Cardiac & Resuscitation, Major Incidents, Operations, Trauma

Effects of Grief

Issue 7 and Volume 36.

I’m awed by some of the problems you face in the field today, Life-Saver. I’m thinking of at least three new challenges that are tougher than anything I ever encountered.

For one thing, I think the public is more dangerous today. They’re angry. Consider the proliferation of international conflicts we see all around us: the outright contempt that pervaded the past two elections, the venomous disrespect we find in so many blogs between people who’ve never met and the hatred that’s spewed like emesis by the most popular radio talk show hosts. (You don’t hate everybody who disagrees with you, right? That’s the worst kind of arrogance.)

This year’s Grammy winner for best song was Neil Young’s “Angry World,” and it’s a sho-’nuff tirade. A month prior to the writing of this article, somebody shot a uniformed paramedic, fergoshsakes, who was just doing his job. And two days later, somebody beat another medic half to death over a major-league baseball game. (A baseball game?)

People seem depressed, too. So many of them seem to believe they have nothing to lose. When you put your life’s savings into a retirement account or a house, and the bank or the market fails, that’s scary. When a tornado turns your home into toothpicks, or an oil leak destroys your whole world, those are things you don’t deserve and can’t control. Throw in the loss of your income and maybe a divorce, and it’s not too hard to imagine how you might lose hope. Our little system here in
Colorado has seen a doubling of completed suicides during the past two years, most notably hangings.

Finally, it seems to me that fewer people naturally tell the truth nowadays. Of course, field providers have always been lied to for a living. We all try not to take that too personally, but it’s never fun. We’ve talked about lying before in this column. We learned long ago how common it is among cardiac patients to deny their chest pain, just as we learned to expect denial when people lose their loved ones. Denial is how an addict supports their addiction. Lying is certainly standard practice in law and politics. And among ordinary people, it seems to be a common way to deal with stress.

So … anger, depression and denial. Do those three things sound familiar? Of course they do; we recognize them as stages of grief, don’t we? And when you think of the losses so many of us have suffered, grief makes sense: The loss of our innocence, maybe or our sense of control over our own destinies. And maybe our general respect for one another.

I think many people today are simply scared. They’re buried in so much digital bad news that many of them (and us) are overwhelmed. Not only that, but have you noticed that people have changed the way they communicate? People compress thoughts into text messages instead of talking to one another in complete sentences. Not only does texting limit the content of our messages, but it also presupposes we’re all functionally literate.

And if you’ve visited even one blog site, you know that ain’t necessarily so. Most of us seem to have lost the ability to construct a proper sentence, punctuate and spell. Those skills are important, considering how much we all depend on subtle things like our choice of words, our inflection and our tone of voice to interact verbally.

Texting empowers you to express yourself instantly, but it curtails your ability to assess the effectiveness of your words—like, say, talking to somebody who can instantly give you feedback in the form of a facial expression, a question or even tears.

All of which is important, considering what you do most of the time: take care of ordinary people, many of whom are having the worst days of their lives. Maybe it’s a little easier to tolerate someone’s dishonesty, anger or outright verbal abuse when you realize they’re just scared to death. And maybe it’s also easier to tolerate the angst of a colleague (or even a friend) who’s having a bad time of their own.

Twenty thousand patients (and some fine caregivers) have taught me to see fear as a component of all suffering. And for whatever it’s worth, I’ve noticed that when you mitigate somebody’s fear, everything else you do for them matters just a little more.
Good thing to know when you’re trying to help somebody, and they retaliate instead of telling you this: Thanks, for all you do! JEMS

This article originally appeared in July 2011 JEMS as “Scary Behaviors: Is this grief we’re seeing here?”