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Guest Editorial By Tracey A. Loscar, MICP The Psychology of the Shirt Why you may need to distance yourself from injured colleagues As our EMS careers progress, we become accustomed patient became ghost-white and said, “I’m to being exposed to images and situations in our everyday going to pass out.” working lives that devastate those involved and can deeply With his injury covered it was hard to process affect witnesses and caregivers alike. Through this process of what was going on. I ended up saying, “Come gradual and continuous exposure, we often become inured to on now! We can do this, it’s what we do.” As such situations and incidents, taking the trauma for granted a unit, the four of us grabbed him and lifted and letting it wash over us like water off a duck’s back. him onto the stretcher. As we started to realize Sometimes we’re accused of being impersonal, distant and we were dealing with a blast injury, it became not invested enough, but such mechanisms serve to shield us clear what our next steps should be. At that and keep us functional. point, I noticed his shirt, really noticed it. He It is when we personally identify with a patient that we risk was wearing a summer uniform shirt and losing the cushion of distance that helps protect our psyches looked just like the rest of us. We were trying and allows us to perform in high-stress situations. For some to check his chest and back without removing providers, calls involving children are especially challenging, the shirt. I grabbed his shirt, looked at the for others it might be when responding to victims of a EMT next to me and said, “We have to cut it.” particular crime. However, there is one situation that leaves Doesn’t sound like such a big deal, does it? providers vulnerable to their emotions—responding to That’s what we do with trauma patients; we line-of-duty incidents. When the patient is one of your own, cut off their clothes. But in our eyes, he wasn’t a patient, he everything seems to change. Seasoned veterans can lose their focus, while brand-new providers might ﬁnd emotional reserves they didn’t know they had. But why are such calls was one of us. We started to cut off his shirt and the rubber band snapped, just like that. Time returned to normal, we started to talk above him and around him, and things got “patient the When particularly challenging? done to the best of our ability. In fact, the surgeons reported It has to do with identity. Our badges, patches and uniforms that our initial actions contributed to their ability to save and is one of deﬁne who we are. They tell the outside world that we will be rebuild as much of his hand as they could. calling the shots during the next 30 minutes. Our uniforms There is no layer of invulnerability sewn into our uniform
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