Guns, Babies & Karma Yoga
As a human, it isn't easy to sense the balance of the cosmos in our day-to-day lives. We usually have to ascend to gain perspective to see the miracle that is our existence. The higher we go, both in a physical and cognitive sense, the more the minuscule and mundane fade away, and we finally glimpse the bigger picture. I imagine this is why most people climb mountains; as Conrad Anker once said, "Nobody gets it…we do it for the view". I've always had a lingering notion that the back of an ambulance is like the peak of a mountain overlooking humanity. The view from the captain's chair or CPR seat can be a summit to observe the balance and beauty of nature. On June 24th, life came full circle.
The shift started as many other shifts do. My partner and I checked off our supplies in the ambulance and managed a morning meal. Two low acuity calls went out for our ambulance, requiring minimal supportive care and a quick ride to the hospital. It wasn't until I sat down for an early dinner, did the tones go off for the third time. You could tell by the tone in the dispatcher's voice that they were excited, meaning this call had the likelihood of being an actual emergency. We were dispatched to a GSW (gunshot wound) victim with two gunshots to the abdomen. Immediately, my partner and I got in our ambulance and started driving as the call wasn't far from our station. We arrived to find exactly what we expected to see—a young, late 20-year-old male, barely responsive, lying on his back. By the time we arrived, he already had the classic "thousand-yard stare," an ominous sign that our time was nearly running out. Training immediately kicked in, and after palpating a feint radial pulse and ensuring direct pressure was maintained, we carried the patient to the stretcher and into the ambulance we went. The basics of emergency management were immediately covered, and transport was initiated to the hospital. About halfway to the hospital, I could no longer feel a pulse during one of my reevaluations. Luckily, I had two additional firefighters in the back of the ambulance with me that initiated CPR. As a medic, I did everything I possibly could; however, despite our efforts and the trauma team's efforts at the receiving hospital, all resuscitative measures were unsuccessful.
After returning to the station, I took a moment to reheat my cold dinner and change my shirt as it was stained with blood from my last patient. Not 30 minutes later, tones dropped again, and another anxious voice came over the radio… 28-year-old female, pregnancy call. The notes were clear; 2 days past due, water had broken, feeling the need to push. Still eating my dinner, we ran back out to the ambulance. We arrived on the scene to find exactly what we expected to find, a young woman in her bathtub in active labor. Similarly, my partner and I utilized our fire department resources to help move the patient down to the ambulance. Once again, transport was initiated expeditiously, and shortly after transport began, I saw the baby's head. Once again, I told my partner to pull over the ambulance, and after a couple of good pushes, out came a healthy baby boy.
In a matter of hours, I witnessed a life coming out and a new life coming into this world. As a medic, I adhered to our code "if you take one out, you have to bring one in." As a yogi, I was taught a valuable lesson in control.
As humans, we naturally apply a vice grip to our world. As progressive as many of us claim to be, our natural state is to be naturally apprehensive towards change, especially when we are the ones responsible. As a medical provider, I wanted to stop life from leaving this young man's body, and in all honesty, my anxious brain wanted to, at least in the immediate sense, prevent the birth of this child in the back of a dirty old ambulance. My efforts in both regards were unsuccessful. In more profound reflections, I am reminded of a scene in the Bhagavad Gita where Krishna imparts onto an anxious and overwhelmed Arjuna to "give up the desire for the fruit of your actions."
As a medical provider, this can be a challenging task and one that, if not mastered, can quickly lead to soulful exhaustion and burnout. We render treatments because we expect to see specific outcomes. Like many of my counterparts, I sometimes walk into hard calls thinking that "we're gonna get this one back." Sometimes we do, and sometimes we don't. The yogi in me was reminded to focus on action in these moments, not outcomes. This is Karma Yoga. The key to preventing burnout is to focus on what you can control rather than that which you cannot. Your action is what matters in those trying moments. Working in medicine, we do the best we can for our patients, though candidly speaking, we do the best we can at times to appease our ego. We have to live with our actions, and it is much easier to sleep at night knowing that you did everything you possibly could. In this same vein, this experience proves another reality in that sometimes your effort is enough; sometimes it isn't. As the sun rose on my drive home that day, the most liberating feeling of all was that, indeed, at the end of the day, it wasn't up to me.
