Critical incidents: it's not heartless, at least I hope not.

Terrible things happen to good and/or undeserving people.  The drunk driver walks away from heaps of scrapped metal.  Parents do the exact opposite of take care of their children. One persons stupidity leads to another persons demise.  Sometimes people just die because of unintended side effects.

I had the misfortune to help with one of these cases the other day.  A young female, no medical history.  Only medication was oral contraceptives (Now I'm hoping as I write this that it doesn't turn into the catholic churches next stand against contraceptives).  Started complaining of not feeling well a few days ago and had fainted earlier on the day I met her.  When I met her she was already intubated and waiting to go to a major hospitals.  She had coded a half dozen times already. 

In EMS we have this silly notion of an "EMS code save" which means very little for people we treat.  It just means that we got them to the hospital with a chemically induced pulse.  Their heart was beating when we got to the hospital so we're now heroes in our own mind.  This is unsurprisingly a fantasy we design to make ourselves feel better about why we're here.  It doesn't matter that our patient may be nothing more then a organ donor; if that.

So this young girl had coded, and coded, and coded.  Epi, two minutes of CPR and we would be back with a pulse.  So in my foolish EMS head she was good!  Epi plus CPR equals an alive person!  we just have to get to major hospital and we'll give her the fighting chance she deserves.  We gave her the chance.  We got her where she needed to be.  In a perfect world we would call it a day and pat ourselves on the back.  I wish I could get away with being that ignorant!  Sadly she wasn't in the perfect shape the EMS brain told me she was in.

On the way back my partner got a call.  The service that brought her in wanted to know if we were going to join the CISD they were hosting.  I had my first critical incident over a month ago.  To me this felt nothing like that.  I still did CPR on a girl with her parents crying and cheering her on next to me but it worked. She came back, at that time I didn't know for how long, but she did come back.  We both politely declined our invitation. 

"Maybe I'm heartless, but we got her there. It's just another call at that point." 

I couldn't help but agree to a certain point. I'm still not sure if it's heartless or not.  I think I'm just a little more callused now.  If we everyone broke down or quit every time someone bad happened then our professional wouldn't last long.  I enjoy EMS and Emergency medicine as a whole.  I just have come to accept it takes a special kind of twisted person to do well in it.

I wish the girls family all the best.  Parents aren't meant to bury their children.  I commend them on their strength during a terrible time.