We’ve all heard it. Chances are, once people find out you’re a paramedic, as often as not they’ll ask “What’s the worst thing you’ve ever seen?” I’m sure doctors and nurses and firefighters and police get the same question. Maybe other jobs as well.
I usually deflect it with something like “my last raise,” which tends to get a smile and maybe gets me out of really answering the question. Because there’s no good way to answer it.
If I’m being honest, you do not want to know the worst thing I’ve seen. And I don’t particularly want to tell you about it.
People either totally understand that sentence, or they don’t. If you work in certain fields, you know what I mean, and if you don’t, well, you won’t get it. Everybody has bad days at work. But we, in emergency medicine, have Bad Days at work.
I’m not trying to play the martyr here. I have a lot more good days, and I love my job most of the time. I knew a long time ago I was going to be an EMS lifer, and I accepted it, warts and all. Never much regretted it. And there are jobs with worse Bad Days than mine. Thing is, I don’t ask people about their worst day.
Don’t get me wrong, I have plenty of stories. I’m thrilled to talk about the funny stuff. Or at least the stuff that medics find funny. Even the embarrassing funny stuff, like the time I tried to walk a paraplegic to the stretcher. Or the time that I had a patient respond to my questions with “No English,” so I switched to Spanish, only to learn that the nice Vietnamese lady didn’t speak that either.
But that’s not what people want to hear about when they ask about things I’ve seen. They want to hear about blood and guts. Car crashes and shootings and machete attacks. That’s not even weird, really. People love blood and violence at a nice safe remove. Just look at the highest grossing movies of any given year and see how many lack a body count.
Thing is, though, blood and guts don’t bother me. They’re just a part of the job. Carpenters don’t get freaked out by sawdust. If trauma upset me, I wouldn’t be a medic. The world needs bartenders, too.
The stuff that’s ickier than blood– smellier, stickier, altogether more disgusting– that doesn’t really scar me either. It’s not a part of the job I like, per se, but it’s something I deal with and then move on.
Even death, most of the time, really isn’t all that horrifying. It’s something we see a lot of, and while it’s not the outcome we want, we get used to it. Most of the time, when we see death, it’s in the very elderly, and we tell ourselves they had a good run, or the very ill, where it’s kind of a relief. Those cases tend to roll off my back. There wasn’t much we could have done. Sooner or later life is terminal.
I can start my shift with an elderly nursing home patient who was found in cardiac arrest when the staff came to hand out morning meds, work in an end-stage cancer patient who has finally succumbed, treat a few messy medical calls, a table saw amputation, a multi car crash and finish up with a gang shooting then go home and sleep like a baby.
What bothers me, what really defines the calls that stay with me, is to see a young life wasted. Death is coming for us all, but sometimes it get impatient, and that’s just not something you’re ever supposed to see. It’s usually unexpected, and hits not just the victim but the family the community and us: police, fire, EMS and the ER, hard. The prom night crashes, the chokings, the accident with young children. Those are the things that haunt us. The calls that leave crews shattered.
And none of us want to tell those stories, or hear those stories.
So, when I’m asked what the worst thing I’ve ever seen is, I try to deflect it with humor. If that doesn’t work, I have to make a choice. That choice is how brutal I want to be. Sure, the question is in poor taste, and people shouldn’t ask, but mostly they don’t know any better. So I have to decide if I want to tell a funny story and laugh about it, or tell about a machete attack, which is what they want, and probably reinforces the questioner’s bad behavior but doesn’t take a toll on me to tell and is the fastest way we get to move on, or do I want to make a point, ruin the evening and come across as a jerk, and pay the price for that, but make them understand?
So, the worst thing I’ve dealt with in sixteen years of EMS is doing CPR on an eight year old pulled from under the ice of a frozen river in December, knowing that the odds were terrible but we had to try, and continuing to work him at the ER for an hour because of his age and hypothermia and that teasing bitch that is hope, knowing his family was waiting for him to walk through the door at his house, wondering why he was late, and knowing that he probably had presents under the tree with his name on them that would never be opened.
That’s the worst thing I’ve ever dealt with.
The eager look in people’s eyes when they ask me the worst thing I’ve seen is up there, but it’s not very close.