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Soul Callus

0600, only a few minutes from shift change. It's been a long night, and we're finally getting around to washing the rig and completing station duties when the call comes in, "Cardiac arrest."

Betty Rubble's demeanor vacillates between excited and pissed off. That first part comes from the natural adrenaline rush that accompanies true emergency calls, where speed and skill really do matter. All rookies get that rush. The second part comes from the realization that we're going to get off shift late, yet again, and we wonder why it's always our truck that gets fucked with the late calls.

That second part, she gets from me.

"It's a 'woke up dead' call," I tell her tiredly, attempting to rein in some of that enthusiasm.

Or perhaps quash it, I can't really tell anymore.

She looks at me questioningly, and I explain. "It's 0600. Somebody just woke up and found their family member dead. Likely as not, they've been dead a while, and all we're going to do is pronounce it."

En route to the scene, the data temrinal flashes new call info, "Law enforcement officers on scene, CPR not in progress."

"See what I mean?" I tell her, pointing to the screen. "Cops aren't even doing CPR. Probably rigored up and everything. All we'll do is gather information and run an asystole strip for the coroner, maybe explain the situation to the family. We'll be done in ten minutes."

And as we pull up to the high rise, I see a body crumpled on the lawn, and crime scene tape being strung around the scene. Officers are staring up at an open fifth floor window, lighter than the others around it because this one is missing its screen. Relief floods me as I realize, "Oh great, it's a suicide. Crime scene – even less paperwork for us."

I say as much to Betty Rubble.

She looks at me questioningly, and I point my flashlight up to the open window. "Somebody took the Nestea plunge out their window. Cops aren't gonna want us in there contaminating their scene. We can clear from this as 'no patient found'. No paperwork at all."

Still, I think it prudent that I examine the body, at least, perhaps check a pulse. I tell Betty Rubble to stay outside the tape to limit scene contamination, and carefully approach the victim. From ten feet away, the misshapen body and livor mortis tell me he's far beyond resuscitation. I check a pulse, feel the coldness of his skin, and back away.

Outside the scene tape, the crew from the backup unit is chatting idly with Betty Rubble. Nearby, a cop's radio crackles, "Door was unlocked, found the suicide note on his bathroom counter."

"Wonder what it said?" muses the medic from our backup crew.

"I dunno," I speculate. "Maybe 'Goodbye, cruel world?' Or perhaps, 'If my calculations are correct, these wings should provide me with just enough lift to…'"

Everyone within earshot dissolves into fits of laughter, and I grin.

And then I look up to see the faces staring down at us from other windows, and my grin fades in a wash of shame.

And I ask myself what sort of example I'm setting for Betty Rubble, and the answer is all the more shaming.

"Come on," I say brusquely, "let's go before we catch another call."

On the way back to the station, I stare out the window and wonder when the hell I lost my humanity, and why I didn't miss it when it left.

Comments - Add Yours

  • Lynda Otvos

    Don’t beat yourself up over a slip, AD, we all search for levity at the end of our work shift. It’s a growth opportunity.

  • http://emtmedicalstudent.wordpress.com/ Joe Paczkowski

    Rule 4: The patient is the one with the disease.
    Rule 8: They can always hurt you more.
    Rule 9: The only good admission is a dead admission.

    Of course, this is easy for me as my very sick sense of humor is genetic. I never had a humanity to lose.

    Alternatively, is there something very human by realizing that some day, we’re all going to get sick. Some day we’re all going to feel pain. Some day we’re all going to die. As such, if we can get a good laugh, or even a chuckle, from the events around us, then so be it. After all (at least proverbially speaking as my dead grandmother is sitting in a box on a book case at my parent’s house, and that doesn’t even touch the bad humor and weird circumstances surrounding her death) we’re all going to end up 6 feet under. 

  • Morgan Kee

    Calluses grow to protect the softer more vulnerable parts from frequent irritation.  Don’t hate on the callus for doing what it is supposed to.  Gallows humor is one of those classic defense mechanisms that work one heck of a lot better than EtOH self medication when it comes to longevity in the field.

    If it makes you feel better about your humanity, it is fairly normal to not deeply identify with someone who is/was outside your immediate sphere of association.  (I believe that LabRat called it the Monkeysphere).

