As part of our EMT training, my 28 classmates and I spent 2 days observing and participating at the local ER.  Everyone had different shifts and secretly each person hoped that they would be the person on duty when the most extreme trauma came in.  Maybe it was morbid curiosity, desire for a ‘good learning opportunity’ or the pride of having the ‘gnarliest’  case that fueled this silent competition.  Admittedly, I also hoped that I would see some major trauma or dangerous disease so that I could pick up a few tricks to use in India.  God granted my wish.

The bearded doctor and I were having a discussion.  He had asked me why I was taking the W-EMT course and this led into a long conversation about our health care work in India.   He was asking me questions about different conditions and the leading causes of death in the sub-continent.  I was in the midst of telling him about how measles swept through our village and left 6 children dead for want of a 1 cent tablet each.
The middle aged bald male nurse sitting nearby turned to me and said (in a serious tone), “That’s what I like to call population control.”
(Awkward silence)
I responded in a calm voice, “I would assume then, in your estimation, that the Holocaust was no more than a good example of population control.”
(Longer awkward silence)
“They’re bunnies.”
“Excuse me?”
“They sit on the side of the airport runways waiting for food aid shipments and the whole time they are making more babies.”
“Maybe prevention, education and giving them access to birth control options would be a better option than letting them just be eradicated by disease.”
“It is just an overcrowded system which is limiting itself.”
I managed to say, still in a calm voice,  “I would like to see if you still felt the same way if it was your friends and neighbors dying instead them.  The geographical luck of the draw doesn’t entitle you to access of health care over them.”
After the bald nurse angrily walked away, the bearded doctor said with a tired look on his face, “Oh, I’m sorry.  The people that I have to work with here…” followed by an audible sigh.

On my other ER shift I helped take care of a middle aged male patient who tried to commit suicide by overdosing on pills.  As I held his hand to assess his vitals I thought of my own father who committed suicide at about the same age.  He was sleeping and not even aware of my presence but at least I could play a small roll in his care.  With those feelings in my heart I went out into lobby of the ER.  An ambulance arrived with an EMT who was to transfer him to a psychiatric hospital for observation.  The EMT was speaking with the head nurse.
EMT: “Well do you think he’s a danger?”
Nurse: “Oh, no.  He was a little combative and uncooperative at first but we aren’t worried about him trying to hurt himself again.”
EMT: “No, no, no… is he a danger to me?  He can kill himself for all I care.  I just want to ensure my safety before transporting him!”

During my 2 ER shifts I took vitals, watched over several individuals with alcohol poisoning, washed out the ulcerated fat rolls of an obese man suffering from diabetes, cleaned up the fecal material of a 91 year old man with dementia, cleaned off equipment, helped transfer patients from ambulance gurneys onto ER beds and many other less than exciting tasks.  I wasn’t there when the patient with the sucking chest wound and double open femur fractures showed up.  But I did get to see the most dangerous and destructive disease.  It sucks the life out of people and turns them into hollow shells.  Suffers rarely recover and end their lives in bitterness and stripped of all that is beautiful.  The disease is contagious and its effects can be felt throughout a community in few days to a few weeks.  This illness is often a secondary infection which follows traumas such as compassion fatigue, burnout and a history of being hurt by others.
God granted my wish and showed me the destructive power of indifference.
During my 2 shifts in the ER the incontinent elderly patient I cleaned up, could have been my grandfather.  The patient who attempted suicide had the face of my father, the toddler who needed stitches in his head was Asher, and the woman with the abdominal pain could be my mother in 20 years.   But I wonder who I would be after spending 2 decades in that ER working with those people.  Would I end up like the bearded doctor… kind, gentle, caring and worn out?  Would entropy win?  Would I become calloused and indifferent?  Would I become a man who’s job description was to save life but at the same time advocated death?  All I can do is pray that God preserves my heart and strengthens my immunity to this disease… or should I say epidemic.
This weekend I’ve been studying around the clock to pass the 6 exams which are scheduled for the week.  It has been an intense month and I feel a bit worn out already.  But even if I manage to pass with flying colors, the truest test is yet to come.   A certificate in my hand will mean little without a heart to compliment it.