The patient sat in front of us, short of breath, in the classic tripod position. We clustered into the room uncertainly, and after the initial introduction, one of us ventured with, “So what’s going on for you today?”
“I…feel like…I can’t…breath,” the patient gasped out. Within moments, he slumped into the chair, and my partners and I leapt into action. We felt for a pulse, and upon finding none, one of us began chest compressions while the other two started giving breaths with a bag-valve-mask. Crucially, however, we forgot the AED: the only thing that could have brought the patient back to life.
Luckily for us, the patient was just a simulation. Upon starting medical school at the University of Cincinnati, we were enrolled into an emergency first responder class, a crash course that attempted to fit everything from CPR to bleeding control to geriatric and pediatric emergencies into the short span of two weeks. I had some EMT training previously, but having never practiced as one, my skills were more than rusty. Some of my classmates had entirely no experience in this field, and it was a challenge for all of us to digest the information while simultaneously learning to work as a team. Nonetheless, as the days progressed, we slowly improved. We approached our patients with more confidence, communicated to each other more efficiently. We learned our first lesson from medical school: practice is everything.
In the years since I got my EMT license, I’ve fortunately never had the chance to use it. And yet we know that proper emergency care outside of the hospital can make a crucial difference in saving someone’s life. I still remember my first CPR instructor telling us that there is a chance we could be doing CPR on someone we know one day. BLS skills are vital, not just to healthcare workers, but for the general population as well. Of course, it’s easy to freeze in an adrenaline-filled emergency situation. I went through it during my first mass casualty incident drill, when the realistic screams of our “patients” started to fill the building and my mind embarrassingly went into blank mode. At those points in time, your training becomes crucial. Scene safety. Tap and shout. Check for pulse and breathing. These steps became the framework that guide our actions, in a situation where everything that can go wrong will go wrong.
A physician, of course, has duties that extend far beyond the scope of an EMT. No matter what field you work in, I believe that physicians have the responsibility to keep their skills up-to-date and to respond appropriately in times of emergencies. Moreover, the ability to keep calm is also a crucial skill to have given the stressful situations that healthcare workers often deal with. As Samuel Shem so aptly put it in The House of God: “At a cardiac arrest, the first procedure is to take your own pulse”. After all, how can we assess the scene properly if we go into panic mode?
All this points to the fact that you have to keep on learning in the field of medicine: about new knowledge, about advances in procedures, and most importantly, about yourself. I’ve realized that the actual practice of medicine is never precise; people are built differently, metabolize drugs at different rates, and more often than not, patients present with symptoms that deviate from textbooks’ descriptions. Every step we take is a decision of risks versus benefits, especially in the field of emergency medicine, where situations can often deteriorate rapidly without necessary interventions. So the best thing we can do is to seek after experiences that can help us improve. We have to be confident in our knowledge and skills, yet open-minded enough to continue learning. We have to lead, yet be humble enough to realize our own limits and to listen to others’ feedback.
As a medical student who is just starting on this journey to become a doctor, I still don’t know if I would be any good in emergency situations. To keep my skills fresh and to educate others on emergency preparedness, I’ve signed up to become an assistant teacher for Stop the Bleed courses. Even the most experienced doctors, however, make mistakes — but if I never try something because I am afraid of failure, then I will never improve. Therefore, I will continue to try and seek out new experiences, and to learn from others. I hope that the ACLS Scholarship for Healthcare Providers can aid me on this path of becoming the compassionate, prepared, and knowledgeable provider I want to be.