Ive spent a good 25 years of my life working on articulating my experience of having been one of the first paramedics in the country. My point of view has been the sheer wonder of working on the edge of life and death. I often joke that everything Ive learned about life, Ive learned in the back of an ambulance. Its no joke, really. Whereas others would think I would have learned about death, the fact is, I learned quite the opposite. One of my key conclusions is that given the proper outward and inner circumstances, I am quite capable of doing anything; no matter how horrid, morbid, or glorious. Thats just the way it is, and I suspect none of us is immune to it. One of my biggest prejudices as a medic was against people who threatened suicide and did not follow through. In my paramedic surety, I reasoned that, having been put in the situation time, and time again of struggling vainly to revive the life of someone who really wanted to live, I really had no patience with those who had life and wanted to end it. I learned to recognize when people were serious, and when they were not. I could sense pretty well when the thought of suicide was based on circumstances that would soon pass, or when the action of suicide was a logical next step in the persons life. One of my biggest professional conflicts occurred when I was attending a woman whom I had picked up no less than three times before on suicide attempts. I despised her, not because she wanted to kill herself, but because she had been so incompetent at it! Coming from my circumstances, I have to admit to a certain respect for those whom I arrived too late to save from their own hands. I admire conviction, almost no matter how expressed. I especially appreciated that I would not be wasting time with an attempt while someone else, wanting to live, was struggling. Something very unusual happened this time, however. I recognized that, unlike the other three attempts where fate chose me as her attendant, this time, she was really serious. My term for it is The switch was turned on. From here on she would not rest until she did herself in. Until that time I didnt recognize that there does seem to be an internal mechanism of self-destruction that, when activated, will pursue it until it is accomplished. Sometimes its fast, sometimes slow. What allowed me to put all this together was that, unlike most other of my attempted-suicide patients, she was quite articulate. She was actually resigned to it and at peace with it. I found myself asking her to tell me her story, which she did. Yes, the words were important but most important of all was, within the context of her life, she really had examined all the factors and options and come to a logical conclusion that death at her own hands not only made sense, but was welcomed. At the conclusion of her story which was a literal horror-story of a life on a terribly wrong, long and painful track she said these words: I realize that there was no pain I could suffer that would be worse than my continuing to live. I understood her. I believed her. She wasnt trying to convince anyone of anything. This is just the way it was. Then, for the first and the last time in my professional career, I found myself talking to a human being about the most effective and painless ways to do herself in. She did eventually follow-through, though neither on my shift nor in one of the ways I had instructed, thank God! I wrote about this in a chapter of my book A Paramedics Journey. At the time, I knew this would be the most controversial chapter. To test it out, I brought it to a writers group that I was thinking of joining. There were about ten people who met on a bi-weekly basis and read to each other from their evolving projects. This was a sort-of audition for me. I read the chapter, and not without a little trepidation, for few people understand how participating so intimately with lifes struggles shapes your worldview into something that could assault anyones civilized sensibilities. At the end of my reading, the silence was thicker than rubber. A couple of people shook their heads. One woman was crying. Another man, face pale as a ghost, simply said, Im speechless, and left. It felt like no one wanted to breech the subject, and there was a reason having something to do with someone in the room because I noticed them glancing at each other furtively. I had no idea of the details of how the chapter was affecting my audience because everyone seemed to be in a state of shock. Forget my worries about being accepted into the group, I was terrified that I would be viewed as a murderer. After about two minutes of blazing silence, a woman in her early twenties came to sit by me on the couch. She took my hand in hers and said these words, aloud, so all could hear them: In the last year, Ive had two of my sisters commit suicide. Ive never been able to start to grasp any of it until now. Thank you, I have something to work with. I suddenly found myself amidst a group of friends, all of us struggling to explore our own reasons for living. Next, second chances. |
