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Suicide and salvation in EMS: How to save a medic's life

No one understands the pressures we face like a fellow EMT; respond to depression and burnout with more than just words

By Kelly Grayson

A few years ago, I ran over someone in an ambulance.

It was dark, late at night, on a lonely section of a highway. At first, I thought it was road debris. When I stopped to inspect the ambulance for damage and found none, I was convinced I had run over a shredded semi-trailer tire.

It wasn’t until I reached the hospital an hour later, and found blood spattered all over the back doors of the ambulance, that I thought otherwise. Still, the human capacity for self-delusion is boundless, and on the drive home, my partner and I had halfway convinced ourselves that I had run over a road-killed deer.

When we saw the state troopers and crime scene unit on the way back home, that delusion was shattered.

I’m here to tell you, there is no feeling more horrible than the realization that you may have just killed someone.

Company response
As it turned out, the state police determined that I was the second or third vehicle to run over the body, and that he was almost certainly dead before I hit him. Still, the supervisor called to the scene was supportive, and concerned about my emotional welfare. I took a legally mandated drug test administered by the state police, and rode home in another ambulance, since mine was impounded for evidence collection.

Acadian’s crisis counselor called me before I even got back to the station. My local supervisor told me to take the next shift off. I told him I was capable of working, and I’d be there at shift change, as scheduled.

I went home and crawled into bed, and stared at the ceiling for nine hours. Two hours before my shift was scheduled to start, I called in sick. My supervisor immediately called me back and told me not to worry about it. No mention was made of the fact that calling in two hours before my shift violated Acadian’s call-in policy.

The crisis counselor called me again, as did my partner and the crew who gave me the ride back to my station. Everyone was concerned about my welfare, and made it clear that no matter what, they had my back.

Of course, the rumor mill being what it was, a number of other co-workers spread it around that I had mowed down a pedestrian and gotten away with it. The same guys who called to check on me set the rumormongers straight.

A suicide
Recently, an Acadian employee took his life behind one of our ambulance stations. His partner discovered the body, and attempted resuscitation. I can only imagine the mental and emotional anguish he went through, second only to the mental and emotional anguish that led a young, promising paramedic to take his own life.

And as in my case, Acadian took care of its own. They provided emotional support for his partner, arranged for crisis counseling, and took him off the rig. Since an ice storm had shut down local roads, they put him up in a local hotel, and then arranged for him to get home.

And of course, the rumor mill being what it is, most of Facebook heard about it before many Acadian employees and managers. It was widely disseminated that Acadian was heartless enough to make the partner complete his scheduled shift, even though the exact opposite was true.

In both his case and mine, the response flipped the paradigm about colleagues and corporations. In both cases, the supposedly heartless, profit-centered corporation was the first to reach out and assure the well-being of one of its employees.

Plenty of other commenters on Facebook offered their prayers and support for the medic who took his life, and the partner who found him. Just as many offered their scorn for Acadian, accepting at face value that a company would force an EMT to complete a shift after his partner killed himself.

Thoughts vs action
But I wonder how many went any farther than that? Has this phenomenon we call social media actually disconnected us, instead of bringing us closer together? How many people typed “How sad, praying for you!” and left it at that?

Is that enough? And what kind of anguish did it bring to the local manager who had to deal with the horror of that day, especially after reading hundreds of comments condemning him over a heartless act he didn’t commit?

I wonder how many people reached out to him and said, “Hey, are you okay? We appreciate everything you’ve done. Way to look out for your people.”

My gut tells me that plenty of people did, just not publicly. I imagine people volunteered to cover shifts for the medic’s partner. Probably those who knew the medic outside of work offered support to his family.

This being Cajun country, I’m sure someone brought food, because nothing says “I care about you,” quite like a covered dish and volunteering for babysitting duty.

But none of that came early enough for a young man with a full life ahead of him. When you’re isolated and depressed, it’s easy to convince yourself that you are truly alone, and that no one cares, and that, God forbid, your loved ones would be better off without you.

Depths of despair
Despair should never be allowed to whisper in a friend’s ear without a contrary voice assuring him that those dark thoughts are lies. I’ve suffered from depression, and I spent those dark months glued to the computer. Surfing the Internet and chatting online were easier than actual human interaction, even though the outside world was exactly what I needed to drag me out of my funk.

It takes action. It requires re-engaging with life. Prayers and support after the act ring hollow. We should care enough to intervene before the act.

On Feb. 2, one of Bryan Bledsoe’s 4,845 Facebook friends posted a cry for help on his page.

Bryan acted, and sought to get the guy the help he needed. One hundred and eighty-eight of his friends posted supportive comments. A handful of those actually went beyond that, and found the guy’s employer, friends and family, and had the police intervene. That man has a second chance, and I pray he makes the most of it.

And I applaud the people who went beyond words of support, and took action. Quite likely, they saved a life.

Peer support
No one understands the pressures we face like a fellow EMT. Not your friends, your family, or your priest. I may discount the effectiveness of CISM and debriefings based upon the scientific evidence, but one tenet of CISM is invaluable: peer support.

Look for the signs of depression and burnout in your co-workers. Be alert for inappropriate anger, or flat affect, or the other physical manifestations of stress.

And when you do, reach out with more than words. Take them for a workout. Indulge in a little retail therapy. Go turn some ammunition into smoke and noise. Drag them out for a meal after your shift. Let them decompress, safe in the knowledge that their rant goes no further than the two of you.

Beer and nachos are an excellent remedy for burnout. The healing isn’t in the hops and barley and the cheese and chili, it’s in the fellowship with the person that has your back.

Look out for each other, because often, each other is all we’ve got.

 

Kelly Grayson, NREMT-P, CCEMT-P, is a critical care paramedic in Louisiana. He has spent the past 14 years as a field paramedic, critical care transport paramedic, field supervisor and educator. He is a former president of the Louisiana EMS Instructor Society and board member of the LA Association of Nationally Registered EMTs, and currently operates an EMS training and consulting firm, MEDIC Training Solutions. He is a frequent EMS conference speaker, and has provided expert content review of several EMS training texts. Kelly is the author of the book En Route: A Paramedic's Stories of Life, Death, and Everything In Between, and the popular blog A Day in the Life of An Ambulance Driver. To contact Kelly, email kelly.grayson@ems1.com.




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