EMS: Courage And Compassion In Action

By Shawn Godfrey
12:00AM / Monday, March 19, 2007

Shawn Godfrey is operations manager for the Village Ambulance Service and a certified paramedic.

Deep Wounds

Welcome to "EMS:Courage and Compassion In Action," a weekly column written by Village Ambulance Services Operations Manager and paramedic Shawn Godfrey. Godfrey's columns will appear on Monday and will focus on the reality of the emergency services medical profession.

Suicide is one of the ten leading causes of death in the United States, resulting in approximately 30,000 deaths per year. Suicide exacts a significant toll on the lives of the citizens of Massachusetts. Our Commonwealth loses an average of 500 lives to suicide each year. The subsequent suffering, trauma, and loss devastate the lives of family members, friends and co-workers.

Prior to the start of my emergency medical service career, I didn't realize that, in most cases, the EMT (emergency medical technician) has more interaction with the suicidal person than other emergency responders. We are the first to witness their environment; to comfort them, and ultimately get a general impression of their personality.

Unfortunately, we also see them at the height of their vulnerability. For example, some victims, while realizing the injuries won't actually kill them, will superficially lacerate their wrists as a way to initiate a need for help. We also see those who are far more serious about it, actively seeking a method, but uncertain if they’ll actually follow through with it. Then there are those we must attempt to resuscitate because the method has been effectively carried out.

The Unthinkable

One early winter morning, I was dispatched to a call for a “possible self-inflicted shotgun wound to the head; male victim.”

As I arrived, I could see two women through a large bay window, frantically hurrying to greet me at the front door. Both were physically distraught and were breathing heavily. Their skin was pale and the horrified look in their reddened eyes uncovered the true gravity of what I was about to embark on.

“I think my husband tried to kill himself,” the older of the two women said, as she swiftly opened the door.

“Please, hurry. My dad is in the basement,” the second woman pleaded.

The cellar stairwell was dimly lit; however, a small window allowed the alternating beacon lights of our ambulance to color the walls red, which cast an eerie atmosphere that made one think of how hell might appear.

I made my way down the stairs to the basement. A police officer was holding a shotgun as the patient lay face-down and motionless in a large pool of blood. A First Responder, who was kneeling beside the victim, confirmed that the patient still exhibited signs of life, including a slow, faint pulse and shallow respirations. I quickly made the decision to try and resuscitate the patient.

Reaching Out

As we rolled the patient onto his back, we observed implausible destruction to the patient’s face; his lower jaw bone, nose, and left eye were gone, and strands of his hair lay strewn on the floor.

Using a portable vacuum device, I repeatedly suctioned blood from the patient’s malformed mouth, and inserted a breathing tube. Following further stabilization, including oxygen administration, intravenous line insertion, and bleeding control, the victim was immediately extricated on a backboard from the cellar to the ambulance.

During transport to the emergency department, I asked the victim to squeeze my hand with his. Unexpectedly, he clutched my hand and vigorously began squeezing. This exam indicated the victim suffered no acute neurological deficits, and based on this, I formulated a system for the man to answer my questions in transit: thumb up for “yes” and thumb down for “no.” Extraordinarily, the man answered every question with an oriented response.

Going Home

Following further stabilization in the emergency department, admission to the intensive care unit, and extensive reconstructive surgery, the man returned home three weeks later. Due to the injuries sustained, he now suffered left eye blindness and lost all ability to speak. His only means of breathing came by way of a small hole in the front of his neck, and his upper and lower jaw was grafted using bone from his upper back.

I would later learn that the patient was distraught over a marital situation. Apparently, he knelt down, prayed, and then placed the shotgun under his chin. According to medical reports, the patient is alive today because, during the gun’s discharge, the thrust inadvertently tipped the patient’s head back too far, ultimately causing significant soft-tissue injury rather than death.

I have not seen the man since this unfortunate event; however, I have heard that he and his wife began counseling with hopes of improving their marriage and their lives.

Listening

This is just a one example of how suicide can deeply impact not only the victim, but family and friends of the victim as well. Mental illness can bring out the unthinkable in all of us, so each statement made by the afflicted must be taken seriously. By simply listening and responding to threats or ideations of self-harm, each of us can be important contributors in the fight against suicide-related deaths.

References used for this article are:

National Center for Injury Prevention and Control, Center for Disease Control

Vital Registry of Records and Statistics, MA Department of Public Health