Be well. Practice big medicine.

Rooker | The Positive Paramedic Project #92 Just what do you say?

The remains of the Our Lady of the Sierras Convent. Photo by Norm Rooker.

A nugget of Big Medicine for your consideration from Norm Rooker. #92 Just what do you say?

Vicki, my bride of 29 years and counting, and I were making good time on Interstate 10 across Alabama on our way to Galveston, Texas.  2012 has been a very active year for me with the majority of it being spent away from home.  Between a three-month contract in Saudi Arabia teaching structural firefighting and this year’s devastating wildfire season, Vicki and I have not had a heck of a lot of quality time together.

We were making up for it with a two-month road trip that literally was taking us from the Atlantic to the Pacific Ocean visiting family, friends and other activities along the way.  As I was saying, we were making good time along I-10 when she made what I have come to call the third certainty.  You know, nothing is certain except death and taxes.  Well the third one for me is that long before I need to, the love of my life will quietly announce that she needs me to find a restroom for her.

We have traveled long enough together and frankly since my bladder cancer, I don’t have the “iron bladder” that I used to, so I don’t argue, sigh or even make comments like “again?” or “marking your route across (fill in the blank)?” or some other equally insensitive expression of mild spousal frustration.  Nope, it was, “Yes dear” and “How immediate is this request?” Vicki, being a retired paramedic herself with 22 years on the job, of course identified her discomfort/need on the 10 scale.  Fortunately it was only a 5 or 6 on the 10 scale of needing to micturate.  So we had a little wiggle room before we finally got off on exit 4 and pulled up to a service station/quick shop.  While Vicki was taking care of her business I went inside to refill my soda cup and that is where things got momentarily awkward.

There was no one behind the counter as I made my way over to the soda dispenser but from somewhere in the back I heard a woman’s voice holler out a muffled “Good Afternoon.”

Since it was only 11:30 and me being me, I responded back by saying “Well technically, it’s still morning so good morning to you.”

A big old friendly gal came out from the back office apologizing stating that she just wasn’t feeling right but that it would be a good afternoon eventually.

Her comment about “not feeling right” immediately activated my medic “Spidey senses” and while still smiling and with no change in the tone of my voice, I switched over to medic mode and started doing an initial assessment.  You know, when you begin your patient assessment with your general impression.

She was smiling, although it looked almost forced, was speaking in full sentences, didn’t appear to be diaphoretic and her skin color was good but something wasn’t quite right.  She just looked off.

“Darlin’, are you alright?” I asked her.  In the meantime my mind is working through rule-outs for a stroke, TIA or possibly some other cardiac event.

The woman, I never did get her name, looked up at me with a weak smile and that is when things actually got a “bit” awkward.

“Well, I don’t know.  I guess I’m fine but my former daughter-in-law was just murdered three nights ago and I just don’t know what or how I am supposed to be feeling.”

A number of conflicting thoughts shot through my head, one after the other and not all of them reflected well on me.

The first was ‘TMI, whoa, too much information!’ Quickly followed by the exact opposite, ‘Great! She’s not having an MI and I don’t have to call 911 for her’ quickly replaced by, well, ‘What exactly is the proper polite response to someone when they suddenly share an awkward bit of sensitive personal information with you?’

“I’m sorry, are you doing OK?” was all I could initially manage, which far from comforting her, actually seemed to make things a bit more uncomfortable.

I didn’t want to leave this woman like this, call it that Pavlovian rescue response, but I knew I had to do better than just brushing her off.  That and at the same time not prying or saying the wrong thing.

“Ma’am, you said it was your former daughter-in-law?”

She looked up at me with a warmth in her eyes that I had not expected.  The store clerk went on to inform me that the murdered girl and her son had gotten divorced, but despite that the girl had stayed in touch with the woman and made sure that she had access to their two children. She had stated that just because she and the woman’s son were unable to stay married didn’t mean that they weren’t both still parents and that the children still had all of their grandparents and now this was all just so unfair and she didn’t know what or how she was supposed to feel.  That nothing in her upbringing, education or even the bible had prepared her for an event like this and she really hoped that she wasn’t going crazy.

WOW!  That’s one heck of a lot to share with a total stranger. Run on sentence notwithstanding.  But at the same time, how near the edge must she be feeling to need to share this much with a stranger?

Talk about awkward with a capitol A.

