On PTSD

So I’ve been watching Grey’s Anatomy of late. I’m almost up to current episodes. They did some interesting symmetry where the hospital was held up at gunpoint at the end of season 6, and in this episode I just watched (set 6 months later), they’re caring for the victims of a mass shooting, so they’re all processing their traumas in their various ways. Lots of healing taking place in this episode.

So about 4 years ago I witnessed a horrible accident, car vs pedestrian. It looked mostly like suicide by SUV. I wasn’t the one who hit the guy, but I was immediately behind him – I had to swing into the next lane so as to not rear-end the driver who did hit the pedestrian, because he was braking so hard. The pedestrian hit his head HARD on the curb. When I got there, he was on his side. Someone else (about 3 or 4 of us stopped aside from the one who hit the pedestrian) was on the phone with 911 – I didn’t have a cell phone at the time – and she was screaming at me that the 911 operator was telling her that we should not roll him over. I was screaming back that he had NO PULSE and shouldn’t we be rolling him in order to do CPR – wasn’t a potential spinal injury better than certain death? She never did manage to relay that to the operator. I don’t know how long it was before the paramedics came – seconds? hours? Couldn’t have been long, given other events that happened that night to give me a timeline, but it felt like forever. I felt better when the paramedics didn’t try CPR either, they just covered the guy up. In retrospect, I realize that the amount of blood that was POURING into the gutter should have told me that there was no chance of saving him. And if there’d been more light, I probably would have seen brain matter in the gutter. I think I’m glad that I didn’t see that.

Anyway. I’ve been CPR certified pretty much continuously since I was a teenager – my first job was working at the YMCA, where all staff are required to be CPR certified (adult, child, and infant) because all staff potentially work with children. Then I worked in various sorts of medical fields pretty much from then on. So CPR certification classes are no big deal for me. I’ve twice done NRP/CPR certification since the accident, required for the birth center where I work (NRP = Neonatal Resuscitation Program, same concept as CPR, just different protocols for people from birth-24 hours than from 24 hours-1 year). And both times, I’ve found that it’s given me VIVID memories of the accident, and I’ve had a harder time driving by the area where it happened (which is part of my commute to one of the birth centers). I’m not having flashbacks, night terrors, etc, it’s not full PTSD – but it does feel related, just on a smaller scale. I think I need to be a bit more aware of this in the future, take some special care when I have to do these classes (especially since I didn’t get CPR attached to the NRP this time, so I’ll be doing that within the month). I wonder if this will always become a problem when I get recertified? I hope not. Because it’s rough. I think it’s the main reason I didn’t sleep last night – even having taken my xanax, I was anxious and stressed and couldn’t figure out why.

I’ve been CPR certified since I was about 16. I know the protocols inside-out and backward. I could probably certify in my sleep. (though I hear they’ve changed the protocols recently – as I said, haven’t done the CPR yet this year) I have always prayed that I will never need to use it. However, given what I do, there’s a higher chance that I will, as compared to someone in a “typical” job. Less so for me than for the midwives – by the time I get called in, the vitals have all been stable for a while – but there’s always a chance that they could destabilize.

I do wonder sometimes how I would react if I had to do CPR on a client – especially a newborn. I’d like to think I’d be totally calm and handle it perfectly. I am afraid that I’d totally freeze and the baby would die. Reality would probably fall somewhere in between those two possibilities. But I do know *what* to do – in some ways, I’m more worried about my emotional reaction than about handling the situation itself. Knowing my usual reactions, I suspect that I’d start to freak out, catch myself, get the baby resuscitated, get 911 called (once you start CPR on a neonate, they HAVE to go to the hospital, even if vitals are stable when the paramedics arrive – too great a chance of ribs detaching from the sternum and/or the spine), keep a strong front on for the family – and then fall apart once they went on to the hospital. At least when the birth teams have to resuscitate a baby, there are 2-4 of them there; they process it afterward, both between themselves and then again at staff meetings and such. I don’t have that net – it’s just me. And that’s a very lonely kind of a thought.

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