew, even some close friends, and to be honest it never bothered me that much. The only thing that ever plays on my mind is if I think I didn't do the best job possible. Beyond that, it's out of my hands.

Inevitably as the only medical provider in my family, when interacting with their friends, usually over dinner (which is not a problem for me, I can work a code and eat a pizza at the same time), somebody always asks what is the worse thing I have seen.

As if they want to know.

Usually I give them an anecdote of something that is a bit serious, but has a light humor side to it.

When discussing it with medical providers, the worst thing I have ever seen is honestly not an illness or injury or death. It is how poorly people treat other people.

The details of that I save for myself.

Amen to that. It always sets my teeth on edge when I get asked that. To be sure I have seen some awful things. Just last week I was in at my favourite coffee shop getting my usual espresso when someone walked in off the street. For all intents and purposes he looked like a normal person, well dressed, clean, not at all crazy looking. However, when he walked up to the counter he proceeded to order a soy chai latte. I will never forget that sick feeling of horror and disbelief as I watched him actually drink it...
People are truely capable of terrible things.

 

[CAOX3]

I also don't remember the majority of my codes, I remember one in particular, everything actually.

I think we all have those calls. The thing is to know when healthy thoughts drift into disruptive obsession.

 

[Bullets]

Honesty, and this would sound terrible to a layperson, but when i am working on a code, i dont view the patient as a "person" everything about them that made them human is gone at that point, its just a body and you just dont look at them the same. i dont see a person when i look at their face, its just routine. PRESS PRESS PRESS PRESS PRESS PRESS STOP GIVE BREATHS PRESS PRESS PRESS, its all i hear or see

 

[Veneficus]

Honesty, and this would sound terrible to a layperson, but when i am working on a code, i dont view the patient as a "person" everything about them that made them human is gone at that point, its just a body and you just dont look at them the same. i dont see a person when i look at their face, its just routine. PRESS PRESS PRESS PRESS PRESS PRESS STOP GIVE BREATHS PRESS PRESS PRESS, its all i hear or see

I think many of us start that way, but after a while, the routine becomes so ingrained that your mind has plenty of time for other thoughts.

 

[citizensoldierny]

I don't know if I have really good or bad defense mechanisms but outside of my first death and one or two that have been pretty horrendous, I have forgotten a whole lot dead folks. On the other hand if I make a mistake on a call I let it bug me for a good long time.