First Responders

The following blog was started about three weeks ago.  In light of this weekend’s horrific events in Paris, I feel compelled to finish.  Friday was yet another example of the unforeseeable bravery in each of us that gets called upon in the most horrific of situations.


I am obsessed with first responders. One would think that someone like me should be an EMT or ED nurse as a result of my obsession. This, however, is not my strength. Trauma equally fascinates and horrifies me. In nursing school and in life, I have "participated" in a hand full of traumas. I will tell you that I keep a cool head, but I will also tell you it is scary for me. In the moment, I feel competent in managing the situation: A.. B.. C.. Airway.. Breathing... Circulation.. I've even done CPR on a gentleman in a parking lot whose wife was in my book club!

First responders have my UTMOST respect. I always think about 9/11 and pray for those who selflessly carried out their job at their own peril. Last night I ordered something from for Sean and at check out noticed that there was a first responder discount. Slow clap for the NBA. These folks are HEROES!

Recently, a very dear friend's daughter (12) was hit by a car. An unbelievably terrifying situation.  Thank the good Lord, this precious girl is alive and rehabilitating. My head is bowed to the first responders. The first first responder in her case was a nurse, responding in an unofficial capacity.  As Emma lay severely injured and wholly terrified, this “stranger” lay on Emma, repeating words of comfort. In Emma’s shock, she wanted to stand up and get away from this pain and fear. Her first responder provided compassion and strength and got her own hands and clothing bloodied to do what needed to be done.

It is my belief, based on the traumas to which I have responded, that first responders are not, in fact, fearless. They are, in truth, fully human and keenly aware of fear and mortality and danger. The difference is they seize the moment to elicit bravery and HOPE to respond and be present.

In many of my presentations about hope, I talk about first responders. I firmly believe that HOPE is the fuel that drives them into the situation from which most of us would run. HOPE to help, HOPE to save, HOPE to comfort. It never ceases to amaze me how HOPE can anesthetize the "that's a goddamn bomb" and produce "I'm going in - feet don't fail me now".

So now I say this. In the hospice world, I am a first responder. Many of you reading are, too.

The irony is people think of hospice as "slowing down", "giving up", "getting ready to die".  In my world, when someone calls hospice -  even if it is just for information about hospice- that is a 911 call.

I don’t say this to trivialize the work of firefighters or EMTs. These men and women put their own lives at risk to go in and attempt to rescue the helpless. I get it and I applaud it. I understand that while my call is to a dire circumstance, my life is not in danger.

As a hospice nurse whose primary responsibility is to introduce the concept of hospice to a patient and family, I am not entirely unfamiliar with some of the experiences of first responders. I, too, answer the call of the helpless. And hopeless.

Here’s the scenario so many of you know. “Hello, how are you? Wanted to let you know Mrs. C is at Northside Hospital. Yes, this is her third admission in six weeks. You remember. She has ovarian cancer and a total bowel obstruction. I know… she’s 56. She’s not accepting that she really can’t eat anymore. Can you come talk to her and her daughter?”

And I come- as do so many of you, professionals and friends alike. I don’t come with whistles and sirens (thankfully) but my visit is a “first response” to a family in trauma. Hospice? No more treatment? End of life decisions? And just like sweet Emma’s first responder, I figuratively lie on top of them. Don’t get up, don’t try to run. Let me bring help. It’s on the way. Trust me. Wait.

I don’t mean to make this comparison lightly. The panic. The need. The frantic feeling of helplessness exists in each patient and family discussing hospice just as it does in trauma victims.

I feel so fortunate that families let me in, answer the door, ask me to stay on the day hospice is introduced. To me, being the first responder I get to be, is humbling.

I write this to acknowledge not only EMTs and firefighters and not just hospice nurses or social workers. The universal truth that we need to acknowledge is that in many ways WE ARE ALL FIRST RESPONDERS. And just as we applaud and admire first responders, so should we do for our own selves.

If you’ve ever shown up, professionally or personally, after receiving a call like, “Hi… I don’t.. can’t… the doctor is sending him home.  His cancer is everywhere, they say…. I don’t know… what am I going to do?” You are a first responder.

The common link is this: having the bravery to stare in the face of a fellow human who is beyond terrified and cannot fathom what will come next or how they will survive that is the core of a first responder. Don’t move. I’ve done this before. Help is on the way.

It is the best and scariest part of my job when this exchange takes place. To take on the fear of families is a privilege to which I get entrusted. To deliver the help is a blessing.

In closing, I recently saw a very sweet patient with an incredibly bad case of head and neck cancer. Her disease and subsequent treatment has left a softball sized hole in her jaw/cheek. Her 24 year old son is her primary caregiver. The patient is from El Salvador and doesn’t speak English.  Despite the multiple services in place, the patient is uncomfortable and the son is anxious. After our lengthy visit discussing her symptoms, her son said in the most simple , but most rewarding way, “You are the first to answer, how do you say, respond, to my worries?”

When each of us do that, we are heroic first responders.