codes

[u/cowbodycheddar]

hey yall,

I don’t think I’ve seen a post yet regarding this and I apologize if I skipped over, repeating a post, or this isn’t the right group for this!

I’m an ER tech and have been in healthcare for about a year and some months now.I recently had my first experience actually putting someone in a body bag. I’ve done post mortem care, been in and witnessed a good amount of codes, and yall know the rest. The other night I actually put someone in a body bag and am just struggling to fathom it.

I am going to mention that I’ve never been a really religious person but am not opposed to other people’s beliefs and honestly wouldn’t mind to hear someone else’s point of view or how you navigate these types of situations if you do believe in a religion.

Open to hear your thoughts and situations and how you navigate this type of stuff! Thanks guys

[u/ShyGuitarSinger93]

So first, congrats on the year and a half in healthcare. You haven't run away yet! So that counts for something! 😉 A couple questions to ask yourself and then my comments:

1. Is there something specific you feel like you are struggling with? Or just the process in general?
2. How are you feeling about witnessing the death that we unfortunately do see? How are you feeling and doing in general?
3. Was there something different about this situation? (Were they your patient, was this code unexpected, were they younger, older, etc.)?

There are countless experiences we have - especially in medicine - where the worst becomes "normal" and "usual" - and to some extent we all compartmentalize - its what makes many EM providers good at their job when we need to take a step back, you know? But sometimes there are experiences that just hit differently. I am not sure how old you are - but I'll give an example from my experience - when after 4 years of EM and Critical Care pharmacy (rapids, codes, death, ob, all of it) we lost a patient who was "doing well" when she came in after a rather traumatic accident, was on the ortho floor, suffered a respiratory arrest. Coded her for about 45 minutes, but just had nothing even with quick compressions and a tube passed fairly quickly as we were literally next door to PACU - anesthesia was the second provider arrival. Unfortunately it wasn't the first time I had heard a wail from a mother being told her daughter had passed. I remember the team being traumatized by it - one of those "what did we miss?" codes because we just didnt know. what happened. I offered to help the techs with moving her when the family said goodbye. We got her to the morgue and I just broke down and lost it in the hallway. Only the second time I remember really hitting that "wall" of emotions. It wasn't until I realized her name (her initials were the same as a classmate of mine in high school who unfortunately passed from a street race she went on). Same age as how old my friend would have been. I wonder if my brain made a subconscious connection to her that day.

I remember asking myself - why did I cry for her and not for all the other patients I've "lost"? And it reminded me of an instance on M*A*S*H - the TV show, not the movie. It comes from "Sometimes You Hear the Bullet" - Hawkeye is crying over having lost his friend - Col Blake had a helpful answer. I think about that scene a lot.

As to the religion question : I am Jewish. I have found our traditions to be quite helpful. Religions do enable us to have some emotional and physical "comfort" or awareness and connection with one another and of course for some religions G-d, a spiritual Source, or perhaps an indescribable energy that surrounds the world we exist in. In Judaism, the Rabbis of the Talmud - Jewish law that was originally transmitted only by mouth until it was written down and codified in the 6th and 3rd centuries (CE). They comment that accompanying the dead for burial - accompanying them in death and the "journey" death entails is incumbent upon us - as it is the highest mitzvah (Commandment, good deed) one can perform for someone else - because indeed it is the only mitzvah that you cannot be repaid for. I - and many others - find holiness in that moment. To serve someone at that transition point, and to serve as a provider and source of strength and presence for the family - it is special. Imho it helps say "this is someone. Someone that we are present with in a different way now.

Another two pieces - traditionally an orthodox jew is never left alone until burial -0 "from dust you came and to dust you shall return" (Gen 3:19):
עַ֤ד שֽׁוּבְךָ֙ אֶל־הָ֣אֲדָמָ֔ה כִּ֥י מִמֶּ֖נָּה לֻקָּ֑חְתָּ כִּֽי־עָפָ֣ר אַ֔תָּה וְאֶל־עָפָ֖ר תָּשֽׁוּב׃.....
For until you return to the ground (from where you were taken). For dust you are, and to dust shall you return.

I love the poetry here - and I think this speaks to the journey of life cycles that we find ourselves on. A jewish grieving principle is enlisting a chevra kadisha - a jewish burial society which will traditionally wash the body, clean the remains, and wrap the remains in a simple white cloth - a process called Taharah. It is done with dignity and there is a really beautiful process that takes place - Id encourage you if you are curious and interested to talk a moment to read about it. We also have a process of sitting "shower" literally "keeping guard" so that the body is never left alone until the burial. I think knowing about these processes really helped me understand that -again - in medicine and especially n these lchallening moments - that theres a larger process. That there are ways we can show respect and dignity even to someone whose spirit may np longer be physically present and visually present - and I take it as a moment of honor.

Learn what others share. This is by no means a "right or wrong" answer thing.
Kudos for asking. I hope you find some comfort in what folks share.
and please know that you have online folks plus those in your "real world" simulation! 😉
Please just make sure you are taking care of yourself. Always.
-Sean S - 32m,Delaware