Wednesday, November 23, 2011

WHO HEALS THE HEALERS? Notes On Trauma & Child Sex Abuse



* * * * Trigger Alert: This post deals with physical and sexual abuse of children. It's mostly non-specific and doesn't go into graphic details, mostly chronicling the emotional response of this first-responder to the event. * * * *

Last week, for the first time in I don't know how long, the job made me feel cracked open and emptied out. I know why. Much as it hurt, I tip my hat to the somber reminder of my own humanity and keep it moving, wiser and stronger for it.

I've written on this blog and at The Rejectionist about how the action of healing, even when the patient doesn't make it, is a built-in instant form of self-care. We don't carry around the ghosts of all the horrible shit we see because we don't just see it, we work with it, throw our bodies and minds full throttle into the thick of it and become, however momentarily, part of the story. There's a cleansing that comes with taking action, even action that ultimately fails. It's as true in the larger community/world aspect as it is in the day to day grind of this job.

Anyway, that's exactly what didn't happen last Tuesday and that's exactly why I struggled with it so much after that fact. My mind was already heavy with the Penn State rape tragedy. Think it was a day or two after the JoePa riots and the news was all awash with creepy justifications, including that ghastly interview with Sandusky himself, and that shit was weighing on me. They sent us to a "BURNMAJOR" job. PD had been called in on a child abuse alert and found burn marks, old ones, on the kids arm.

I'm not gonna do details right now. It's all horrific, triggering type stuff and not necessary to the story. I'll just say that without anything being acutely wrong with the kid - who was running around and laughing, giving everyone high-fives - it was still the worst, most horrific job I've ever been on, for the unravelling of each nauseating detail of abuse as the detectives and my partner and I tried to understand what had been going on.

And then we drove them to the hospital, dropped them off and that was that. No IV, no oxygen needed, just some highfives and smiles and a gentle ride without lights or sirens. It was the end the tour and there was paperwork to be done and supplies to be restocked and radios to be handed off to the oncoming crew. And I felt...empty. Angry and horrified and full of sorrow and wrath and disbelief and heavy with the confused imaginings of wanting to deck the bastard who did it and knowing how useless and stupid an action that was and wanting to be still and hurl curses at the sky and run and call up everyone I knew and be all alone, all at the same  time. And still; horribly empty.

It was raining when I walked out of the hospital and down Gun Hill Road towards the train.  The Brooklyn-bound 4 was empty but thoughts of the past hour crowded in on me; the dull throbbing sorrow of nothing-you-can-do and the clenched up frustration of a hundred impossible thoughts. I let them come, mostly because I knew there was nothing I could do to stop them. And when the only action that's left to us is processing, that's what it has to be.
I'm blessed to have those sacred type of people close to me that know how to be there just enough in times of need without overwhelming; people that can be light with my heaviness and prod me to go deeper when I try to fake blow it off. Over the course of the night, through sad, hilarious, challenging conversations with
myself and my loved ones, I resurfaced, found my feet again, stopped feeling so empty and so began another day, full and ready for life.

Monday, November 14, 2011

NOTES ON ENABLING & A COMPLICATED EXTRACTION

There's a scene in the Buddhacarita where the young Buddha-to-be is sneaking out of his palace one early morning after another night of debauchery. They spend about a full chapter doing the literary equivalent of a slow-pan over all these once gorgeous women all splayed out, makeup smudged, body parts erupting from their clothes in all kinds of rude ways - a total morning after fashion catastrophe.
My job is like that scene sometimes, most specifically between the hours of say 4 AM and noon, when folks that are trying to make it out home from the clubs for one reason or another don't and end up in the back of my ambulance instead. And then puke.
It's not the puke or pee or, worst of all the #2s that I mind so much...Okay, no, I take that back, it is. But what adds insult to, ugh, to injury, is the sheer regularity, the predictability factor that's involved with ferrying the same, yes the same, damn drunks back and forth to the ER night after night after night. It's to the point where you start to feel like an enabler, because really, that's all you are: someone who gets these folks off the street and into a warm place so they can wander out a few hours later and do the whole thing again. And again and again. And you try, you really fucking try, not to let the regularity of all that depravity get to you and make you into some gigantic asshole. And usually you succeed. But it's really that, moreso than the death or the danger or the severed body parts or exposed intestines or whatever, it's THAT that makes this job so difficult and the burnout rates so high.

ANYWAY, that's not what I'm here to talk about today.
Last week, we had a patient that weighed damn near 600 pounds, couldn't get out of bed and had had her first seizure in ten years. Her husband was probably not playing with a full deck and stood WAY too close to people when he spoke. He also had the disconcerting habit of treating everyone like he knew them from waybackwhen. Not just in the buddy buddy way; he would go "Oh hey *mumbles*! How's the *mumbles* from before thingy thing? Oh yeah? Great! And anyway *mumbles* remember?"
And we were like *nod nod* "No."
But he was unfazed, dude just rambled along regardless.
We called for Fire because they've got a special basket for removing the extremely enormous. Crazy husband wanted to know why we didn't just put her on the stretcher.
"The stretcher can only hold 400 pounds."
"Oh! Well she's about 475 so..." He looked at us like the explanation was obvious.
We looked at him like O_O
First of all, she was maybe 475 lbs at birth, but certainly not at this moment. Second of all...no. So Fire showed up, after that awesome conversation, and they'd already been there before. You could tell because as soon as they walked in they started stepping away from the Crazy Husband, who went right up waaay too close to the nearest fireman and said "Oh hey Theoihsofihdgdgjk! Remember the ohgiughdughdgd??"
The Fire Captain explained that the patient didn't fit in their special basket, they'd already tried and they'd have to call Rescue, cuz they have an even specialer net system for such situations.
Meanwhile, the husband still didn't understand why we couldn't just put her on our damn stretcher and be done with the whole thing. For everyone's sanity, we had to start tuning him out around this point. We'd been onscene for well over an hour, drifting in and out of the apartment as much as our noses could stand it  when Rescue made an appearance. They did indeed have a complicated gladiator-style cargo net contraption that we ended up wrapping around the woman and using to lower her onto a special sled. "You alright, dear?" I asked as eight of us guided her from the bed to the sled. She nodded, said she was fine thank you very much and asked how much longer all this would take. The whole thing took about two hours, not counting decon time (she had been in that bed a loooong time) but we finally got her onto our ambulance and around the corner, literally around the corner, to the hospital.