I met a man and had a short conversation with him. He had a headache, ten out of ten, and couldn't talk about anything else but the pain. We were less than a mile from the hospital when he started mumbling incoherently and then went unresponsive. I found out a few hours later he had an acute subarachnoid hemorrhage, so massive that even the neurology folks stepped back in awe. He was forty years old, and alone in this country without family. For the rest of the day I brought patients into that same ER, placing far less sick people into their cots just a few doors down where this man lay, intubated and alone.
I transferred a lady out of the hospital a few days ago after a ten day admission for a swollen foot. She was pretty old and had a complicated medical history but was cheerful nonetheless. She laughed at some of my jokes and rested while I finished up the transfer paperwork. We fluffed her pillow at the nursing home before we left. Today I passed a number 8 endotracheal tube through her vocal cords and directed CPR even as her ribs cracked under the pressure. I couldn't get an IV and had to drill an IO into her tibia. Futile, though, as despite our sweat and effort the flat lines prevailed. She looked like a different lady than I had seen just a few days prior.
Raise your eyebrows if you like, but it makes me somewhat uncomfortable when through their stories, patients become people. A symptomatic tachycardia does not demand empathy. A clonic seizure can't crush a provider's spirit. Only people can do that. Only stories with which we can identify, only smiles and conversations can have that effect.
Prudence demands that we separate the disease from the person. Insult hits much harder than injury, and I think anyone who sees these kinds of things on a daily basis needs to put barriers between these patients and themselves. My paramedic instructor had a mantra that we were advised to live by, that these are "not our emergencies." I remember feeling that the concept was somewhat cold, uncaring, and against the grain of this medical field that I saw as powered through compassion.
Today, I understand its utility.