  • Dixie

    You haven’t lost your humanity. Sometimes you have to laugh to keep from crying.

  • MK

    I think the fact that you’re able to step back and realize what happened speaks volumes, AD. If this call, this moment, meant nothing to you, I’d be far more worried. Everyone slips up, and sometimes our dark humor comes out a little more dark than humor. But it happens–even to newbies, who are supposed to be all bright eyed and innocent and “above” all that stuff.

    This moment might haunt, disgust, and worry you now. It might invade many of your waking thoughts, taking root and giving fruit to other troubling thoughts. But try not to let it psyche you out. In time, this moment will be nothing greater than a (somewhat uncomfortable) reminder of boundaries you don’t want to cross. It’s served its purpose as a wake up call; please, don’t read into it any more than you have to. Feel what you have to. Do what you have to. Then let this moment go.

  • Adamedic

    Finding the humor in a situation isn’t all bad.  As others have said it is a defense/coping mechanism.  I’ve found in my short time in EMS that the trick is to know who is around before saying something.  A family member, friend, or soft hearted coworker probably should not hear it.  A like minded coworker, fellow public service member, or in some circumstances a friend will probably find it useful in lifting the drama of a situation.  Sometimes families and friends need it to cope.  Using dark humor isn’t losing humanity; not caring who hears it is when we had better check ourselves!  Love your blog AD!!  Always make me think and reflect on how to be a better caregiver and person.

  • Shirley, surely

    I don’t remember the exact context of this event, but I’d been trying to get in touch with a woman who’d hired me to do some desktop publishing. I finally managed to talk to her, and I said something to the effect of her still being alive. Well, apparently she was, but her nephew wasn’t! He’d committed suicide and she’d been helping her sister’s family deal with the tragedy. I won’t ever forget the lesson I learned, and have chosen my words carefully ever since.

  • Anonymous

    AD, all you’re doing is coping, maybe not the ‘perfect’ time for the comment, but trust me, we’ve all said/done worse when tired and the ‘morbid’ humor comes to the fore…

  • Ted

    Making a comment like that on-scene is a lapse in professionalism, not a loss of humanity.  The fact that it bothers you this much proves you’re still human.

    Such comments are best reserved for back at the station, or, better, the off-duty watering hole.

  • Christopher Rozman

    During an episode of M*A*S*H Hawkeye said it best.  Though I can’t find the quote the sentiment was along the lines of “If I didn’t laugh I would scream, all the horrors, and all the waste.”

    As paramedics we are told to endure horrors simply because “we signed up for it.”

    The damage this person did to all neighbors, responding personnel, and family is much greater than the damage he inflicted on himself.

    You haven’t lost your humanity, you’ve just protected it.  I’m pretty sure I recall a podcast with you recalling holding grandma’s hand on a transport.

    Carry on, AD.

  • NinjaWifeEMT

    First, I agree with what everyone else has said here. Second, it’s wise to know we walk a fine line. It’s a good thing to stop and check ourselves from time to time. You’ll ultimately have to decide for yourself but I believe that if you can stop and ask, it’s still there. Maybe just a little hidden.

  • Anonymous

    All this proves Kelly is that your human. Even superman had his off days. Don’t beat your self up about this. Take comfort in the fact that it did bother you. I’d be really worried if it didn’t bother you. If you need to sit down with her next shift & talk about what happened , go for it. Use this as a “teachable moment’ for her. I did for me when I finally get my chance to get on the rig.

     stay strong superman…

  • Patrick Sennett

    Total defense mechanism.  I transitioned after about ten years.  Otherwise it becomes a soul-crushing trip to the dark reaches of humanity (or sub-humanity) and it takes you down with it.  You do what you can, and then you do what you need to.

  • Scott Kenny

    I dunno, AD.  I mean, your job has you staring Death in the face just about every day, and sometimes you get to kick his ass.

    If you cannot find humor in situations you’re going to go crazy. And a medic going off the deep end isn’t good for any of us.

    And sometimes we open mouth only long enough to change feet.

  • 40lizard

    Its a normal coping reaction-and don’t worry about it! the fact you realized that the civilians on scene might not appreciate it-your humanity kicked in again.  I have to admit that on one of my third rides as a student-we had a DOA and since we were first in and had to wait on PD to show up- there was that kind of humor as well- at first I was suprised but then I realized its a coping mechanism-we have to have that while on scene because otherwise we’d all crack up right then and there and we’re supposed to be doing our job instead of flipping out like everyone else!    so hang in there and don’t beat yourself up!

