Jeg har været en ambulanceredder de sidste 7 år i Suffolk County, New York. Jeg har været først til stede i en række ulykker fra bilulykker til orkanen Sandy.
I've been a critical care EMT for the past seven years in Suffolk County, New York. I've been a first responder in a number of incidents ranging from car accidents to Hurricane Sandy.
Er du som de fleste, er døden måske noget af det, du frygter mest. Nogle af os vil se det komme. Nogle af os vil ikke. Der er et mindre kendt medicinsk udtryk kaldet "forestående undergang". Det er næsten et symptom. Som redder er jeg trænet til at reagere overfor symptomet som ethvert andet. Når en patient i et hjerteanfald siger: "Jeg kommer til at dø i dag," er vi trænet til at revurdere patientens tilstand.
If you are like most people, death might be one of your greatest fears. Some of us will see it coming. Some of us won't. There is a little-known documented medical term called impending doom. It's almost a symptom. As a medical provider, I'm trained to respond to this symptom like any other, so when a patient having a heart attack looks at me and says, "I'm going to die today," we are trained to reevaluate the patient's condition.
Gennem min karriere har jeg reageret overfor en række situationer, hvor patienten havde minutter tilbage at leve i, og der var intet, jeg kunne gøre for dem. Jeg var i et dilemma: Fortæller jeg den døende, at de snart skal stå til ansigt med døden, eller lyver jeg, for at trøste dem? Tidligt i min karriere klarede jeg dilemmaet ved simpelthen at lyve. Jeg var bange. Jeg var bange for, at hvis jeg fortalte dem sandheden, så ville de dø i rædsel, i frygt, mens de klamrede sig til de sidste øjeblikke af livet.
Throughout my career, I have responded to a number of incidents where the patient had minutes left to live and there was nothing I could do for them. With this, I was faced with a dilemma: Do I tell the dying that they are about to face death, or do I lie to them to comfort them? Early in my career, I faced this dilemma by simply lying. I was afraid. I was afraid if I told them the truth, that they would die in terror, in fear, just grasping for those last moments of life.
Det ændrede sig altsammen ved ét tilfælde. For 5 år siden reagerede jeg på et motorcykeluheld. Motorcyklisten havde lidt kritiske, kritiske kvæstelser. Da jeg tilså ham, indså jeg, at der var intet, der kunne gøres for ham, og som i så mange andre tilfælde, kiggede han mig ind i øjnene og spurgte mig dét spørgsmål: "Kommer jeg til at dø?" I det øjeblik besluttede jeg mig for at gøre noget anderledes. Jeg besluttede mig for at fortælle ham sandheden. Jeg besluttede mig for at fortælle ham, at han skulle dø, og at der var intet, jeg kunne gøre for ham. Hans reaktion chokerede mig til den dag i dag. Han lagde sig simpelt hen tilbage med et udtryk af accept i sit ansigt. Han var ikke mødt med den terror eller frygt, som jeg troede, han ville. Han lå der bare; og da jeg så ham ind i hans øjne, så jeg indre fred og accept. Fra det øjeblik, besluttede jeg, at det ikke var mit job at trøste de døende med mine løgne. Efter at have reageret på mange ulykker siden hen , hvor patienter var i deres sidste øjeblikke, og der var intet, jeg kunne gøre for dem; i næsten hvert eneste tilfælde havde de den samme reaktion overfor sandheden af indre fred og accept. Rent faktisk er der tre mønstre jeg har observeret i alle disse tilfælde.
That all changed with one incident. Five years ago, I responded to a motorcycle accident. The rider had suffered critical, critical injuries. As I assessed him, I realized that there was nothing that could be done for him, and like so many other cases, he looked me in the eye and asked that question: "Am I going to die?" In that moment, I decided to do something different. I decided to tell him the truth. I decided to tell him that he was going to die and that there was nothing I could do for him. His reaction shocked me to this day. He simply laid back and had a look of acceptance on his face. He was not met with that terror or fear that I thought he would be. He simply laid there, and as I looked into his eyes, I saw inner peace and acceptance. From that moment forward, I decided it was not my place to comfort the dying with my lies. Having responded to many cases since then where patients were in their last moments and there was nothing I could do for them, in almost every case, they have all had the same reaction to the truth, of inner peace and acceptance. In fact, there are three patterns I have observed in all these cases.
