Normal vs Abnormal

 

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This week was a week of firsts. My first infant code and consequently my first Critical Incident Stress Debriefing (CISD).

For 18 years I was able to dodge the bullet of having to respond to dead or severely sick or injured babies. One time, there were too many new EMTs that just graduated so I gave my spot to one of them. Another time, I had just fallen asleep in my bunk between two long shifts. Another, I was blessed that the mother wrapped the newborn she left in a park bathroom well enough to survive the elements until we arrived. I have a myriad of tales like those related to bad pediatric jobs. This time when I heard the dispatch come over, “…7 month old CPR in progress.” I knew I would not be spared.

I expected to feel agitated, excited, or frustrated that everything was going too slowly, but while responding to the job a strange calm settled on me and remained throughout the call. The tick in my knee that I get on hot jobs was absent. The scenery rushed past as our caravan of emergency vehicles hurtled to the scene like a strange slow motion montage in an IMAX movie. Even the other first responders on scene were calm. No one yelled, “Rush the bus!”

Everyone worked together as a team even though many of us had never met before this moment. Police, Fire, and EMS all integrated and focused on the task at hand: caring for our patient and the family on the most awful day of their lives. This teamwork extended to post call care for all responders on scene; the fire chief invited all the agencies involved to the CISD event he arranged for his firefighters.

My partner mentioned the invitation to me and immediately a strange, fearful voice piped up in my mind, “Oh no, those folks will think there is something wrong with you.”

Tony and Dr. Melfi in The Sopranos
Tony and Dr. Melfi in The Sopranos

I was appalled at myself! I frequently talk about CISD and the importance of talking to each other and having an open mind when others need to talk about incidents and changing the culture of machismo we have been a slave to for so long. Yet, here I was thinking I couldn’t talk freely because I might get sent to a head shrinker. My partner sensed my hesitation and offered me an out that I happily agreed to so we didn’t have to go.

Then the Chief called our building personally. I am so happy he did.

It wasn’t as bad as I thought and based on body language I wasn’t the only one who was initially hesitant. There were no couches or straight jackets present. The gentleman who lead the debriefing promoted a relaxing atmosphere and assured us that the discussions during the meeting would not be shared, and accordingly I will not share them here. I do want to share some of the important things he told us that can be applied to any incident, although they are not a replacement for a proper CISD if you or your department need one.

 

  • You are having a normal reaction to an abnormal situation. The things we see are not normal by any means. We don’t normally imagine babies as dead or heads being detached from bodies or people being assaulted violently. Feeling upset about any of these or any other abnormal events is normal.
  • Don’t over or under indulge in caffeine, food, alcohol, etc. for the next 48 hours. If you normally drink 3 cups of coffee, don’t increase or decrease that amount as it will change how your body normally operates and can mask your feelings.
  • Don’t go home and not communicate what happened or pick a fight because you feel stressed. The family dog is not extra bad today, you are just more sensitive. That is normal! If you feel yourself getting upset, take a moment and relax.
  • Give yourself about 48 hours for your body to start to return to normal. Stress, like physical injuries, can have physiological effects. Your body needs time to heal.
  • If you are not starting to feel better and note you are starting to feel increasingly stressed, talk to someone. You can call the CISD staff for references, call your EAP plan, or talk to your agency leadership.

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These are all very sensible recommendations and you might be wondering what the benefit to actually going to a CISD meeting is when you could just google the information above and finish your lunch instead of pouring your heart out. There is something cathartic about being in a room with the men and women you shared a heartbreaking experience with. Something only the few of you will understand without words and can gain comfort just from each others’ presence. There is something healing in knowing you are not the only one who felt a rupture in their being from having a human reaction to a horrible circumstance that no one should have to experience, let alone think about.

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I am glad I went and allowed my heart to begin to knit itself back together again and to find out that I am human and how I felt, how all of us felt, is a normal reaction to an abnormal situation.

 

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