(I am loving the comments that have been made on my last few posts – many more and I'll have to start a forum…)

There comes a time in the life of every emergency worker when they start to suspect that they have become a psychopath. You find yourself losing empathy for your patients, they become yet another body moving through the conveyor belt of treatment and audit. They become speed-bumps on the much more important task of meeting the targets set by our governmental over-masters.

(See, ORCON, 4 Hour A&E Breach targets, Caesarian birth targets, Police detection rates and whatever the fireservice are measured on).

You find yourself going home and not worrying about your patients – this is where TV dramas have it wrong, we don't tend to have nervous breakdowns, we just slowly become unfeeling bastards.

And then you get a job that nearly moves you to tears. And you hang onto it, because it reminds you that you are still human.

Mine was a lovely elderly lady. She's 93 years old, lives alone in her spotless flat and has no health problems to speak of. She often pops down the shops for her food, and yesterday was going to have a look to see if she could find a coat for winter.

We were called to her because she'd 'fallen over'.

What had actually happened was that some scummy bastard had mugged her – grabbing her handbag and knocked her to the ground. She's 93 years old, small enough to be put in your pocket and some 'man' had picked her as an easy target.

Luckily she wasn't seriously injured, but she was a bit shaken up. So we took her to hospital for a check up and, as I sit in the back of the ambulance talking to her, I'm having to fight back the tears that are making my eyes moist. I feel so sorry for her, I just want to snatch her up and give her a cuddle.

Then I want to hunt down the fucker that did this to her and remove his teeth one-by-one.

While I booked her into the hospital my crewmate made her a cup of tea, in the circumstances it's the best we could do. It's incredibly unlikely that the police will catch her attacker as she wasn't able to give a good description of the mugger.

She tells me that this is the second time she has been mugged, but “didn't want to make a fuss and get anyone in trouble”.

My feelings go between sadness for what has happened to this inoffensive, polite, lovely woman and utter burning hatred in my gut for the scum that did this.

I once went to a 'patient' that admitted mugging people to maintain her Temazepam habit, and I sat there listening to her as she made herself out to be a victim.

I suspect that I would not be so calm if I had to pick that patient up again. And yet we must, otherwise we would be 'in trouble'. We can't let our feelings affect the way we treat people. But just once in a while it would be nice.

And yet, as I type this, sad and angry, I'm thankful that at least I'm feeling something.

24 thoughts on “Feeling”

  1. It's when you permanently view patients in the same way you see sliced up meat in Sainsburys that you should worry. For then you would have lost the quality of compassion that made you choose your career.You are human and as such your days are dictated by moods that you are not aware change from day to day and also during the day. It's part of the make-up that separates us from animals.Take solace that you're not feeling emotionally numb all the time – then you would have a problem. You are human and one of the finest I know.BTW. That's the first time I've seen you use the 'f' word.

  2. You are so very right.I once led the resus of a 14-year old boy who had hanged himself. Sadly it wasn't successful. Afterwards the cas sister and I both cried. Bizzarely I felt almost slightly “weak” at the time; however when the initial emotion of the event had subsided, I came to exactly the same conclusion that you did – the day when something like that doesn't make me cry is the day that I should leave medicine.

    On the other side of the coin, yesterday evening in surgery I had a lovely chat with one of our patients – an eighty-odd year old lady. I discovered she'd been the first ever WPC in our area. I felt honoured to be part of this lady's life.

  3. Bless her! Why are some people so evil and wicked! I hope she is ok.Tom, the feelings are still there just numbed by the management and some of the scum you have to pick up.

    I state once again you do a great job, don't let the buggers get you down.

  4. “then can we really say that every mother mugger is clever enough to make an informed choice?”Not his fault then eh?

  5. “we just slowly become unfeeling bastards.”I guess its the best defence mechanism available, and it makes you a whole lot more useful than if you had a nervous breakdown after every shift. We all know you are not really a psychopath … probably …

    Forum – Great idea!

  6. How people can treat anyone, let along a elderly lady who was alive during the first world war, like that is beyond me. I'd guess she's almost certainly seen 4, if not 5 times as many years as whoever did that to her, and that deserves more than a little respect.I'd love to say more, but I've got to rush off – I'm heading back to my parents to join the rest of my family in celebrating my grandmother's 93rd birthday.

  7. i work in an NICU, i regularly go to premature deliveries, and i recently realised the same, i have stopped caring -Last week we were sent to a neonatal resus, it ended up being called, i just went back to the unit and carried on as if nothing had happened – time for a new job i think.

