What's the Worst Thing You've Ever Seen?

Oh, THIS QUESTION.

I know what you’re expecting. Some bloody traumatic injury, bones and gristle all exposed. Severed limbs. Open chests. Eyeballs on the cheek. Maybe a Christmas tree being extracted from a place it shouldn’t be. And I have those stories, dozens, if not hundreds of them. I’ve been doing this a loooooong time. Say I saw a terrible thing a month, so 12 times a year. Multiply by 18. Somewhere in that neighborhood. Probably more because of the law of threes and sevens. If you’re not familiar with that piece of superstition, it’s a common belief that bad things in our world happen in threes or sevens. So, if you have two codes in the department on day shift, there’s either one or four more to go before the cycle is broken. 

But you can find the gore in any horror movies with good special effects. We’ve seen that, up close, and it’s really not that cool. It’s disturbing and traumatic and horrible, so those aren’t stories we revisit very often. It’s more along the way of “remember that cop that threw up after he handed you that arm in a grocery bag?” I have seen every body part opened and every organ, or part of it, up close before. I’ve been there when chests are cracked open and seen more blood than I thought was possible, gouged myself accidentally on an exposed shattered bone, and seen things turned inside out that weren’t built for that.

So I’m not going to be able to tell you the worst thing I’ve ever seen. Because there’s a lot, and because it’s painful, and because it’s not for public consumption. If I tell it, it’s to educate someone for when that happens to them. Not for a reaction.

What I can tell you—

The sound of anguished parents when their child passes is the worst thing I’ve ever heard. 

The quieter a trauma or code is, is directly related to how it’s going.

That five second wait while someone palpates for a pulse check is an eternity. 

The silence after someone says “they’ve been down for forty minutes, we’ve done A-Z, does anyone have any ideas?” is heavy.

Doing chest compressions while listening to the family member in the room beg their loved one to come back hurts.

Taking an EMS call on a drowning victim and hearing them end with “there are still others missing, water search and rescue still ongoing.”

The patient from a car accident asking you how their spouse/significant others/children/parents/friends and asking yourself if you tell them now or wait for a support person to arrive to tell them they didn’t make it.

Desperately trying to find a family member or friend to be with someone who is about to find out they have metastatic and probably terminal cancer.

Treating an injured child who has injuries of varying timeframes not consistent with the reported event. 

All of these are “the worst” things I’ve ever seen. 

Depressing, right? How does one absorb all that and continue on?

Well, what about the BEST?

You ever achieved ROSC? Return of spontaneous circulation? That’s right! That’s bringing someone back to life and IT IS AWESOME. 

Have you ever brought an entire family into a room while their family member passed peacefully surrounded by love? 

You ever had someone in the middle of having a massive heart attack, gotten an EKG, multiple IV sites, Aspirin, Nitro, and Heparin on board in less than ten minutes and had them stop by a few days later to say thank you?

Given TPA and had someone begin to speak again?

Told someone who thought they were dying of cancer they just had appendicitis?

Restored circulation to someone’s leg and now they get to keep it?

Gone out to get a family member from the waiting room and been able to tell them while the accident was bad, their loved one will recover?

Been there when someone found out it was not a miscarriage and the baby was fine?

Helped turn a blue, silent baby into a pink, screaming one?

Had someone hug you and tell you that you made their horrible experience better? 

Given someone in excruciating pain relief?

Had a sick kid not only get better but pick YOU as their favorite nurse?

That’s why! 

Let me tell you one of MY favorite things to do in the ER. Cardioversion. Someone comes in with their heart pounding out of their chest, pale, diaphoretic, with that whole “sense of impending doom” look. Slap those patches on baby, slip them their sedative, and do the shocky shock thing. CLEAR! and five minutes later they open their eyes and the look when they realize.....they’re back to normal.

Another is starting pediatric IVs. There is nothing better than explaining a procedure and gaining a kids trust and then delivering on it. Never lie to them, though. It’s a pinch but then it goes away, buddy, we got this, you and me! 

Also, and this is our dark, dirty secret.....most of us LOVE WOUNDS AND ABSCESSES. I may or may not have knocked someone out of the way with my ample size in order to assist with an incision and drainage. You think pimple popper videos are cool, well, you should be in on some of this stuff. And there was this time (and may still be) when some people were putting maggots on their wounds to eat the dead tissue. That is some really cool shit, ok?

I know it sounds gross and I’m almost ashamed to admit it! But I’ll dress a big bad wound every day because I LOVE IT. 

Also, people can be really cool. They have all kinds of interesting stuff they’ll tell you about if you make a connection. Flying old planes in the war. Taming a litter of raccoons. Woodstock. Meeting presidents of years past. That they wrote a book, or had a dozen children, or they once had a Guinness Book World Record on largest quilt. 

Don’t ask us what the worst thing we ever saw was.

Ask what the best thing we ever did was.

— the Midwestern One