Misunderstanding Trauma Junkies

“How’s your patient?”
“He’s easy, I’m kinda bored.”
“Ah bummer.”
“I know, right? Sometimes I wonder if that makes me sick myself for liking the challenge of a sick patient.”
“I don’t think so.”
“I never wish for someone to be sick, I just prefer them over the routine ones.”

It was a conversation I had with a fellow clinician regarding a patient she was caring for. And it brought up an interesting dilemma that those of us who care for the sick and dying find ourselves in. It’s common for us to enjoy the rush, the challenge, and the camaraderie often found in those moments.

But it’s hard to be open about it, especially around those who are not directly familiar with what it is we do. It’s easy to appear brash, uncaring, morbid, and even malevolent. It’s hard to describe a sense of satisfaction experienced through someone else’s tragedy without appearing twisted. 

There are plenty of us that often feel this way. Most of us only express these feelings in the confidence of others who share similar sentiments. We keep these feelings to ourselves when around the civilian world as it’s unbecoming to our respective professions. But these feelings exist in many of us. We derive satisfaction from the role we play in tragedy – we are called “Trauma Junkies.”

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Details of this event have been changed or intentionally left vague in respect to the victims and those involved.
Reader caution: graphic trauma is depicted.

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The national news described it as a horrific tragedy, a senseless act that left one dead and several others injured after a deadly assault; and they were right – it was. My heart goes out to the victims of that day. They truly experienced horror. But the memory of my involvement and my perspective of the role I played in it is something extremely different.

I describe it as awesome, amazing, exhilarating. A call that I will remember with a certain fondness for a long time. It was the kind of call that makes me love my job – the reason why EMS is amazing. It is the reason why I am proud of what my colleagues and I do every day. It feels wrong to remember a tragedy this way, but I do. So many times I have held back expressing that I found satisfaction in my involvement in these types of incidents. It’s easier than trying to explain that I in fact enjoyed the role I played in it. 

I walked with purpose alongside my partner towards the approaching ambulance carrying my gear. I was ready. I was not sure what I would be met with in the back of that ambulance, but I had a pretty good idea that it wasn’t going to be pretty. I knew I was called to the scene of a multiple victim incident, and I knew one victim was already pulseless. I also knew that I was being called because things weren’t okay, and that was what I spent my entire career preparing for – the times when things aren’t okay – and I was ready. 

I opened the door of the ambulance and was met with a horrible and gruesome sight. This poor young man’s abdomen was split entirely open from sternum to pubis, the contents spilling out, accompanied by heavy bleeding. He was awake but fading fast.

My partner and I jumped into the ambulance to assist the crew, attempting to control the bleeding, ensuring intravenous access, initiating a blood transfusion, sedating him and placing a breathing tube, all in under ten minutes. We expedited transport to a trauma center. Shortly after leaving the scene, he lost pulses. He was clinically dead. 

We performed bilateral finger thoracostomies – a surgical incision through the chest wall to release trapped air and blood accumulating in the chest that could be collapsing the lungs. We assessed his heart with an ultrasound confirming he had no bleeding into the pericardium (the sac around his heart). We also confirmed that he was in fact in cardiac standstill and not just a low state of blood flow caused by hemorrhage.

We administered medications to help slow down internal bleeding and others to help get his heart started again. We performed CPR and ventilated him. We did all this, just the two of us, with our wits, experience, and limited resources, in a confined space, racing towards a level one trauma center.

We continued CPR and breathing for him the whole way to the hospital, and miraculously, while arriving at the hospital, we felt a pulse again. They immediately went to work on him, seamlessly continuing the care we started and quickly taking him to surgery. Watching him being wheeled down the hallway towards the operating room, I knew his chances of survival were slim, but I also knew that I was part of the team that assured he had a chance at all. 

The next day, we received word that not only did he survive hours of surgery, but he was awake, mentally intact, the breathing tube was removed, and was described as being in stable condition.

So yes, this incident was a senseless and horrible tragedy. But myself, my partner, the rest of the first responders, the emergency department, and the operating room staff are the reason the headline didn’t read “two dead.”

I got to do the things I trained to do, use skills I have spent years honing, and perform procedures that directly affected his outcome. I got to work as part of an amazing team that got to do something about the bad things that happen. And we did them damn well. 

Does this mean I wish ill on others? Of course not. Does it mean I go to work hoping someone finds themselves in a horrific situation so I can jump in and get my fix? Also no. But if bad things are going to happen in this world, and they always will, then I want to be the one that gets to do something about it. 

But if bad things are going to happen in this world, and they always will, then I want to be the one that gets to do something about it. 

I spent a long time learning, training, and practicing my skills. When I am given the opportunity to  use it, regardless of the circumstances that surround it, I will absolutely be proud of my performance and the role I play in tragedy. While I wish harm on no one, I enjoy my craft, and derive satisfaction from being challenged in it.

Signed, an unashamed trauma junkie