So, the past few weeks at work have been rather rough. Usually patients don't bother me, but I have had a string of patients who have, for one reason or the other, gotten underneath that tough skin and bothered me. Here is the rough version I wrote late one night about one patient that bothered me. Warning: for tough stomachs only, this is not pretty. This was a 17 year old suicide patient, I was the paramedic student who declared her dead on scene from hanging herself. She was a frequent at my ER before she killed herself.
I didn't even learn her name, but I knew her. Knew her from previous despair-laden visits. Knew her from desperate cries for help before it got to late. Now, it was just to late. Too late to make a difference, to late to change anything. I didn't go to school to learn how pronounce 17 year olds dead, I went to school to learn how to keep them alive. Now, all I can do is comfort Mom, right after I told her the light of her eyes was dead. Dead despite her excellent CPR, dead despite all the attempts to keep her despair in check. Dead, even despite all I could do. It felt like total, utter defeat to walk away. Defeat that said despite all my training, I really can't change the end. I am powerless before something so much bigger than me. The decision was made, and I could do nothing to change it. Her hair flowed away from her head, making ripples on the cold, hard concrete floor. It was black, dyed to have red highlights. It was full of life, full, luscious, it would have bounced against her head as she ran in the sunlight, laughing, playing. Which is where she should have been, dancing, laughing, chasing and being chased. Out in the sunlight, the dawn of her life; not locked in some cold basement hanging from the rafters, despair so thick it engulfed her until she couldn't take it anymore. She had marks on her, repeated marks, marks that told the story of many other despair filled, dark days. Days where she couldn't face the sunlight, couldn't face the joy; but instead locked her self into her despair. Days where the only release from the pain was to hurt herself. Marks hidden well away from prying eyes, the inside of her arms, her upper belly. Marks calculated to hurt, to mutilate, to release the pain; but not to kill. I remembered the marks, remembered trying to get someone to help her. Remembered seeing those marks as the signs of something far deeper. Remembered thinking that if she doesn't get any help, someday it will be more than marks. I just never imagined it would be in front of me. I never imagined I would see the full depth of her pain released in such raw agony in front of me. The green rope was still hanging from the rafters, tattered where it had been severed in haste by a despair-laden Mother. The other piece was underneath, also tattered where that same Mother desperately tore it from around her lovely daughter's neck. Her chest was indented, where that Mother had done such excellent CPR. A desperate effort to save the pride of her life from her ultimate despair. Her tears mingled with her daughters on that face as Mother struggled and tried so hard to save her life. There was a sister, a sister in almost the same shape. The same marks on her arms, the same despair-laden face, the same drab clothes. The difference was it wasn't yet to late to save the sister. Screams echoed throughout the massive house. The screams of a sister recognizing how the despair ate her up. The screams of despair, of hopelessness. The officers stood in silent attention all down the hall way, Witnesses to the destruction of a young life. Silent senitals ensuring we had a way out if something happened. Silent recorders of all that was transpiring, and researchers of what had transpired. The only evidence of emotion was in their eyes, the tortured expressions written there. They to, did not train for this, they trained to try to save before this, before the destruction. The house was massive, beautiful. Furnished with everything a teenage girl could desire. Beside the rope were hanging enough sports equipment for a gym. And yet, obviously something went wrong somewhere. We can only speculate, reminisce about the times we tried. Try to remember what we could have done differently, what might have changed this horrible outcome. Remember how hard we worked, remember how we tried for her, tried to help her. And that is perhaps all that matters. I tried. I tried my best. I tried my best several times. I can't change the entire system. I can't change what was done. I can't change the outcome. But, I can try to change the person, one moment at a time, one try at a time, one smile, one touch at a time. I tried, and I succeeded in doing my best.