I Was Not Okay. Every medic has a call that they fear. One that they know will trigger them. Today, many years after that initial fear set in, I finally had to face that call. A few years ago, my little sister died by hanging. A “suspicious death” on her death certificate is all we have for closure.
Medically, we’re trained to know how a body will present when it has been hanged. You know the eyes will be blood shot. You know they will be partially opened. You know one hand will be raised up as the body’s last attempt to fight. You know the tongue will protrude slightly. You know the color of the head will be remarkably different from the rest of the body. I know this, because I have to.
My last image of my sister, the one that haunts my nightmares, is an image of my training, with her body in place of the faceless, genderless, anatomical figure we all know.I didn’t see her like that. At least not in person. I didn’t need to. I know what she looked like. I know what those medics found. I’ve often wondered how they handled it. Did it affect them? Did they make a joke, like we often do to hide the trauma? Did they decide on dinner over her body? These are the scenes that run through my head.
I’ve been in EMS for a while, over five years, but under ten. I’m still a rookie, still bright eyed, still in love with the job. But no longer the naive girl who wanted to save the world, Thank God.Whatever innocence I still held on to, was about to be burned to the ground.We were on what we knew would be a false alarm call. Our district and our neighboring district had gone to hell in a matter of minutes and we were hurrying to get clear and get in service.
I didn’t hear the call over the radio. I was laughing and cutting up with the firefighters when I caught my partner’s eyes. Something in his face had changed and I felt my stomach drop. He said “its a hanging. We have to jump it.”
My instinct was right.My world was about to change. My relative level of comfort with my job, my crew and my surroundings was about to go out the window. This moment was going to change me, as a medic and as a person. I looked sheepishly at the men standing around me on the porch of this strangers home. I’d trust these guys with my life. They’re my brothers. But I cannot share this with them. This is going to break me and I have to handle it alone. I will not show weakness. I will not be vulnerable. Ever.
I turned to my partner, dropped my voice to a whisper and said to him “I can’t. I can’t go in there.” He whispered back “Ok. You don’t have to go in. I’ll handle it. The rookie can help me.”
He and I don’t share a lot about our personal lives. We both tend to keep to ourselves. But he knows me well enough to not question me when I state that I cannot handle something. He knows I’m not copping out. He knows I have my reasons, though I’ll never explain them. We did our standard walk through and confirmed our call was in fact a false alarm. I cleared us on the radio, my words jumbled, my heart pounding and my head spinning.
I knew the second I said we were in service, that mic in my ear would beep to life and I would be en route to that call. When we got in the truck, I flipped the siren on and turned to my partner and said “So, my sister died like that. I can’t go in.”
His face read shock and he just looked at me. He knew I lost my little sister, but I’d never told him how. I don’t talk about it with many people. He said “its going to be ok.” I said “No. It won’t. But I have to face this. I can’t run from it for the next 20 years.”
We got on scene. I couldn’t even look our trainee in the eye when he came out of the back of the box. I grabbed the gear and off loaded the stretcher. A firefighter came out of the engine parked next to us. Her face said everything I needed to hear. But no one said what I wanted to hear. No one said “Cancel EMS. Obvious dead on arrival.”
The walk to the door took ten seconds but my legs were shaking and my heart was pounding. Still no one said it! We aren’t being cancelled. Damn it, I have to go in. I can’t leave my partner with a trainee to work this code, if we have to work it. I walked in the room and I saw our victim. The death was obvious. No question.
Immediately my body betrayed my brain. The room began to spin and a loud ringing filled my ears. I looked at my partner and saw his hands make that familiar sign. I’d seen him do it dozens of times. I knew it meant we weren’t working the code. I knew it meant my freedom to retreat to the truck. I knew that’s where I needed to go, but my legs wouldn’t move. I cannot hear anything but ringing. Everything in my brain was willing, urging, screaming at me to run, but my body refused to cooperate. I was trapped, staring at my sister’s dead body. She and I are alone together now. Alone in this room full of disembodied uniforms. I forgot how her black hair, looked blue when the light hit it. I could see it so clearly now. As if I could reach out and touch her.
All I could do was stand there and feel my head spin, swallow the vomit rising in my esophagus and be deafened by this loud ringing that I couldn’t find the source of, the ringing no one else seemed to hear. A police officer brushed my arm as he walked by me. That brought my body to life, like someone firing a gun at a swim meet. I dive off. I turn and I walk. I can hear my chief in my head as if he were walking next to me, coaching me through this. He always coaches me through the bad ones. His mantra resonates in my ears. “Always walk. Never run.
Running creates dead medics and missed patients. Always walk never run.” Okay, Chief. I’m walking.Slow down your breathing. I’m now coaching myself through each breath. You’re blowing off too much carbon dioxode. You’re going to pass out. Where is that damn ringing coming from?! These are the words running through my head.
