Signs Of Life

I’m an EMT volunteer who knew the paramedics ‘working my mother.’ Reboarding an ambulance after her death, I discovered a new dimension to my service.

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That January day the high temperature was just eight degrees, unusually cold for the DC-area. In the early afternoon, my mother bundled up and drove to pick up my non-verbal, autistic daughter from school, as she did every day during the week. They came home, she unpacked my daughter’s lunch, they went upstairs, and my mother died very suddenly. What happened in those few hours until my husband came home and found my mother on the landing, with our daughter circling her in vain, will remain forever a mystery.

EMS

The author

The EMS crew responding to my husband’s 911 call worked at the fire department where I volunteer as an EMT. I like and respect the paramedics who “worked my mother,” as we say. Our house, as is customary in such cases, was crawling with EMTs and police officers that afternoon. At the time, I was in Los Angeles on a work trip. So many people who knew me knew about my mother’s fate, as I sat in a sunny conference room, blissfully unaware of the events unfolding at home.

My mother was relatively young – she had turned sixty-seven days before she died. She had no cardiac history. She’d never even been really ill or hospitalized. She was the glue that held my life together – helping me care for my two disabled children so that my husband and I could work to provide for their needs, and sitting on the other end of the occasional long phone call as I droned on about problems endlessly while she silently sympathized, as if she had none of her own. To say her death was a shock to our family is an understatement.

She loved poetry. Once, she read me T.S. Eliot’s “The Hollow Men.” In the days after she died, the final stanza replayed in my mind:

This is the way the world ends
This is the way the world ends
This is the way the world ends
Not with a bang but a whimper.

Her world ended with bang for me because it was sudden, but with a whimper to the outside world, because on that remarkably cold day that she died, EMS services in our county experienced a six-fold spike in number of calls – so remarkable that our then-Chief wrote an email to all of us a few weeks afterward to thank us for our deftness in handling such a massive spike in the demand for our services (and a remarkable spike in the number of deaths – pathologists always say people die in bunches).

With that, my mother faded into one of the many.

And I was left to figure out the rest of my life and how to get back to it. “What if,” I thought, “the next call comes and it is a cardiac arrest?” Panic formed a lump that lodged in my throat, threatening to choke me. “What will I do? Will I break down in front of the family? In front of my colleagues?” I returned to the station a few weeks after my mother’s memorial service to colleagues who hugged me before looking uncomfortably at their shoes, and I wondered if I could do this anymore.

Then the State of Maryland changed its protocols for EMS providers. We were now entitled to stop resuscitation efforts in some circumstances, and to declare death in the field. We were also required to be trained on how to relate to families in which “the loved one does not have a good outcome.” I stared, unblinking, the first time I attended the training. I wanted to be anywhere on Earth, other than there. Perhaps the title was too much: “Break It To Me Gently.”  How can the unexpected death of a loved one ever be gentle?

I went hiking in the mountains that summer, hoping to forget all about it. I thought that my life in EMS was over, a life of service I once felt so strongly was part of my obligation to give back to a world that had given me so much. Once in the mountains, though, I did a lot of thinking, and I felt I could find my way back. I just needed to find a new way of relating to patients and their families.

A year passed. Shortly thereafter, I slowly started riding the ambulance again. The distance had indeed given me some perspective. When I looked at the worried faces of a patient’s family members, I stopped looking for my face there. Each person’s fear, grief and loss is unique, and that is true for each individual family member. I reminded myself I had to entitle people to their own experience, and that I could not analogize their situation to mine. I learned I could risk showing compassion, and that my relationship to families (and patients) would be better for it.

I’d love to tell you what happened made me a better EMT, but I am not sure that it has. What I am sure of is that it did add a new dimension to what I bring as a first-responder, and that by giving myself time and space to heal, I looked inside myself and found signs of life.

Deana Cairo is a volunteer EMT with and the President of the Silver Spring Volunteer Fire Department in Maryland.  You can find her at yourinsidevoice.net.  

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