  • Evyl Robot Michael

    I would think that if you didn’t have some level of gallows humor, you would certainly lose your humanity. 

  • Joe Allen

    When you perform a hard task repeatedly, you form callouses. They protect the delicate tissue beneath, and allow you to continue to perform the task at hand. Sometimes, when you touch someone who has never had to toil at that kind of work, they can be rough and uncomfortable. Without them though, those hard tasks would leave you shredded and bloody.

    I pray to God that, in my hour of darkest need, He sends to me the calloused hands of a professional.

  • Jim

    Some of us walk with demons for company from time to time. We do what to most is unthinkable, on a daily basis. Often we eventually walk away and try to put the memories into a box tucked away deep inside and become “normal” again. For others it becomes a calling. Humor is shield to deflect the pain, the grief, and especially the fear. Others may not understand. Thankfully they don’t have to because they walk far from the demons. 

  • Bob

    If you don’t have or develop a dark sense of humor, you will never make it in this business.

  • Hawk839

    A very good question, one that has as many answers as there are people involved in EMS in any way. A memory from those days comes from taking a patient into ER that had more ‘frequent flyer’ miles with us than an airline pilot.  The patient actually kept a currant, up to date copy of the Physicians Desk Reference on her coffee table.  We’d see her 4, 5, or 6 times in a week, then nothing for a short while.  We took her in one day, it was the usual total BS call, but we did our job.  As we were checking her in at the ER, the receptionist asked “Any other medical problems?”, just as the MICU nurse walked by.  He muttered “Yeah, she survived birth”.  Hilarious to us, not to the patient, but it was good stress relief.  On the way back, I said to our paramedic/Captain “One of these days, we’re going to walk in & it’s going to be genuine, and we’re all going to stop & say ‘Oh shit'”.  The next day, just that happened.  I walked in, just to be handed the keys to the drug box, didn’t need to be told what to get, just went & got it & said just that.  We tereated & transported, never saw her for about 3 months, then it was back to the same old routine.  thinking about it, as I type this on the fly, I don’t think we ever truly lose our humanity, we just change & adapt to the situations we are in.  At least, I hope we don’t, because if any of us actually do, then it’s definitely time to call it a day.

  • SoCalEMS17

    Dispatchers are the same way… My first week on the job, a full arrest came in, we were DANGEROUSLY low unit levels, and I heard a coworker say “Hope this fucker is dead already”. I had to take a break, it scared the hell out of me that I could end up like that.

    Within six months… I was hoping for cancels, DOA’s, and Police Officers to get their heads out of their asses. Once you’re at that point, there’s no going back to the way you are, except for this moment of realization.

  • Colleen

    Love the blog. Thanks for being so honest. I am still such a newbie with a bunch of EMS Woo Woo thrown in. Yesterday I was at the pediatrician with my daughter. The receptionist says, “I dont know how you do it. You see so much horrible stuff.” I just looked and her and said, “We get used to it. Some of us are even called to it. It’s not that bad.” (Looking back I think I must of looked like Barney Fife when I said that.)  Then she asked if I was with XYZ Dept. I said, ” yes, that is one of them.”Then she said, “I sure miss Greg. I grew up with him. I looked at her and said, “Greg?” She replied with his last name. I quickly remembered the pain and helplessness. Greg was a young, promising firefighter in our dept.  that had been hit and killed by a drunk driver over a year ago.  I couldn’t speak. Tears starting running down my face. I waived my goodbye, as we were done checking out.  I guess in some areas I still dont have a callus. I just was not expecting her to say that. I was so caught off guard.

  • Countrymedic29

    I have found myself saying or thinking alot of the same things and when I make my mind up to change I get the bs calls and here I go again. So what’s there to do. After 6 yrs with 2 yrs being a medic I have found alot of calls I go on, I find myself I caught up in the, they have a car in the driveway why am I here, moment.

