Fatigue -/fəˈtēɡ/- extreme tiredness, typically resulting from mental or physical exertion or illness
I, like many others before me, looked in the mirror today and said “to hell with this life”. It wasn’t the pay. It wasn’t the hours. It wasn’t the autonomy. Maybe it was the fact that I had to strip my uniform off in the laundry room before heading upstairs because I was afraid of tracking in the last drunk’s vomit or having my kids see blood on my uniform from the 19 year-old that was shot in the head in a drive by…
As much as you try to turn off the camera in your mind, the internal hard drive can’t be erased. Why didn’t anyone warn me about this before I became a paramedic? I almost gave it up today. I was teetering on the precipice of futility and purpose. That makes it sound like I emerged victorious. I didn’t, but I came away reminding myself that I can get through one more day. Maybe help one more person. The truth is, every shift is a choice.
I guess you could say that this inner monologue started a few months ago. It was 0300. I woke up, drenched in sweat. Hyperventilating. I was there again. Like it just happened. She was 25. I remember standing over her flaccid body, staring at the tube in her mouth wondering what I could have done differently. The monitor illuminated the room, the apnea alarm shrieked like an animal caught in a trap. Nothing. No pulse. No breathing. No soul. Her eyes were wide and pupils dilated, like she could see everything we did. Everything we tried to do.
As the wind drifted through the cracked window, I could almost hear her whisper, “Why couldn’t you save me?”
A disheveled shadow came out from another room. His burnt fingertips continued to feed through his hair as his eyes darted back and forth. The Pink Floyd shirt he wore was tattered and had numerous stains on it. The stench that followed him around was a mixture of bleach and tobacco. With tremulous hands he reached for his pockets, and then continued to fidget with his hair.
“Any of you have a light?”
My partner and I shook our heads and continued about our business. The lanky man stepped over the fluorescent red bio-hazard bag and reached into the lifeless woman’s pocket.
“Hey, what the hell are you doing?!” I yelled.
Retrieving a pack of cigarettes and tie-dyed lighter, the man turned and winked at me. “These will do.” The hairs on the back of my head stood up straight like soldiers waiting at attention. A few officers stopped him and began to question the sordid figure about his involvement with the girl. My partner was speaking with the coroner on the phone, while I went back to picking up the Epi vials and wiping the emesis off of the defibrillator cords. I heard two small voices downstairs. A younger officer came up to me.
“They want to see their mother.”
Two unkempt children climbed the narrow staircase. The boy was maybe five and the girl around seven. Their hair oily and teeth crooked and yellow. It was 1230 in the afternoon, and they were getting hungry for lunch. Mom hadn’t fed them all day long, probably because there was no food in the house. The children’s grandparents had dropped the kids off that morning at the dilapidated residence. What we found out later was that the children’s grandparents were actually their legal guardians. After several heroin related arrests, their mother had her parenting privileges revoked. She pleaded with the grandparents to let her see her children. After months of begging, they agreed to let her have a “trial day”. Instead of buying food for her children, a “friend” came over and the mother disappeared. As the children’s stomachs grumbled, they went in search of their mother, and they found her…
“Is she going to wake up?” the boy asked.
I fought back the tears trying as hard as I could and tried to cushion the truth. “No… She’s not going to wake up…” I didn’t know what else to say. Never in my absurdly short training period did anyone ever cover explaining death and grief to school-aged children to me. I escorted them back downstairs and sat them on the couch. Clicking on the remote, Dora the Explorer emerged on to the t.v. screen. Both of them sat their. Silently. I rummaged through the cabinets and the refrigerator only to add to my disappointment. Running out to the bus, I grabbed my lunch box and came back in with a cheese stick, apple slices, and half a sandwich. Before the next commercial break, all that remained were plastic baggies that the kids had wadded up and thrown on the couch.
A green station wagon pulled up to the front of the house and both of the kids bolted out the door. An officer and I followed them out, as they piled into their grandparent’s vehicle. A few minutes later, they turned off down the street and on their way back to what I can only pray was a reprieve from the insanity that they had just experienced.
A few minutes later, our equipment was organized and thrown back into the ambulance. Maybe it was a blessing in disguise that we worked for a high-volume urban service and didn’t have time to think about what we just witnessed. Maybe that’s why I’m thinking about it now. For the rest of the shift, my partner and I played the nursing home shuffle and ran a few other minor medical calls. It was quiet, though. None of the normal chatter that we bandied about most days.
I find it odd that three years after this call happened, I can still remember every detail. I remember the rank smell of cat urine and the tobacco stains on the rug. I remember the holes in the planks going up the stairs and the obscenely dark room with no functional lights. The overflowing toilet that sat there stagnantly for God only knows how long. I’ve had calls like this before, but this is the one I remember. This is the one that wakes me up in the middle of the night. The one that I think about on Father’s day, wondering if those kids will ever have a steady figure in their lives to help them sort out the hell they’ve lived through.
I went out to the couch and sat down. Hunched over the coffee table, a bowl of Frosted Flakes in tow, I needed an escape. The television flickered in the background as I turned down the volume hoping to not wake anyone up. There had to be something on this late to take my mind off of my dreams. I stumbled upon an older episode from Batman: The Animated Series. Perfect. Childhood nostalgia was what I needed, but I got more than what I bargained for. What I had hoped for was that Batman would swoop in and save someone in distress while simultaneously pounding his adversary into oblivion. Because that’s how the real world works. In this episode, however, Batman was struggling with his sense of efficacy. In a rare moment of utter humanity, he sat dejected in a chair by himself in the Batcave. As his butler, Alfred, approached they had this conversation:
Alfred: Master Bruce, are you alright, sir?
Batman: I’m tired, Alfred.
Alfred: Well I shouldn’t wonder, you’ve taken no meals today, and I can’t recall when you last slept.
Batman: A weary body can be dealt with, but a weary spirit, that’s something else. Sometimes, old friend, I wonder if I’m really doing any good out there.
Alfred: How can you doubt it? The lives you’ve saved, the criminals you’ve brought to justice.
Batman: I’ve put out a few fires yes, won a few battles, but the war goes on Alfred, on and on…
The rest of the episode went on to validate Batman’s calling to protect those around, and to the seven year old me, I’m sure it would’ve been awe-inspiring. This time it was different. This time I sat alone in the dark just like my childhood idol wondering what fires I was going to try to put out…