As I’m walking, not running and trying to slow down my breathing, the victim’s….mother? Aunt? Sister? I don’t know who she is but she is running full speed at me. Not me. She’s running towards the scene. Muscle memory takes over, thankfully, because I am no longer in my body. I put my hands up and catch her by the shoulders. All of her weight falls into my body. Right foot back. Brace yourself. Don’t let her fall. I hear you, Chief. I’m holding her up. “You can’t go in there. I’m so sorry. Ma’am, he’s dead. There is nothing we can do. I am so sorry. You don’t want to go in there. You can’t. Ma’am its a crime scene.”
She hits my chest with her fists, harder and harder with each strike. She grabs me by the hair, to hold my face in front of hers, to force our eyes to lock. The full weight of her body is on my chest now. I see the fire crew in my peripheral vision. They’ve moved towards me to help hold her up or maybe to stop her from punching me. I don’t know. I am suddenly very aware of my own shaking body and I wonder if they see it, too. Maybe that’s why they move. I don’t want any of them to see me break down. I won’t let them see me like that. The woman beats my shoulders with her hands. I take each blow and continue to hold her up. She grabs the collar of my shirt and looks into my eyes.
She knows. Now she knows. She buries her face into my chest and makes that primal, guttural scream that only true loss, true pain, can produce. Oh. That’s who she is. I know she is his mother. I’ve heard that scream before. From my own mother. From lots of mothers. It never gets easier. Nothing else sounds like that. She falls apart into my chest. I hold her up. Her weight comes off of me. A man has taken her. I don’t know who he is. But again, it means my freedom. I walk to my truck, throw open the side door and throw my body, steadily betraying me, into the Captain’s Chair and feel myself unravel.
This is my safe space. This is my home. In here, I know what to do. Right? My breathing is heavier and faster, my chest is heavy, I feel my pulse in my ears. My shirt is stained and wet with tears and makeup. Not mine. Hers. The wounded creature still wailing outside. My fingers and lips are tingling and I feel myself beginning to pass out. I’ve hyperventilated for the first time in my life. I need to rebreathe the carbon dioxide that I have blown off. I grabbed a non-rebreather mask and held it as tight as I could to my face. Breathe. Breathe. You’re ok. Breathe.
My partner knocks and asks if he can open the door. I shoved the mask into the biohazard bag and scrubbed my face off with a scratchy hospital towel and choked out “Yea. I’m good.”
He knows I’m not. He tells me to stay in the truck. He’ll wrap up with PD and have the rookie drive us back. I rode back to the station in the back of the box and tried to calm myself down.I’m humiliated. I’m broken. I’m damaged goods. I just got better from the last time. But this time its so much worse. This time, its her, my sweet little sister. It was a good two months of being okay after that little boy died in my arms. It was hell for a month. This is going to take a lot longer. As soon as I felt the truck stop, I ran and hid. I smoked about seven cigarettes back to back, trying to kill some of the over abundance of oxygen in my lungs. I saw him. I saw my sister. I saw him. I saw my sister.
The tingling came back ten fold and I knew I would pass out. I braced myself against a reserve unit and waited to hit the bricks. Instead, I felt a hand grab my arm, turn me and hug me. My old partner heard about the call and came as fast as she could to the station. She promoted a year ago. She’s an officer now. I miss her. My current partner came out and put his hand on my back. Big heavy sobs escaped my chest. They both coached me through my breathing. I could hear them.
No more ringing. I was getting better. I was going to be ok. My partner thanked me for having the courage to go into the scene and not leaving him to do it alone. He said he was proud of me. I didn’t feel proud of myself. I felt weak. But it meant a lot coming from a man who has no “feels” most of the time. He’s a good guy. A good medic. A good partner.Critical Incident Stress Management was activated. I spoke to my chief. I spoke to the CISM representative. I declined coming off of the truck. I need to be here.
Here, I know what to do. My hands know what to do, if they would just stop shaking. My people, my partner, my fire crew, my cops, they know me. They know not to ask questions. They know to let me be alone. They know I’ll work. That was hour two of this 48 hour shift. Its hour six now. I put a 12 lead on a patient and forgot to run the EKG. I put a stethoscope in my ears and couldn’t remember how to use it. My short term memory is crap right now. My thoughts are jumbled. I’m rational, but I’m not sure if I’m logical. I don’t know how or what I feel. I know muscle memory is a hell of an ally and I know that this is going to take me down. Not today. Not tomorrow. But the next day, definitely. I’ll go home.
My husband will be at work. My children will be at school. I’ll be alone. In the quiet of an empty house and I’ll fall apart. I’ll fall to the floor. I’ll scream. I’ll curse at the ceiling. I’ll call God a bastard. Then I’ll get up and throw my uniform across the room as if it burns my skin, because in this moment, it does. It chokes the life out of me. I’ll put on my running shoes and put in my headphones and I’ll run until I nearly die from exhaustion. Until I physically can’t will my legs to move anymore. I’ll decline every phone call and ignore every text. I’ll get home and stand in the shower until the hot water is gone. Then I’ll stand in the cold. I won’t eat. I won’t eat for the next four days. Then I’ll get dressed and I’ll drive. Nowhere in particular.
