The following is an excerpt from my lecture “Resilience: Surviving the Work of Trauma” given at The Penn Trauma & Critical Care Conference, October 2016
The “bat phone” rings and the senior emergency medicine resident answers it. “We’ve got two police officers shot in route!” he yells over to the charge nurse. Minutes later a police paddy wagon, full lights and squawking siren, comes to a screeching halt at the doors of the ambulance entrance. The acrid smell of burning brakes and smoking tires fills my nostrils as I push a stretcher towards the van. The doors open to reveal lifeless, uniformed bodies, both with gunshot wounds to their heads. I am Trauma Nurse One and one of these men is my patient. Unfortunately, I feel overwhelmed and lack any confidence.
I am 23 years old. I possess 18 months of emergency department experience. I just completed a six week orientation to Trauma Nursing. This is my first trauma patient.
I can only think is, “You should not be here!”
Panicked screams from the officers tending to their wounded brothers snap me from my momentary freeze. I assist them in transferring the first officer onto the stretcher. I gain a voice as I bark “make a hole!” to part the swelling sea of blue uniforms blocking my way. Every one of them wants to do something but their work here is done. His life is now in my hands.
The gravity of the situation weighs heavy as I deliver him to the Trauma Bay. My scissors cut by the shield over his heart and I read his name pin as I remove his shirt. Concentration is difficult and frenzied because the swell of officers followed me into the bay. A policeman is yelling in my ear, “Save him, save him!” as I try to place an IV. There’s another officer in the corner jumping up and down. His hands cover his face but fail to stifle his loud sobbing. The rest of the team can barely get to the patient and the other injured officer is following right behind us. Two of our nurses, one a former football player and the other a former police captain, improve scene control by pushing officers out the door. The team gets back to work in a battle that lasts hours; the fight occurs across many fronts – Trauma Bay then CT scan then Trauma ICU. Any resuscitative step forward falls backwards by five throughout our endeavor. Death claims its victory despite all we pour into this hero.
I return to the ED exhausted and defeated. A grief stricken woman escorted by a police lieutenant passes me along the way. Three young boys stoically follow her. They are easily identifiable by their buzz cuts. Their shorn hair makes them appear as miniature versions of their father, my patient. This is the straw that breaks me. I quickly move to our breakroom and burst into tears.
(I hear several days later that the boys’ haircuts occurred under great protest. This resulted in a huge argument between mother and sons. The fight ended when their father took the clippers to his own head. Freshly cut, he told his boys, “If it’s good enough for me, it’s good enough for you.” He then left for the shift from which he would not return.)
A formal trauma team debriefing occurs several days later and nearly everyone involved in this event participates. The facilitators expertly draw out feelings, emotions and the other things trauma workers like to shove down deep. The debriefing is effective and cathartic for all involved. This patient, despite his loss, turns us into a great team and a force for righting life’s wrongs in the years that follow.
In the 20+ years that have followed, I often find myself returning to that night. It chokes me up to think of the loss I’m sure his family continues to feel. At the same time, I reflect on how this negative event produced a legacy of dedicated, compassionate and talented emergency care providers. I remain in close contact with several of my team members from that night. I occasionally run into others and find our shared bond remains. We grew despite trauma and adversity and our work honors the loss of this officer.
I hope one day his family comes to know this and in some way, it provides peace and rest.