There are times when there is nothing so fine as being an EMT. Delivering a baby, seeing a heart rhythm change from the ugly death scrawl of ventricular fibrillation to a perfusing rhythm, feeling your patient take a breath through the bag-mask that was only moments before providing the life-sustaining oxygen that the patient could not…
… those are the moments we live for.
We don't even need to see the child grow up, or see the patient we saved celebrate a second shot at life with his family. Thanks are nice, but not necessary. Birthday party invitations are more Rescue 911 than real life, anyway, and our imaginations are quite good enough to fill in the blanks.
We know what we did. We know what it meant. And we know that not just anyone could do it. Sure, luck and timing play a large role, and CPR can be learned by laypeople, but to do what we do, day in and day out… it takes someone special.
It takes an EMT.
And when you are an EMT, there are also days that try your patience, and your anger management, and your understanding, and your love for your fellow man, and your physical stamina. Those days always outnumber the good ones. That's why it takes stern stuff to make an EMT. Martin Luther King said it best:
"We must combine the toughness of the serpent with the softness of the dove, a tough mind and a tender heart."
It is a rare and wonderful thing to find those qualities in equal measure within the same person, but somehow EMT's manage to pull it off.
And then there are days like Friday, when nothing can prepare you for the horror you faced, and no amount of code saves, or babies birthed, or little old ladies comforted, no amount of joy your career as an EMT has brought you before or since, can erase the scar it leaves on your soul. You only triaged three from Sandy Hook School as red. All the rest were blacks. Only one you transported lived beyond the Emergency Department. And given that you're a small volunteer department, odds are you knew many of the children killed.
People who do not work in EMS do not understand triage. Sure, they may grasp the concept of it; sickest transported first, stable patients transported next to last, dead patients transported last of all. They may even know what the colors red, yellow, black and green signify.
But what they can never know is the pain in making the decision, the awful, horrible knowledge that some of the patients you triage as black… still have signs of life. And they will never know the doubt that creeps at the edge of your mind, never know the torture you will feel as you ask yourself in the days, months and years to come if your decision was the right one.
They'll never know how often you played "If only…" in the dead of the night as your wife or husband held you and brushed the tears away. They'll never know how hard it is to face the parents of the dead children, parents you know, parents you work and go to church with, and wonder if you could not have done more. And when they thank you and tell you how grateful they are for everything you did, it only twists the knife.
If only we'd gotten there sooner…
If only there had been more of us…
I'm just a volunteer EMT. If only I had been a paramedic, that innocent child I triaged as a black might have been a red…
If only I had been more skilled, maybe one of them would be alive to celebrate Christmas. At least one family would have some joy this season…
And nothing I can say or do will spare you those thoughts.
Days like Friday will shake the faith of the most devout, make you question the existence of a merciful and loving God. And those who do not believe will take it as further proof that there is none, but their faith in the goodness of their fellow man will be shaken just the same.
Days like Friday will cause despair to gnaw at your soul, casting doubt on every decision you make. Do you really make a difference? Does anything you did really matter? I'm a volunteer, this isn't even my real job. Why do I keep doing this? Am I ever going to feel whole again? God, I must be a selfish bastard, my kid wasn't even killed and I'm still a wreck…
And you know, plenty of people in our own profession have belittled you in the past. You're volunteers. You're poorly trained. You aren't even real professionals, you're just… EMS hobbyists.
But most of us don't feel that way. Some of us know what you're going through, and we ache for you, powerless to take away your pain.
And you know how maddening, and discouraging it is for an EMT to feel powerless to do something.
And many of us, myself included, don't know what you're going through, and we pray that we never know.
But we feel your pain nonetheless, and if knowing that millions of other EMT's pray for your peace and comfort tonight… well, you know. We are.
At times like this, pundits will opine and politicians will dance in the blood of the innocent to advance their political agendas, and most of them – on both sides – will be wrong. People will debate the superficial and simplistic reasons and the unworkable and politically expedient solutions fiercely on Facebook and social media and television and print and radio. I am ashamed to say, I have engaged in it myself. Too easily forgotten in the fighting are the names of the fallen. Too easily forgotten are your names, and what you did.
