Grief – a paramedic’s ringside view
Every now and then a callout unfolds in a way that etches itself indelibly into your mind. Early evening, my partner and I are attending a man in cardiac arrest. He is in his fifties, an age I now argue vehemently is still young and prime of life. No prizes for guessing my age. The man has suddenly collapsed in his lounge room. Arriving minutes later, we have commenced CPR and called for intensive care ambulance support.
It is a hot night and soon we are both lathered in perspiration. The house, his home, is full of emotion even more than usual. His wife is already crying and occasionally screaming out at her husband to recover. She is slapping herself so hard, two younger women fight to restrain her. My assurances that we are doing everything is clearly useless as we continue to press his chest and ventilate his lungs.
Moments later, the front yard of the house is filled with light. The air vibrates with a sound that takes me a few moments to register and decipher. It is the ambulance helicopter and it is apparently landing in a school yard across the road. Most unexpected this is since we are in suburban Melbourne. They were literally flying overhead when the call went out. On the up side this event does have the effect of making her finally notice my ‘we are doing everything’ claims.
The IC flight paramedic and aircrewman arrive and, despite a textbook resuscitation effort, the man is eventually declared deceased some hour later. The relative calm the helicopter crew managed to bring dissipates immediately as this announcement vaporises all barriers to emotional release. Around me several people have thrown themselves onto the floor, his wife holds the man’s head literally banging it on the floor howling for him to return to life.
Normally we would try to move some of our equipment out of the way at such a time and similarly get ourselves out of the way. Expressions of emotion can be a very helpful in outpouring the grief. This was more extreme though and, unable to offer anything that could possibly help, we find ourselves trapped as unwitting witnesses in this drama.
As a young and very new paramedic, I was forced from the outset to face and deal with the concept of human grief. I was in fact no stranger to grief even by this early stage in my life. Despite my relatively short journey I had already been made to say goodbye to a mother, a brother and a sister already and dad didn’t last much longer. You really don’t expect to be the last person standing by your twenty first birthday but already I had just about run out of family members.
However as an ambo I now had to regularly watch close up what grief was like for others and the many forms it could unfold in. Ambulance school introduced me to the writer Kubler Ross who spoke of the different stages of grief. Though I cannot recall precisely what the entire theory was I think it included such diverse stepwise emotions as anger, denial, negotiation and bargaining and acceptance. This was the first time I had thought of grief as any sort of science rather than just one really bad time in a person’s life.
I have always believed that understanding the behaviour of others opens the door to predicting what they might then do. It can also increase your ability to empathise by seeing the world through their eyes. Surely these are useful skills to develop in all walks of life, especially as an ambo.
The shortcoming of the Kubler Ross theory, at least as far as a paramedic is concerned, is that pretty much only the first stage is ever going to be encountered. And encounter it we do. Every paramedic eventually acquires a plethora of grief stories. Some are even bizarrely comical, not that there is anything at all to laugh at in the grief of others. The ambulance world has a testing way of placing head shaking unbelievable side by side in the same moment with heart wrenching emotion.
The climax of this story is only just arriving though. Out the front of the house we hear tyres screeching. A car turns sharply from the street into the driveway. It is all too clear the car is travelling too fast. There is no front fence allowing the car to freely mount the kerb then onto the front lawn. Unbelievably the driver of the car opens his door and steps out of the car even while it is still rolling. Somehow managing to remain upright he climbs the front steps in almost one stride and launches himself into a room of already superheated emotion.
My attention is transfixed yet divided between the man’s dramatic entrance into this pandemonium of grief and the final continuation of the car’s short remaining journey. It rolls into the front wall of the house with an inevitable crashing sound. This was certainly loud and managed to turn the next few seconds into a shattering cacophony of noise. A giant window pane right before us on the front wall of the lounge looks surely set to shatter as the car impacts right beneath it. Incredibly it does not somehow avoiding showering everyone, including us, with glass. I exhale relieved.
This is the son who apparently is not going to be the tower of strength to hold the others together. Before any of us can speak to him he is given the news by another family member. Despite suspecting the worst already, he wails with the loudest grief stricken cry I have ever heard. He turns himself around in circles clutching his head.
He has one more surprise left for which none of us are prepared. Given all that has gone on in the last few minutes could there still be a surprise left? The man turns and in one bound throws himself through the miracle front window. Leaping forward to the jagged gaping opening, we can see he now lies, on his back, limbs splayed, sprawled across the front of his own car. He is covered in lacerations with bleeding already evident. The family howling amplifies now at this second terrible turn of events with all hope of any calm flying out that window with the son.
I don’t remember Kubler Ross describing any of the stages quite like this.
Jeff Kenneally www.prehemt.com