  • Protector

    I am still in the training phase of EMS. I just finished EMT school and on my way to Paramedic courses so I am in no place to critique you on your performance or your professionalism and I am not going to. I did however spend enough time downrange to see not only myself but everyone I lived with lose some of their humanity. You have to, it is one of the sacrifices that is demanded from “The Job” that everyone refers to when they talk about First Responders and Military Personnel. Like Adamedic said, it is a defense/coping mechanism. If you cannot find a way to tolerate the situation by any means necessary, including dark humor, you will lose your sanity before you lose anything else. But having the ability to look at yourself from an outside perspective shows that you do have humility and compassion. The day you need to question yourself is the day you don’t want to look at yourself from the outside. Keep up the great work man, you’re doing just fine.

  • terrywb

    I have recently asked a similar question. A very close friend and co worker had an answer for me. She asked me, ” Do you still talk to your paitents? Do you still try to put yourself in their shoes to get a better understanding of what they are going through, try to empathize with them?” My answer was, ” yes of course” and she replied to me that have not lost the “human touch” to the job.

    I agree with so many others here, the jokes are part of a coping method. And lets face it….. sometimes the jokes are pretty damn funny 

  • Stingray

    For what it’s worth, I lol’d hard at “if my calculations are correct”.
    Not sure if that’s in the “stop helping” category or not, but I for one hope someone drops one half that witty when I go.

  • Mike

    As others have said, you haven’t lost your humanity; it’s just being protected by the callus you mention in the title.  It was your humanity that made you feel ashamed when you looked at the faces above; someone who has truly lost their humanity would have continued making jokes about the onlookers, rather than realizing what had happened and leaving.

    As long as you can still notice such things, whether at the time, or later after the call, then you have your humanity; it’s just being protected by that sad but necessary callus of gallows humor and on-scene detachment.

  • Rnphrn

    Wow, thank you for sharing.  I have been feeling some of the same lately.  Your post was helpful.  The callus is there for protection.  I can see that underneath that, you have a good soul.  It might be tired, but it still contains compassion.  Will say a prayer for you tonight AD.  Thanks again.

  • David

    My grandmother’s last 10 years were a roller coaster descent into dementia.  During this time the insanity, anger and vitriol that she inflicted on everyone around her, in most cases, overwhelmed the 80 years of good will and memories that most of us were priviledged to experience some part of.

    Late the night before her funneral about 30 of us were standing around at the funeral home just killing time as family from out of town showed up.  I was trying really hard to focus on the first 30 years of my life and my memories of my grandmother from those years.  While I tried really hard to forget all the horribly insane things she had said and done to me the last 10 years.  My 18 year old niece who was struggling with the same problem leaned against me, and whispered “I really need you to say something stupid, or funny, or stupidly funny right now.”

    Trying to be funny was the last thing on my mind at the moment.  I looked down at her, then over to her mother, who nodded and said “We could all use that right now.”

    Great, a lifetime of being the irreverent family smartass was finally coming home to roost.  When they needed me to be just that guy and I had – nothing.  So I stood there with one arm around my 9 year old daughter whose only memories of her great-grandmother were one of an insane, hateful old woman, and the other around a young girl who desperately wanted to remember the kindly old woman who taught her to bake cookies, garden and spit sunflower seeds.  All I could do was trust in 40 years of smartassery instincts so I opened my mouth and heard “Do you think she is wearing those ugly old red garage sale shoes she loved?” came out.

    My funeral director, who was an old family friend, walked up to the casket, flipped open the part of the lid that covered grandma’s feet and sure enough – there were the ugly old red garage sale shoes, and the knee high nylon stockings that were always bunched around her ankles instead of pulled up to her knees.  Everyone in the room busted out laughing.

    Two hours later we were still laughing.  Family that wandered in late were stunned to find a room full of people hanging around an open coffin, eating fried spam sandwiches (grandma’s specialty) and telling their favorite no-shit-she-really-did-this story about grandma.

    Yes gallows humor is a self defense mechanism.  But sometimes it is just what you need.  And sometimes it is just what your family, or friends, or coworkers need.  It doesn’t make you evil, or heartless, or a bad example.  Maybe it just makes you the guy who filled a need for your coworkers at that moment.  The people who know you will know the kind of guy your really are.  The rest – who cares…

  • omar

    loose your humanity, or loose your sanity.  after 27 years in this job, i think i have lost a little of both.  it is part of the perks of the profession.