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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The Pit of Fear

The true terror began when I saw the room.

A friend sent me a photo of the room I was to be speaking in at my first national EMS conference just a few days before the event. As soon as I saw it the pit of mindless fear opened in my belly. Until that point, I almost felt as if I was preparing a program for someone else to present. That made it easier to quell the relentless voice in my head asking, “What if you mess up?” If you thought the world of EMS was small, I would call the circle of speakers at EMS conferences miniscule. Everyone truly knows everyone. If I blew it, this was the only chance I would ever get.

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Previously, I had been encouraged to submit to other conferences, but I was not ready. Trepidation and doubt nailed my feet to the floor. Submission dates passed and the encouraging voices waned. I had no intention of applying to this conference either, but someone reminded me about the deadline the afternoon it was due: New Years Eve. I heard somewhere that what you do on New Years Eve is what you will do all year. I submitted, not thinking I would ever get accepted. Imagine my surprise when I received an acceptance letter.

Now was the time to put up or shut up. My chosen topic was The Silent Killer: EMS Suicide. I wondered why on earth I picked such a sensitive topic to talk about at my first event. I had previously had mixed reactions from different providers during discussions including quite a loud, angry discussion at what had originated as a fun outing.

painOf course, I had writer’s block for weeks while I was supposed to be updating my presentation. Intermittently, when I thought of me in front of the audience, all I could imagine was disaster. A good friend encouraged me to close my eyes and imagine every detail to the perfect performance: what I would wear, how my hair was styled, what the Power Point would look like behind me, how full the room was, and most importantly: the positive audience reaction. Thankfully, I also had an honest mentor that when I thought I was done (YES!), returned my slides back to me with more comments. His suggestions improved my presentation exponentially. If you intend on moving up in this business, clinical or otherwise, you need to find a mentor in the area you wish to excel in.

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The day to present finally came. I woke up with my stomach tight and my attempt at breakfast was poorly received. I didn’t go on for another 6 hours! It was going to be a very long day indeed. I watched some other classes and found my mind wandering back to my subject matter while I wondered aimlessly around the host hotel and eventually decided to review one more time. It comforted me to run through the slides and make notes like someone with OCD arranges their desk over and over.

998572_10151784552212290_476214675_nAbout 20 minutes before I was scheduled to start, I went to find my assigned room and attempt to mentally prepare and put on the business face. I felt like an imposter when I walked to the front of the room to load my presentation. Everyone’s eyes felt like an accusation, “You don’t belong up there!”

The room started to get a little fuller and it was time to begin. I opened my mouth to introduce myself and the fear that had plagued me for weeks dissipated with every returned smile from the audience. I spoke and spoke, people nodding in agreement, smiling at anecdotes, silent when convicted. I shared secrets I only realized I had days before, the vulnerability uniting us, members of a secret club, no longer alone. I concluded and people came up to hug me and shake my hand. One young woman came up to me, speechless only able to utter, “ I just wanted to say thank you.” My friends surrounded me as I surrendered the lectern to the next speaker, the terror of just an hour ago growing into an indescribable high. And as I walked out of the room the joy and excitement bubbling from my heart I wondered, “When can I do it again?!?”

The Author Speaking

Maybe this is how you feel about public speaking. Maybe you think, “ I could NEVER do that.” Is there a topic you are passionate about? If you don’t talk about it, who will? I’m just a provider with an interest that stood up and said something.

What do you have to say?

 

The Courage to Write.

Initially, I thought I arrived here by “accident.

I can be a bit rambunctious and not everyone can appreciate that, so I ran into a little trouble at work and avoiding a long story that will bore you, I found myself looking for a new gig. A few weeks later, I went on an interview at a place I did not really like or want to work at and afterward found myself trolling Marshalls trying to feel better. New shoes, clothes, purses, or household crap for you to dust can do that for a girl.

thWhile strolling through the aisle of various pots and pans, a friend messaged me and asked if I could read something. We had talked about our individual school work and research demands previously and I thought highly of him (hes kind of a big deal), so I was SO excited to be included into this exclusive club to check out his writing! I read it right there next to the All-clad frying pans, the Stepford Wives shooting me dirty looks for blocking up the aisle and all. It was a management article, but he was speaking about my life! Specifically, the trouble at work situation and the type of manager I just encountered. I silently wished he had written it a few years earlier and saved me some agitation.

I began to wonder, “How can I write like that?” So I asked.

Hey, how did you get started writing for magazines?”

This gentleman was gracious enough to tell me a little bit about his journey and even offered to review anything that I wrote. WHAT!?! ME?!? I was honored, but didnt think anyone wanted to hear what I had to say, much less felt that I could influence someone positively. Didnt I just get into trouble for opening my big mouth?

Honestly, I was scared.

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As time went on, this militant thought consistently reared its head, “Why not me?” I began to write a piece and shared it with a few people. To my surprise and pleasure, they liked it and were honest with me and told me how to improve it. Still I waited, unsure if I could really “do” this, I mean who was I to tell anyone anything? I had A LOT of “reasons.”

I don’t have a degree.

Im only an EMT.

I don’t have a fancy job as a platform.

I just ride on a truck.

Who would listen to anything I had to say anyway?

Another good friend with a flair for the literary and a silver tongue encouraged me to build a blog. I thought, “Uh, arent blogs for people with nothing going for them?” I received a quick education on EMS blogging and got lost in the internet for many hours finding amazing writing ranging from clinical topics to florid tales regaling the family that is EMS. More talking myself out of writing ensued after I read some of these authors who left me in stitches unable to breathe and others who made me shut the computer off heart broken and crying, knowing I could NEVER write like that.

c3d4fe411b27e8acd660c1509e0babc2I didn’t get here by accident. Life, destiny, the Universe, whatever you want to call it has been setting me up for years. As a little girl, I got busted sneaking books to bed and still I stub my toes on the stacks that don’t fit on the shelf. As a young hellion, I met a new friend whose mother was a writer and preacher and despite my alternative and undesirable appearance (which she still talks about in front of the congregation when I am in town at church) let me wait in the wings and watch. I learned how to speak to people in power. I learned how to write and speak and back up my position, so I did not just have an opinion. She let me learn how to serve others by imparting parts of myself via her example. She laid the foundation that others would build on during my creation as a writer. This was no accident. Neither is your journey.

speakingLike most FNGs in EMS I decided to fake it ’til I made it. With a lot of help from an accepting and encouraging EMS writing community, I built the blog and posted that first article. Then another and another and another and THEN I got my first piece of hate mail! That sealed it for me, people were listening!

I will tell you a secret. I am still terrified.

We do this every day. We speak to people and influence their healthcare decisions as a provider. We uplift our friends and family when we offer messages of encouragement or commiseration. We make strangers smile when we offer a pleasant word and smile of our own. Writing is just life via our fingers.

It is easy to listen to your inner critic knock you down and silence your voice. Its easier to turn a blind eye and keep your head down and get by, but what the hell will you have at the end of your life then? A bunch of “I should haves” and no time left.

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There are many things that will try to slow you or distract you or stifle your voice. Dont let them. Your voice is important, what you have to say can only be said by you. You never know who your words will affect and improve or inspire or save.

Yes, the power of life is in your words. Use them.