Det første mønster chokerede mig altid på en måde. Uanset religiøs overbevisning eller kulturel baggrund, er der et behov for tilgivelse. Om de kalder det synd eller simpelt hen siger, at der er noget, de fortryder, så er deres skyld universel. En gang tog jeg mig af en ældre herre, der havde et voldsomt hjerteanfald Som jeg forberedte mig selv og mit udstyr til hans forestående hjertestop, begyndte jeg at fortælle ham om hans forestående bortgang. Han vidste det allerede ud fra min tone og kropssprog. Som jeg placerede elektroderne på hans bryst i forberedelse på, hvad der ville ske, så han mig i øjnene og sagde: "Jeg ville ønske, jeg havde tilbragt mere tid med mine børn og børnebørn, i stedet for at være selvvisk med min tid." Stående overfor en snarlig død, var alt han ønskede tilgivelse.
The first pattern always kind of shocked me. Regardless of religious belief or cultural background, there's a need for forgiveness. Whether they call it sin or they simply say they have a regret, their guilt is universal. I had once cared for an elderly gentleman who was having a massive heart attack. As I prepared myself and my equipment for his imminent cardiac arrest, I began to tell the patient of his imminent demise. He already knew by my tone of voice and body language. As I placed the defibrillator pads on his chest, prepping for what was going to happen, he looked me in the eye and said, "I wish I had spent more time with my children and grandchildren instead of being selfish with my time." Faced with imminent death, all he wanted was forgiveness.
Det andet mønster, jeg observerer, er behovet for at blive husket. Om det var at blive husket af mig eller af deres kære havde de behov for at føle, at de ville leve videre. Der er et behov for uddødelighed i hjerterne og tankerne hos deres elskede, mig selv, mit hold, eller hvem som helst i nærheden. Utallige gange har en patient kigget mig i øjnene og sagt: "Vil du huske mig?"
The second pattern I observe is the need for remembrance. Whether it was to be remembered in my thoughts or their loved ones', they needed to feel that they would be living on. There's a need for immortality within the hearts and thoughts of their loved ones, myself, my crew, or anyone around. Countless times, I have had a patient look me in the eyes and say, "Will you remember me?"
Det sidste mønster, jeg observerer, er det, der altid har rørt mig mest. Den døende har brug for at vide, at deres liv havde mening. De har brug for at vide, at de ikke spildte deres liv på ligegyldige ting.
The final pattern I observe always touched me the deepest, to the soul. The dying need to know that their life had meaning. They need to know that they did not waste their life on meaningless tasks.
Det kom til mig meget, meget tidligt i min karriere. Jeg havde reageret på et kald. En kvinde i slut 50'erne var alvorligt fastklemt i en bil. Hun var blevet ramt fra siden i høj hastighed. Kritisk, kritisk tilstand. Som brandvæsenet arbejdede på at få hende ud af bilen, kravlede jeg ind for at tage mig af hende. Da vi snakkede, havde hun det her at sige til mig: "Der var så meget mere, jeg havde lyst til at gøre med mit liv." Hun følte, at hun ikke havde sat sit præg på denne Jord. Da vi snakkede videre, viste det sig, at hun var mor til to adopterede børn, som begge skulle til at studere medicin. På grund af hende, havde to børn en chance, de aldrig ville have haft ellers, og de ville komme til at redde liv som fuldt uddannede læger. Det endte med at tage 45 minutter at få hende ud af bilen. Men hun var omkommet, inden hun blev befriet.
This came to me very, very early in my career. I had responded to a call. There was a female in her late 50s severely pinned within a vehicle. She had been t-boned at a high rate of speed, critical, critical condition. As the fire department worked to remove her from the car, I climbed in to begin to render care. As we talked, she had said to me, "There was so much more I wanted to do with my life." She had felt she had not left her mark on this Earth. As we talked further, it would turn out that she was a mother of two adopted children who were both on their way to medical school. Because of her, two children had a chance they never would have had otherwise and would go on to save lives in the medical field as medical doctors. It would end up taking 45 minutes to free her from the vehicle. However, she perished prior to freeing her.
Jeg troede på det, man ser i filmene: At i disse sidste øjeblikke er man i absolut terror, frygt. Jeg har indset, at uanset omstændighederne, så er det generelt mødt med indre fred og accept; at det er de mindste ting, de mindste øjeblikke, de mindste ting, man bragte ind i verden, der bringer fred i disse afsluttende øjeblikke.
I believed what you saw in the movies: when you're in those last moments that it's strictly terror, fear. I have come to realize, regardless of the circumstance, it's generally met with peace and acceptance, that it's the littlest things, the littlest moments, the littlest things you brought into the world that give you peace in those final moments.
Tak
Thank you.