I’ll smoke and listen to music and drive. I’ll do this for the next four days. 96 hours exactly.Then I’ll put my uniform back on. I’ll pull my long hair into a tight, neat bun. I’ll clean my boots. I’ll put on my makeup and be even more meticulous than normal, to hide the fact that i haven’t slept or eaten in days and that I’ve cried secretly and continuously for 96 hours. I’ll eat breakfast because at this point I need the glucose. Then I’ll straighten my badge and go back where my body knows how to function.
My crew will ask how I’m doing. I’ll smile and make a lame joke and then laugh and say I’m fine. I won’t admit to not eating. I won’t admit to avoiding my children. I won’t admit to the bottle of wine I downed before 10am on day two. I won’t admit that I intentionally picked a fight with my husband to ensure that he wouldn’t attempt to hug or kiss me. I can’t handle touch of any kind while I’m in this mode. It hurts. It physically hurts.I know this pain. I know this self-destruction. I know it all too well. We’re intimate lovers. We meet in the dark, whenever I’m alone, when its quiet. When everyone else, who doesn’t have these demons, these ghosts, these monsters in their head, they sleep.
That’s when I slip into the dark embrace that my pain, my trauma, my fear and my pride, offers me. We’ve had this torrid love affair a handful of times over the years.I do this alone. I’ll talk to a handful of people I trust with my dark secrets. They’ll get me through. They know. They’ve been there. We share the same dark secrets, the same pain and the same bad habits we believe heal us, knowing they only patch a wound that just won’t heal.I’ll damage my marriage a little more, because yet again, I’ve shut him out. But I have to. I don’t want this horror show to be in my head. Why would I put it in his? He gets to live behind the curtain, where babies don’t die for no reason, where bodies aren’t mangled in car accidents, where people don’t shoot, stab, rape, beat and abuse each other. He can sit with his back to a door, but I can’t.
He can sleep without noise on but I can’t. Sometimes I’m envious of that blissful ignorance.That kindness and gentleness about him, that made me fall in love with him, now makes me angry. I don’t understand it. How can you be so kind and happy and gentle and so unbelievably positive all the time?! Don’t you know how ugly this world is?! He wants to be a fireman. He’s a volunteer now and a good one at that. People love him. Everybody loves him. I should be supportive and I do try to be. But I know what it’ll do to him. He once said that I had become hardened and he didn’t know how to reach me. He wanted that sweet naive girl back. We’ve been together for half of our lives. I still love him, he still loves me and most days we like each other. This wasn’t one of those days.
I told him she was dead. I delivered the news with poison on my tongue. I wanted it to be clearly understood that that stupid, foolish, innocent, sweet girl was dead. I didn’t kill her. They did. Those ghosts and demons killed her. They slowly and methodically suffocated her, until she was dead and destroyed. What’s left is just a shell. I’m a good mom, a decent wife, an okay friend. I’m not really great at much of anything. I do well among other people on the job. I know how to talk to them. I understand them. Other people, even those I call friends, feel more like patients. Their “problems” seem so minor compared to the shit I see. Its hard to validate their feelings and I just end up giving them the same false sympathy I have to give to some of my patients. Its exhausting and it devours a sliver of my soul one bad call at a time. On the bad days, I want to walk away, turn in my badge and never look back. I say that, knowing full well that I would never give up this job. I need it. I’m addicted to it and I depend on it. I function here.
Every where else, I mess up everything I touch. I exist out there. In here, I live. In here I make sense. In here, I know what to expect. Beyond that, I love it. I became a paramedic because I wanted to save lives. In actuality, EMS saved mine. It gave me purpose and a path and a tribe of people who are just as damaged as I am and they know it. We use our pain to heal the pain of others. We know pain and we know how to treat it, medicinally and emotionally. We just can’t heal our own pain or our own trauma. That’s why we come back, tour after tour. We seek healing, both to give it and to receive it. We atone for our perceived sins by giving until we bleed, hoping that the blood-letting will cleanse and purify us.
We cannot walk away. This dance of mine will go on for a few weeks, and then I’ll be okay. I’ll pick myself up and move on. I’ll move on to help another patient. I’ll move on to hold another hand. I’ll move on to run another drug seeker to the ER for the fourth time in a 48 hour tour. I’ll move on to another hanging. One I’ll have to cut down. One I’ll have to work. Then it’ll start all over again. But there will be days in between. Days where I’m healthy and I’m whole and I laugh and I hug and I kiss and I touch and I allow myself to be given the same affection. Days where I won’t see them, those nameless faces, those ghosts and rabid demons, that paw at my heart with their icy fingers. Days where they won’t win. Days where I will lean into a hug from a friend. Days where I will see the sun reflected in the sapphire blue of my daughters eyes. Days where hope and love and kindness will rain down onto my skin. Thank God for those days.
I wrote this several months ago after running the call depicted, as a way to process it. I had never shared it with anyone, but one very close friend. This friend encouraged me to share it, in hopes that it would help someone else. If it helps even one person, then its worth baring my soul, exposing that vein of vulnerability and maybe allowing someone to see that they are not alone. I have been in counseling with a therapist who specializes in PTSD for a couple of months now. Not all days are good, but there are far more good days than there used to be.
– Story written by an anonymous female paramedic.