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Critical Care


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									             Life Support
                                                                                                                        By Mike Rubin, BS, NREMT-P

              Critical Care
              Compassion won’t weaken us as providers—in fact, it’s often what we need

                Some calls stay with us longer than others. You know what         providing comfort, all I did was listen to her and, occasionally,
              I mean.                                                             respond. Care was secondary to caring—a new concept for
                My patient was a 50-ish female complaining of…well,               me that seemed to work for both of us.
              she wasn’t really complaining about anything. I found her             Do feelings interfere with our performance? Many of
              contracted in bed with animated eyes and a sly smile. I             my colleagues would respond affirmatively. The “John
              learned from her daughter that mom had spina bifida and              Wayne” culture of essential services discourages emotion.
              was in constant pain. She also seemed to be a little short          Expressions of empathy for patients frequently are regarded
              of breath. When I announced, after a brief exam, that her           as weaknesses to be wrung out of providers during primary
              fever and congestion could be signs of pneumonia, my                training. Failure to recognize a middle ground between
              patient exclaimed that she would gladly tolerate any illness        ineffectual sentimentality and robotic comportment leads
              responsible for attracting such a handsome man to her               to reinforcement of the Spartan self-image some of us
              bedroom.                                                            cultivate. We are beginning to understand, however, that
                I think she caught me looking around for a handsome man.          stoicism is less healthy than prompt, informal discussion of
              She tugged at my hand to regain my attention, then told me          acute stressors with family and friends.
              I reminded her of her late husband, except he wasn’t bald.            None of the people I know who resigned after years of

  Care        Her mischievous expression dissolved during a coughing fit,
              but returned when I promised to carry her from her bed to
              our stretcher. As I lifted her scoliotic frame, she asked if that
                                                                                  unhappiness in EMS blamed “caring too much” for their
                                                                                  career change. Quite the opposite: Most of them complained
                                                                                  of apathy, accompanied by a sense of hopelessness. Perhaps
              meant we were engaged.                                              a more robust support structure would have reassured them
secondary       I transported her a second time after her illness had             that they still could make a difference, one patient at a
 to caring    progressed. We indulged in the same playful banter just             time.
              days before she died. I learned of the outcome when her               It would be naive to portray all of our customers as selfless
 —a new       daughter and I nearly sideswiped each other’s shopping              romantics who see us as their spiritual guides. Some merely
  concept     carts in a supermarket aisle. I was surprised at how many           want the facts—and maybe a sliver of speculation—about

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