  8. This is what bothers me so much: I'm supposed to happily send an ambulance to unpleasant scrotes who itake drugs, self-harm, get drunk and walk into things/have a fight/punch walls etc. I'm supposed to do it with a happy clappy, carey sharey, pink and fluffy smile on my face. In reality, I wish those people would have something REALLY nasty happen to them , the way “karma” is supposed to work.And while I'm sending to those little shits, I'll probably have no ambulance to send to the 93 year old lady who “doesn't want to bother us.”

    Luckily, I can sometimes “juggle” things a little bit, just to point “karma” in the right direction….. šŸ˜‰

  9. Dude, I think someone need to pick *you* up and give you a cuddle. You're more human than most of us. Don't worry about it šŸ™‚

  10. Hiya, I don't know you or anything about you, but all I can say is that if I was in your unit and next in your working day, I'd rather you'd come professionally unfeeling from a failed resus than shaking and upset, mulling more on big philosophical questions than on my immediate needs.How can anyone face tragedy every day, and not have to close off a little at times?

    But like I said, guest, I don't know you, I'm just putting my selfish point of view for what it's worth, which may well be what you paid for it. I wish you well whatever choice you make.

  11. i completely agree with smoochie597, better to come unfeeling from a failed resus than all emotional & shaky & too upset to do your job properly. sometimes you can't allow yourself to feel because there's just too much to do with all the other patients who are still alive and still need you to look after them. it's so, so cruel to do this, a self-inflicted violence to your soul, but it's a cruel necessity because otherwise your patients will suffer and you will lose your mind through too much caring.

  12. Things like this just make me seethe. It's an indicator of the state of things when one of the only things reminding you your still human is one of the basest and most disgusting acts a man is capable of.Sometimes I really don't know how you do what you do. Chin up šŸ™‚

  13. my experience in the social welfare sector in which i work is that you know you've been in it too long when you read a blog entry like this and immediatly think…'ah, tha's for all you know, how do you know that little old lady isn't herslef a benefit cheat/ didn't abuse her children/ doesn't have a background with the Nazis/ security forces/ ethnic tribal terrorists/ isn't a drugs runner/ brothel keeper…just because she seemed to you like a lovely little elderly lady….

  14. AKA, seeing the worst in everyone, as opposed to seeing nothing?I think I get it.

    I think I did experience it once, as the subject, long time ago, no desire to post details.

    Maybe there's “positive indifference” = “healthy baby just died, I just delivered your disabled baby who will die before age 40, I cannot apply any judgement” and;

    “negative indifference” – “your baby just died but may have become the Hitler of the 2020's…”

    I'm up for about 25 hours, so if none of this makes sense, apologies, and I will try to be more rigourous in future replies.

  15. I think the fire service are measured in terms of insurance bills, having seen what they will do to the roof of the car given a chance. It's also possible they are measured in gallons, or by the number of people they can get to a scene within 20 minutes.

  16. Brilliant Matt, I had never thought of measuring Trumpton like that!!! Although now when I turn up to anything that they are attending, I will be thinking about your “measurement” and have a little chuckle to myself.As for becoming unfeeling Tom, just like the others have mentioned previously, in this job you have to become numb to some of these jobs, you can't just continue on bottling things up, otherwise your head will just explode…. I too find myself moved by the jobs that we attend to.

    Going out to the “drunken eastern european” whilst Mrs Miggins is being brought in to hospital by a friend because she didn't want to worry anyone about the heavy weight she feels in her chest and the pains in her arm and throat that she has had for two days (yes the very basic symptoms of an MI) the service is abused (although not necessarily by anyone from europe I hasten to add) but we have to harden ourselves up to the fact that nothing is going to change. We have to deal with everyone equally, even if we have just had them cut out of a car, stinking of alcohol and wondering why we are helping this person who has chosen to drink heavily and then drive his/her car into someone elses while we have just “called” the driver of the other car because they are just too badly injured to help.

  17. Now I have calmed down at my fury at LOL being mugged; what I wanted to say Tom, was; I wonder if you get any less effected by your work, or do you just build up defences; the jobs that hit your own personal 'emotional hot spots' get protected by layers of experience, but every now and then something seeps,or floods (as in this job?) through.

  18. I'm glad you posted this.Two months ago I was on a crew that picked up a five day old, six week premature infant with difficulty breathing. He was all purple and staring and his mother was frantic; she also had a raging fever and didn't put him in his crib that night because she was worried something was wrong. It was. He was septic, his liver shut down, he went to a big children's hospital, which tried valiantly to save him. Last week his poor little body gave out. I have no real right to any grief; I didn't know his family; and yet I feel an ache that comes from a very childish 'this isn't supposed to happen to a baby' place. I'm learning how to be okay with the things we can't fix, the times we are simply witnesses to What Is, to pain I am not trained, not equipped, and not able to alleviate.

