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This past week I had nearly finished a new set of writings for the JEMS Web site. The pieces started out describing an evening on a gambling boat and led to a discussion of why both casinos and EMS managers need to think of people as numbers. It seemed a decent concept as it came to life on my computer, and someday it still may be.

But then I logged onto my Internet provider to find a thin young man in an orange jumpsuit sitting quietly before five hooded men. The headline below said he had been beheaded. Clicking on the link there was video of the man a boy, really looking passively into the camera, obviously having no idea what was being said or what was to happen, occasionally shrugging his shoulders in ... impatience? Boredom? Then the clip ended. Like a typical EMS person I had to know the details. I found them in the matching article. Dragged to the floor. A long knife. Five cuts. Screaming. Slaughter. Display.

I recently took a personality test that classified you by shape. I came out as a squiggle, meaning that I tend to move from one thing to the next in rapid succession, never quite knowing where the chips are going to fall. It s great to be a squiggle if you multitask in the heat of the moment. It s hellish when you finally get focused and your thoughts feed off one another.

As clinicians, we re very good about shutting out feelings. So first came the rational searching for the clinical details and the political motivations. Slowly I felt the anger and, as it grew, the need for revenge. And then intellect yielded to sentiment in the absolute brutality of the act. Soon I saw myself back in Zaire, where I had arrived to help cholera victims just after the massacres in Rwanda. I saw again the bodies left on straw mats by the roadside and recalled both the stench of death and my revulsion at getting over it. And then I saw children. I saw the photo of the starving child, crying for food as a vulture stood patiently nearby. There were the two small boys in Zaire, one five and one two, caring for each other in the refugee camp. (Why didn t I take them back with me? No one would have known. They had nobody left to care.) And then I saw me, born in another time and another place, trying to console my little boy, trying to make him laugh as the gas fell down around our faces.

I ve been sleepwalking through life and not sleeping when I should since that day last week. Every time to I try to write, to keep to my deadlines, to finish the work I started, I keep thinking how utterly meaningless our little world of EMS really is compared with the sheer needs of the world. And while my thesis that sometimes it s OK for managers to think of people as numbers may still be valid, it has been replaced with the realization that I can t reconcile it with the millions just a number, mind you who died in the Holocaust, in Rwanda, in the Balkans, in the Soviet Union, under the dictatorships of Latin America. And these are only the ones we have pictures of.

I ve been trying hard to find an EMS lesson in all this. If there is one, it has to be that as people caring for people, we need to stop the madness. I don t know how to do it, but I m convinced that many have no interest in a solution. Violence and intimidation are power, and if power is the ultimate aphrodisiac, then conquest must be ultimate climax.

To be honest, I m beyond caring whose fault it is or how it gets fixed. It s a desperation born of disgust at anyone or anything that claims the will of God or the needs of man to justify the ways of man to oppress, to starve and to kill; to use people especially children as pawns, as sacrifices for causes not of their choosing.

I just can t handle the thought that my son who even now sleeps because he knows his Daddy, his puppy, his stuffed toys and God will keep him safe from the monsters under the bed might someday be a victim of someone s hate simply for who he is. I have this nightmare of him screaming in pain, crying out for his Daddy to protect him from the world.

I checked on my little boy seven times last night. Just as my father did with me, I poked him gently to make sure he moved. I kissed his head and put my hand on his chest to feel his breathing. Each time I did, I prayed that he would never care enough about helping others or a sense of duty to put himself in harm s way. That s not right, and I know that. But I m his Daddy, and I need to keep him safe.

As long as this culture of hate and slaughter are out there, I can never really keep him safe. That s my burden and mine alone.

But maybe someday, together, we might ...


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