This EMT will not forget. This EMT will not mention – ever – the name of the shooter, but I will remember you, Newtown Volunteer Ambulance Corps.
I may not know any of you. I've lectured in Connecticut enough times, and to enough volunteers, that there's a good chance I've met at least some of you. Earlier this year, I was privileged to attend the wedding of a Connecticut state trooper and former paramedic. I watched the camaraderie and brotherhood shared by he and his fellow troopers at the reception. Those guys love each other.
And in the past two days, that young man and several of his compatriots have been at Sandy Hook, identifying bodies, comforting parents, protecting and serving the citizens of Newtown. Their nightmares are just beginning, too.
And I pray for their peace and comfort as well.
It is too trite and easy to chalk this up to the actions of one evil man. Evil is too convenient a label, and to do so tars other innocent children with autism spectrum disorder with the same hateful brush. They're going to suffer from this as well. The mentally ill are already stigmatized in this country, and Friday will only make it worse. Evil is an easy label for a complex problem.
If you want to label something as evil, label the system – or lack of one - that allowed this young man to implode. We have no organized framework to speak of for treating them. It's part of the same fragmented, pushed-to-the-brink-of-collapse system you see every day, every time you transport someone with a minor ailment that could be treated at home, every time you drop off a patient at an ED packed to the gills with people who are healthier than you are.
And it is natural, especially after a day like Friday, to ask yourself what can make a difference. It is natural to believe that despair always wins in the end, that entropy is the natural order of the universe. But there is one thing that will always expose that thought for the lie it is:
You win just by showing up.
It matters not what skills you employed, or what resources you did or didn't have, or what you might do differently next time, given the harsh lessons of Friday.
You win just by showing up.
Every time you get on the ambulance, every time the tones go out and you leave your dinner and your loved ones, we win a little victory against entropy.
Every bandage you place, every hand you hold, every medication you administer – even when you know it is probably too late - you beat back the darkness a little more.
And yes, even when you place that black tag, you win. It doesn't feel like it now, but imagine the pain of being a parent of one of the children killed… and no one showed up to help.
You win just by showing up.
Friday, you showed twenty-six families that for every madman who lashes out in a wanton act of destruction, there are twenty more people who will show up to pick up the pieces.
For every man bent on doing violence, twenty more show up, bringing kindness and acts of mercy.
For every calculated act of hatred, you counter with a dozen simple acts of love and selflessness that are as natural to you as breathing. You don't even think about them, you do them so often.
Sure, you're goofy-looking angels with your turnout gear and rumpled uniforms and bed hair, but only to people who don't look close enough to see your wings. And the people who need you most never care what you look like.
Because you brought hope just by showing up.
So in the days to come, know that millions of EMT's around the country are proud of you, just for showing up. Monday morning quarterbacks will eventually dissect your response and point out all the things they think you did wrong, judging you with the benefit of hindsight. They'll have months to second-guess the decisions you had seconds or minutes to make.
Don't let them bother you. Learn what lessons you can from this, pass what lessons you've learned onto others, and above all, look out for each other just like you look out for the citizens of Newtown. Spread those acts of kindness and understanding and mercy among your fellow squad members, because even the healers need help from time to time.
I'm just a simple medic who writes a blog. I have no answers, no profound truths to share. I have no money to donate. But I do understand brotherhood, and I am proud you are part of mine. Before I close, I'd like to share with you a poem that has brough strength and solace to men far greater and more eloquent than I. May it do the same for you, and your fellow responders from surrounding towns, and the men and women of the Connecticut State Police, and most especially the parents and families of the slain:
Out of the night that covers me,
Black as the pit from pole to pole,
I thank whatever gods may be
For my unconquerable soul.
In the fell clutch of circumstance
I have not winced nor cried aloud.
Under the bludgeonings of chance
My head is bloody, but unbowed.
Beyond this place of wrath and tears
Looms but the Horror of the shade,
And yet the menace of the years
Finds and shall find me unafraid.
It matters not how strait the gate,
How charged with punishments the scroll.
I am the master of my fate:
I am the captain of my soul.
God bless you all, and may you keep showing up.