By Justin Schorr
I have seen many things I wish never to recall.
Usually they visit me on a quiet afternoon, or when I’m in a crowd, trying to figure out why someone looks familiar. Did we go to school together? Do they live in my neighborhood? Often, it is a sudden recollection that sends a chill down my arms. They are not ghosts. They are simply my mind connecting them to a memory of someone I couldn’t help enough.
Screaming is common in my work. People on their worst days, suffering from immeasurable pain, scream and our brain has evolved to know that it means they are in danger. Something is dangerous, that is what the screaming tells us.
Crying is also quite common when helping people. Not just the patients, but the families, friends and bystanders. Crying tells us that emotions have reached their peak and the person has released control of the situation ever so briefly.
These are common sounds when working in emergency services, and they do indeed bother me. But, more frightening than the screaming, more emotional than the crying, is the silence.
Imagine for me the following scenario:
A truck travelling south was towing two trailers, the second one not properly secured. The trailer came loose and flew into the air, striking a car coming the other way on the narrow road. The side of the trailer connected with the driver’s side of the car, killing the driver instantly and causing the car to come to a stop in the middle of the road.
The scene was confusing, chaotic and a mess to say the least. The car was carrying six other people, all covered in blood. None of it was their own. The rest of the family was uninjured, but you’d never know it from the look of them or the car.
As we arrived on scene, there were screams and crying from almost everyone. There were screams about their family member, dead in the front seat. And there were cries about possible injuries of their own. But the loudest thing at that scene was not a grieving wife or her son in pain. To me, what seemed like the loudest thing at that scene was the young woman sitting directly behind the driver.
A section of trailer sat just a foot away from taking her head clean off. She was sitting, seat belt still on, brown hair scattered with blood and brain material from her father in the driver’s seat. She simply looked at me and sighed.
A sob leaked out and she wiped her nose with a blood-splattered hand, adding to the mess on her face. When asked if she was OK, she nodded and reached to unbuckle her seat belt and get out. She stood, looked at her mother screaming and brothers crying, and turned to look at the mountains far off in the distance.
Another sigh.
She was unable to process exactly what was going on, even though she could clearly see what had happened to her father. She should have been screaming or crying, in some way beginning to process the situation, but she was not.
For over 20 years, I have seen her face in various places. An actress on TV I just can’t place, a familiar face in the crowd at a concert, even at the grocery store I have seen her. Her reaction is etched into my life experience, not because of her lack of emotional response to this tragedy, but because I had applied a dangerous filter early in my career: distancing myself from patients.
While forming a relationship with people you’ll only ever see for maybe an hour on their worst day may seem like a bad idea, it can make a huge difference in both their recovery and our own acceptance of what happened. I remember the girl’s name clear as day (I won‘t mention it here), but I couldn’t tell you anything about the rest of the family, except how many there were and all the noises they were making.
Trauma doesn’t just impact the victim, but the rescuer as well. If someone is injured, but not making any noises it doesn’t mean they are faking, or trying to downplay the situation. Sometimes folks need a few minutes to process their situation before they are able to react.
Sometimes we’re there for that transition, sometimes we’re not. It can take minutes, days, months, even years. I have heard far more screams and cries than sobs and sighs, but the impact of those small noises, short breaths and slack facial features makes far more of an impact on us than we’ll ever tell you.
This is why, whenever you ask a paramedic to tell you the worst thing they’ve ever seen, they won’t begin to cry or scream. They won’t gather you around a phone to show you a picture of a mangled leg or a car or a fire. No, they will sigh, remember that dark moment, and then try to think of something less tragic to tell you.
That means we are still trying to process what happened to us on someone else’s darkest day.
