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.
Už 7 rokov pôsobím ako záchranár v okrese Suffolk v štáte New York. Bol som prvý na mieste pri mnohých prípadoch - od dopravných nehôd po hurikán Sandy.
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.
Pokiaľ ste ako väčšina ľudí, smrť môže byť jednou z vašich najväčších obáv. Niektorí z nás budú vidieť ako prichádza. Iní nie. Existuje slabo zdokumentovaný lekársky termín nazvaný blížiaci sa koniec. Je to takmer symptóm. Ako záchranár som trénovaný reagovať aj na tento symptóm. Keď sa na mňa pozrie pacient s infarktom a povie: „Dnes zomriem,“ sme naučení prehodnotiť stav pacienta.
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.
Počas mojej kariéry som zasahoval počas mnohých prípadov, kde pacientom zostávali minúty života a neexistovalo nič, čo som pre nich mohol spraviť. Preto som sa ocitol pred dilemou: Poviem zomierajúcim, že onedlho budú tvárou v tvár smrti alebo im zaklamem, aby som ich utešil? Na začiatku kariéry som sa postavil tejto dileme tak, že som jednoducho klamal. Bál som sa. Bál som sa, že ak im poviem pravdu, tak zomrú v hrôze, v strachu, lapajúc po tých posledných chvíľach života.
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.
To všetko sa zmenilo s jedným prípadom. Pred piatimi rokmi som zasahoval pri nehode motorky. Vodič utrpel kritické zranenia. Ako som ho ošetroval, uvedomil som si, že sa pre neho nedá nič spraviť. A tak, ako v mnohých iných prípadoch, pozrel sa mi do očí a opýtal sa tú otázku: „Teraz zomriem?“ V tej chvíli som sa rozhodol spraviť niečo nezvyčajné. Rozhodol som sa povedať mu pravdu. Rozhodol som sa povedať mu, že teraz zomrie a že nie je nič, čo môžem pre neho spraviť. Dodnes ma jeho reakcia šokuje. Pacient si jednoducho opäť ľahol a mal v tvári výraz prijatia. Nebol pohltený hrôzou a strachom, ako som si myslel, že bude. On tam len ležal – a ako som mu pozrel do očí – videl som vnútorný pokoj a prijatie. Od tej chvíle som sa rozhodol, že mojou úlohou nebolo upokojiť zomierajúcich mojimi klamstvami. Odvtedy som bol pri mnohých prípadoch, kde pacienti prežívali svoje posledné chvíle a neexistovalo nič, čo by som pre nich mohol spraviť. Takmer v každom prípade všetci mali rovnakú reakciu na pravdu: vnútorný pokoj a prijatie. V skutočnosti existujú tri vzory, ktoré som pozoroval vo všetkých týchto prípadoch.
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.
Prvý vzor ma vždy tak trochu šokoval. Bez ohľadu na náboženstvo alebo kultúrne zázemie, prejavuje sa potreba pre odpustenie. Či to nazývajú hriechom alebo jednoducho povedia, že niečo ľutujú, ich pocit viny je univerzálny. Raz som ošetroval staršieho pána, ktorý mal masívny infarkt. Ako som pripravoval seba a moje vybavenie na hroziacu zástavu srdca, začal som tomu pacientovi hovoriť o jeho blížiacej sa smrti. Už to vedel podľa tónu môjho hlasu a reči tela. Ako som umiestňoval podložky defibrilátora na jeho hruď – pripravujúc sa na to, čo malo prísť – pozrel sa mi do očí a povedal: „Kiežby som bol strávil viac času s mojimi deťmi a vnúčatami a nebol som taký egocentrický. Tvárou v tvár blízkej smrti, všetko, po čom túžil, bolo odpustenie.
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?"
Druhý vzor, ktorý pozorujem je potreba na zanechanie spomienky. Či ide o zapamätanie si v mojich myšlienkach alebo myšlienkach ich blízkych, potrebujú cítiť, že budú naďalej žiť. Existuje potreba nesmrteľnosti v srdciach a myšlienkach ich milovaných, mňa, mojej posádky alebo kohokoľvek okolo. Nespočetnekrát som mal pacienta, ktorý sa mi pozrel do očí a spýtal sa: „Zapamätáte si ma?“
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.
Posledný vzor, ktorý pozorujem, ma vždy zasiahol najhlbšie, do duše. Zomierajúci potrebujú vedieť, že ich život mal zmysel. Potrebujú vedieť, že nepremárnili svoj život na nezmyselné úlohy.
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.
Toto sa mi stalo úplne na začiatku mojej kariéry. Zavolali nás k prípadu. Bola to žena, staršia pätdesiatnička, kriticky zakliesnená v aute. Vo veľkej rýchlosti sa bočne zrazili autá. Kritická, kritická situácia. Kým sa ju požiarnici snažili dostať z auta, liezol som k nej, aby som jej poskytol pomoc. Ako sme sa rozprávali, povedala mi: „Bolo toho tak veľa, čo som chcela urobiť so svojím životom.“ Cítila, že nezanechala na tejto zemi svoju stopu. Ako sme sa ďalej rozprávali, vysvitlo, že bola matkou dvoch adoptovaných detí, ktoré mali nastúpiť na lekársku fakultu. Vďaka nej dostali dve deti príležitosť, ktorú by inak nikdy nemali, a vydali sa zachraňovať životy ako doktori. Trvalo to 45 minút, kým ju dostali z toho auta. Avšak zomrela pred jej vyslobodením.
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.
Myslím si, že ste to videli vo filmoch: počas tých posledných chvíľ je to len strach a hrôza. Ja som si uvedomil, že odhliadnuc od okolností, je to vo všeobecnosti prijaté s pokojom a zmierením sa. Tie najmenšie veci, tie najmenšie momenty, najmenšie veci, čo ste priniesli do tohto sveta vám dodajú pokoj v tých posledných chvíľkach.
Thank you.
Ďakujem!
(Applause)
(Potlesk)