"There's a man lying on the level crossing, he's been hit by a car. He's not breathing, and there's stuff coming out his mouth."
I pulled on trousers and t-shirt, still wet, and stuffed on my shoes. Unthinkingly I grabbed my stethoscope and sprinted out the house, vaulting over the garden wall. I could see cars stopped and a crowd of people at the rail tracks in the distance. A man looked at me as I ran past.
"Someone's been hit by a car. It's real bad."
I felt annoyed with him in that split second. Did he think I always ran down the street in skinny jogging bottoms, sopping wet?
As I approached I could see the man's body and someone doing chest compressions. My neighbour was there and she motioned me over.
I could not feel a major pulse. He was not making meaningful attempts at breathing by himself. I took over performing chest compressions, and giving mouth-to-mouth breaths.
In hospital we have nice bags and masks to assist people with their breathing in the case of cardiac arrest. Even when you practice CPR in simulated scenarios, there are hygienic plastic covers to place over the mannequin's mouth, which we then clean with antibacterial wipes. My job allows a strange degree of intimacy with complete strangers. We palpate their bodies to assess for signs of disease. We listen to their fears and concerns and worries about their life; because it usually does not stop at just their chest pain or breathlessness. This professional intimacy is where our own emotions cannot be engaged too much and are usually tightly tethered, safely away from the difficulty and pain of others' lives which we sometimes have to deal with. We cannot connect on a deeply emotional level with every patient we see, and it is not helpful for them for us to do so. How do you deal with drug and alcohol abuse and poverty and mental illness and chronic diseases and trauma and death and feel the depth of the effect that these have on people?
I have cried at work once. An elderly lady begged me to remove the feeding tube from her stomach. She and her husband held hands and cried and told me how happy they had been but that now it was time for her to die. The old lady said that the most important thing you can have in a relationship is trust, and she trusted her husband. But many scenes in my short career have burned themselves on my memory: a toddler smothered almost to death by a distraught teenage mother; a relapsed drug user who was at the end of himself; hearing the screams of a woman who hears that her husband has died in an accident which she survived; the attempted murder of a woman by her partner; telling someone they have lung cancer, with a secondary deposit to their brain. This is messy, gory, painful life, which we see and hear and feel yet protect ourselves from as best as we can. We know it happens to others, and we have inklings that it could be us. It may have been us already.
I have cried at work once. An elderly lady begged me to remove the feeding tube from her stomach. She and her husband held hands and cried and told me how happy they had been but that now it was time for her to die. The old lady said that the most important thing you can have in a relationship is trust, and she trusted her husband. But many scenes in my short career have burned themselves on my memory: a toddler smothered almost to death by a distraught teenage mother; a relapsed drug user who was at the end of himself; hearing the screams of a woman who hears that her husband has died in an accident which she survived; the attempted murder of a woman by her partner; telling someone they have lung cancer, with a secondary deposit to their brain. This is messy, gory, painful life, which we see and hear and feel yet protect ourselves from as best as we can. We know it happens to others, and we have inklings that it could be us. It may have been us already.
This was a new experience however, which anyone might have to do at some point in life. Putting one's mouth over the mouth of a stranger on the road, trying to exhale some of your own respired air into their lungs with the hope that the blood you are manually pushing round their circulation soaks up some oxygen at the blood-alveolar interface. It cut through those protective processes I have erected. My reflex was to spit the moisture from his mouth which was now on mine. This somehow felt too crude, even disrespectful to the man and shocking to bystanders. There was no plastic between me and him. It was just my breath into him, my mouth over his.
It was difficult to tell whether the man was making some 'death' or agonal breaths, or whether his stomach contents was refluxing from the vigorous chest compressions. This man who had been hit from his bike by a car travelling at 50kmh and who was at high risk of having an injury to his spinal cord.
I was already aware that without monitoring of this man and intravenous access and medications, and then eventually x-ray and CT scans, the only paltry offering I could bring was effective CPR. Now there was the decision to protect his airway and to risk potential future disability. I thought he was going to vomit so I turned his head.
I was already aware that without monitoring of this man and intravenous access and medications, and then eventually x-ray and CT scans, the only paltry offering I could bring was effective CPR. Now there was the decision to protect his airway and to risk potential future disability. I thought he was going to vomit so I turned his head.
*******
I don't want to conjecture too much about this man, out of respect for him and his family at this time. I know nothing of him, or the grief that they are experiencing. My impression was that he was incredibly fit, late on in life. Maybe, now retired, he spent his days relaxing, cycling, enjoying his beautiful city. I wondered if, after his cycle, he would meet his wife for coffee at the beach. Maybe they had grown children, and grandchildren, their reward for long years of work and busyness.
It feels so cruel and harsh, a dreadful, real outcome of his chosen sport and some moments of a combination of an unknown quantity of factors. I was an observer in some dreadful moments of his life, imparting some attempt at stemming the effects of a traumatic injury.
How do we remain feeling and open to the trauma that we see around us? People are beheaded in the name of revenge and for a greater cause. Missiles are fired in the name of an even greater cause. A gas explosion happens in the middle of the night, and a man waits to find out the outcome of his missing wife and baby.
It is a wonderful gift of being human that we do continue hoping and acting and working to combat tragedy. This in itself is an incredibly uniting thing. Some kind of unspoken, even divine, spark keeps us believing and not bowing to nihilism or fatalism. We keep trying to be a force for good and change, in most cases. And it is a struggle sometimes, not to relax into cynicism and an acceptance of the status quo.
May we all continue, in our little ever-expanding ripples of influence, believe in the possibility of change and rehabilitation and healing and peace.
How do we remain feeling and open to the trauma that we see around us? People are beheaded in the name of revenge and for a greater cause. Missiles are fired in the name of an even greater cause. A gas explosion happens in the middle of the night, and a man waits to find out the outcome of his missing wife and baby.
It is a wonderful gift of being human that we do continue hoping and acting and working to combat tragedy. This in itself is an incredibly uniting thing. Some kind of unspoken, even divine, spark keeps us believing and not bowing to nihilism or fatalism. We keep trying to be a force for good and change, in most cases. And it is a struggle sometimes, not to relax into cynicism and an acceptance of the status quo.
May we all continue, in our little ever-expanding ripples of influence, believe in the possibility of change and rehabilitation and healing and peace.