  19. When I was in my first training school to become a Paramedic, one of my fellow students brought an American “Wildest Trauma” style video in to watch. After watching the video he asked one of our Paramedic educators (with around 15 years service), “How long does it take to become desensitized and have no feelings in the job when we see all that stuff”?The class was politely told in no uncertain terms that, “if we all thought that was what it was all about we should leave right now!”.

    I often think back to that day when I am feeling tired and cross and am well and truly over the 3rd fallen over drunk for the night, or the 3am call because the lady can't remove her contact lens etc etc.

    I cried after my fourth day on the road I went to a 1 year old sudden infant death, I cried after my first fatal car crash in which a 16 year old boy was killed and several of his mates were critically injured, I (and my 3 colleagues on the case) cried after a particularly nasty suicide of a teenage girl.

    But it isn't all about the bad, how much joy do I remember from my first child birth or defibrillating a patient in cardiac arrest and enjoying a joke with him four weeks later. Or the man (alive to this day) who I happened to come across in my supervisor car 2-3 minutes after a bus ran over him who had a traumatic amputation of 1 leg and a multiple fractures of his other leg along with major pelvic/abdominal trauma. He would have bled to death by the time that first ambulance arrived 10 minutes later as a bystander had popped a blanket over him so they didn't have to look at the mess and all the blood spurting fom his artery.

    Nothing gives me more satisfaction than simply putting my hand on the shoulder of someone injured, ill or distressed, and this simple gesture of compassion can make such a difference to reduce the level of stress and anxiety.

    Anyway, enough rambling from me, keep up the good work Tom.

    PS: that fine Paramedic Educator who gave us those words of wisdom sadly succumbed to cancer a couple of years later, the world was a better place for his time here.

  20. Your post bought tears to my eyes Tom. I would disagree that we become unfeeling though admit we do get de-sensitised to these things. If we didn't then we wouldn't be able to do our jobs properly. However, that's not to say that we lose our empathy and compassion for others. As that has obviously not happened to you then I would say that you have nothing to worry about. You looked after the lady and treated her with compassion whilst still giving her her dignity. Very important thing but especially to the elderly.Full marks to you Tom, you're doing a great job.

  21. When we lose the ability to feel and cry over something like this, it's time to change jobs. I know how you feel Tom having cared someone who generated similar feelings within me… It might be a breach of confidentiality (i've only been in this job part time for a few weeks and am still learning… let me know if i'm out of order!) but i doubt any of you will meet her and i'll keep it as vague as i can…When i first started working at the Nursing Home, i learnt to deal with all the kinds of illnesses you come to expect such as dementia and diabetes and for the most part i enjoyed learning about how to cater to the residenta individual needs. I guess most of you know that you get to be like a family in a Nursing Home if you're there often enough and actually give a damn. But one little lady's story still haunts me and is why i'm determined not to become a shallow empty shell.

    I initially thought she had had a stroke as she was all hunched and twisted (i know this isn't the most sympathetic terminology but i've not got enough medical knowledge to name it properly). I guess i should have read the care plans but you know what, i wasn't even told how to change a catheter, never mind that i should read the care plans.

    She was the sweetest little thing; when you brought her her breakfast and fed her, she would murmur about how nice it was and give you little smiles which just brightened your day. But sometimes the heart-wrenching fear in her eyes would chill you, as she cried and murmured for you not to go. I asked one of the more experienced Carer's why this was, thinking it was a side effect of her stroke.

    Turns out she wasn't suffering from a stroke but was the victim of 10 years of rape courtesy of her son. That was why she was so hunched, creid when you touched her legs and occasionally hated to be alone. That's why she was in the Nursing Home, couldn't walk, had to be fed a pureed diet and was on a concoction of god only knows what to keep her depression at bay.

    I don't even need to tell you how utterly incensed i was. In that moment i swore i was never going to be caught out like that again; i was going to know the care plans of all my residents. And whilst i may become hardened to the reality of working with such people and become somewhat robotic, hopefully this haunting picture of the utter BS life deals out to innocent people will remind me that actually i can feel emotion and that it IS a good thing.

    This is about a month later than everyone else but i had to get that off my chest. Keep fighting the good fight Tom, you've won over another fan here šŸ™‚

    Helen x

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