r/emergencymedicine • u/Amazing-Ad8160 • Feb 09 '25

Advice Tips for a difficult death

New attending. Had a gruesome death of a little boy happen in front of me the other day. I will spare the specific details but it was a penetrating trauma. Peds trauma cracked his chest, chest tubes, whole blood, blood on the floor, fingers in the wounds to stop the bleeding, the whole deal. Screaming parents and grandparents afterword. Have two sons similarly aged and I can’t get this out of my head to function normally at home. Just so happened to happen right before a week off so haven’t been back to work yet. Seen what seems like tons of deaths at this point and was never affected to this degree . Never seen a traumatic death of a healthy child though (seen pediatric codes but chronically Ill kids on borrowed time) Any tips for getting over it? How do you deal with bad deaths and making sure you don’t develop ptsd/burn out? I love what I do but if this was any weekly occurrence I would quit.

303 Upvotes

99% Upvoted

81 comments sorted by

View all comments

Show parent comments

75

u/toremypants Feb 09 '25

I think they haunt you even if you’ve processed them.

-88

u/MrFunnything9 Feb 09 '25

You haven’t done enough therapy. All wounds heal, sometimes they leave a scar but you become a stronger provider from it.

73

u/ProsocialRecluse Feb 09 '25

That's a somewhat graceless response. I will always advocate for therapy but I don't think we should tell people that they "haven't done enough". Some trauma just takes a toll, no matter how much you mitigate the damage, and giving people space to acknowledge that is okay. I've seen people keep throwing themselves into their trauma because if they just do "enough" therapy that they'll be "stronger". And they were not okay in the end. Sometimes it's okay for someone to put in what they can and then step away when it's time.

-24

u/MrFunnything9 Feb 09 '25

I agree my response was not nice, but I also don’t think the commenter was right to say things always haunt you on a post for someone in a dark place. You are right though, sometimes the best thing to do is walk away.

13

u/SkyeJewell Feb 09 '25

So saying, “you haven’t done enough therapy” was the right response? When is enough therapy? How do we determine how much is enough therapy when a wound still leaves a scar and may be very visible but healed at the same time?…

-1

u/MrFunnything9 Feb 09 '25

It wasn’t the right response you are correct. I don’t particularly understand your comment. The goal would be that a person is able to still live a sustainable/fulfilling life and doesn’t have to use substances to cope with their trauma.

12

u/V3nusD00m Feb 09 '25

I don't ask this to be unkind, but are you a therapist?

0

u/MrFunnything9 Feb 09 '25

Negative, I have experience in EMS and inpatient Psych. I recognize my comment as insensitive and not helpful, I just get jaded seeing folks discourage therapy. Which wasn’t the case, he was just saying things still stick with you.

1

u/V3nusD00m Feb 09 '25

Retired therapist 🙋🏼‍♀️. He wasn't wrong. If you get sick of seeing people downplay the need for therapy (which yes, let's work on removing the stigma), imagine how people feel when the impact of trauma is downplayed. Just as an example, the Vietnam War was 50 years ago. My combat vet uncle has adjusted as well as he can, having been in VA programs off and on pretty much this entire time. But around the 4th of July, he still goes door to door to the houses around him to ask if they plan on shooting fireworks at home. He says if he knows it's coming, he can cope better. But even when he knows it's coming, I've seen his physical reaction when he hears them. He may not be having flashbacks (he can talk to us while it's happening), but his body is still programmed for that response. Fifty years after the conflict. He's 79 years old. That will never leave him.

2

u/ProsocialRecluse Feb 09 '25

Yeah, I recognize that you're trying to be optimistic for OP. I think that's kind of you. We just need to be careful about setting external expectations around trauma. I think the person you replied to was just trying to say that the trauma may still live with you even if it is processed, but they also probably didn't pick the best language with consideration of OP. I appreciate your concern for them, I think that should be all of our priority in this thread.

1

u/the-hourglass-man Paramedic Feb 09 '25

So instead of validating their feelings, lets blame them for not working hard enough to "solve" their feelings!

Spoiler alert: feelings aren't problems to be solved. That is something you learn on day 1 of therapy