But actually, it wasn’t.  All of us have been there at some point in our lives or careers.  Not the murder part, at least hopefully not.  But rather the ‘am I nuts for feeling this way?  I should or should not be feeling …”

And then the answer, the right answer, at least the right answer for this woman, came to me.

Set the way back machine for 1983.  I was attending the National Fire Academy in Emmitsburg, Maryland for a pair of back-to-back two-week courses.  Between the first and second classes I had made arrangements to do a ride-along with the Bethesda-Chevy Chase Rescue Squad.  The EMS Chief for Prince Georges County Fire & Rescue, of which BCC was a part of, was Chief Marybeth Michos.

While I was signing the various ride along waivers and permission slips I learned that Chief Michos was the chair of the relatively new EMS section of the International Association of Fire Service Instructors.  She followed that statement up with a query in that unique Chief Michos style,  “and was I the same Norm Rooker who had recently joined her section?”

When I acknowledged that I was I learned that the cost of my ride along would be that I would be attending the FDIC, the Fire Dept. Instructor’s Conference for free the following March but that I would be serving as the facilitator for two of the EMS sessions.

“Yes ma’am, thank you ma’am.”  For those of you who have never had the privilege of working with or interacting with Chief Michos, there really is no other appropriate answer.

So in March of 1984 my brand new bride and sister medic, Vic the Chick, and I made our way to Cincinnati, Ohio, where I had the privilege of facilitating a presentation by Dr. Jeffrey Mitchell where he rolled out his then radically new concept of Critical Incident Stress Debriefing.  It was an excellent talk and Vicki and I both benefited greatly from it.  And it was the core concept from Dr. Mitchell’s talk that I was able to pass along to this woman.

As the clerk gave me change back for my soda I looked her in the eye and told her that she wasn’t going crazy, that she was just an ordinary person having an ordinary reaction to an extraordinary event. That there was no “right” way to feel and that again, I was sorry for her loss.

It must have been what she needed to hear as her smile now beamed.  Me, I ducked my head and slipped most of my change into the donation jar for the murder victim’s family, and with a final encouraging nod to the store clerk, made my way as calmly but as quickly as possible out of the store.

Vicki and I resumed our journey with over 300 miles still to go until we arrived at our destination.  As the miles rolled by the VCR/DVR in my head couldn’t help but replay the encounter. I hope I said and did the right thing.  Regardless of the right or wrong of my response, the one thing I don’t regret, is that the conversation took place.

If we are to acknowledge that life is not all unicorns and fairies, then we must also be ready to deal with the other aspects that make life “real”.  That there is no “fast forward” button on life.  And that includes honestly acknowledging that someone is hurting and that it is alright for them to be in pain and not “perfect”.

Dr. Brené Brown, Ph.D., LMSW is a research professor at the University of Houston Graduate College of Social Work. Dr. Brown has spent over a decade studying vulnerability, courage, worthiness, and shame.

I had just recently listened to her talk entitled Listening to Shame.  Towards the end of this well done presentation Dr. Brown related an interaction with a man in which he stated that as a man, a husband and a father, he was not allowed to lay it out there, to be vulnerable, and that it was not the fault of his father, his coaches or other dominant male figures in his life and upbringing.

That the worst perpetrators of this were his wife and daughters.  That they would rather he die on that white horse than fall off it or admit his vulnerabilities.

Over the course of my almost four decades in emergency response Vicki and I have lost 10 brother and sister emergency responders to suicide.  Folks who were hurting, hurting so bad that the only way they saw to get out of their pain was to end their life.

Would they have taken the same action if they felt, if they knew it was okay to be vulnerable and that they would not be ostracized for doing so?  I don’t know but I strongly suspect that not wanting to appear weak or vulnerable to the extraordinary events or circumstances they were dealing with at the moment was a major contributing factor to their decision to end it all.

But for them to be able to do that, to acknowledge their pain, then we need to be able to deal with our own discomfort over a potentially “awkward encounter”.  Easier said than done but very, very possible. That is if we allow it to be.

By the time Vicki and I arrived at our destination for that day I knew that I had allowed myself to do just that.  This woman, in her pain had actually given me a gift, a chance to be human.  The chance to interact with my emotional armor down and realize that I could, no – make that would, live to tell about it.  No easy feat for me and a lesson I needed.

Take care everyone and best wishes for healthy and happy holidays for you and yours.

Be well. Practice big medicine.


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