EMS and Suicide Prevention
One night, several years ago, I was working a shift on the ambulance. My partner and I were sent to a roadside for a female having a panic attack after being pulled over by the police…
Note: Locations, ages, etc. have been changed for privacy and whatnot.
Basically, the police were looking for a white sedan that was seen fleeing from a crime or something and they were pulling over all whiteish sedans in the area if they fit the vehicle description. This girl just happened to be driving down the road in a white sedan and was pulled over. Law enforcement caught the actual vehicle about fifteen minutes later, but that isn’t really relevant to the story.
The officer pulled this random white sedan over around midnight. The only occupant was the driver, a petite female who was about twenty-five years old. The officer did their routine pull-over stuff, discovered that this wasn’t the vehicle they were looking for, and told her she was free to go. Then the girl suddenly freaked out and started having a massive panic attack. Like a huge panic attack, complete with the whole, “Oh my goodness! I can’t breathe, the walls are collapsing, I can’t breathe, I can’t breathe, I can’t breathe, I’m dying, I’m going to die, I can’t breathe!”
So the officer requested EMS, us.
We arrived at the scene about ten minutes later. The officer met us on the roadside between our truck and the vehicle and gave us a rundown of the whole thing. She was still freaking out, fully engaged in panic mode.
My partner and I walked up to the car on the passenger side, since we were on a busy road and all, introduced ourselves, and talked to her through the window for a few minutes. The girl was still wigged out and hyperventilating and didn’t want to get out of the car or sit in our ambulance.
Since she didn’t want to come to our truck, I asked if I could have a seat in her car so I wouldn’t have to bend over and talk through the window. Talking through vehicle windows on the side of the road is always dramatic, and drama isn’t generally something that helps panic attacks. She said yes, so I opened the door and plopped down in the passenger seat all casual, just like plopping down on Grandma’s couch when going to visit.
While all of this is going on, she was still freaking out, but she started saying, “I’m going to be in so much trouble. My parents are going to be so mad at me. I’m in so much trouble…”
After I made myself comfortable, I noticed this open cantaloupe-sized pouch on the passenger floorboard filled with a fine, white powder. Naturally, I had to ask about it in the most disarming way possible: I asked, jokingly, and I’m not making this up, “Is that cocaine in the bag?”
That caught her off guard and she actually stopped freaking out and started to laugh. She said it was hand chalk powder for rock wall climbing. Then I noticed that she was wearing rubber rock climbing shoes. They were purple with black soles, the same color as the bag. She spent the next few minutes telling us how she loved doing inside rock climbing and had just left some late night climbing something-or-other.
A few minutes after that, she had settled down significantly more, but would still occasionally slip in the “I’m in so much trouble” stuff. We did some strategic questioning and she told us that she sometimes had panic attacks and depression and anxiety and that she had stopped taking one of her medications a few weeks earlier.
To this day, I’m still not sure what exactly provoked my partner that night to say any of this, but the conversation went like this:
“You know you’re not in trouble, right?” my partner asked.
“Oh, no,” the patient replied, “my parents are going to kill me for this.”
“Kill you for what? Getting pulled over by the police for having a car that looks similar to the car they were looking for? Trust me, you’re not in trouble,” he said.
We talked for another minute or so and then my partner said this, just out of the blue:
“Are you planning on committing suicide or something?”
The girl stared at us both for several long seconds, befuddled.
During those several long seconds my partner and I made brief eye contact with each other; an unspoken conversation saying that he had just asked the exact the right question.
“How did you… Yes,” she said while blinking back tears.
“How about we go to the hospital and get you some help, yeah?” my partner asked gently.
She consented and we helped her grab her things, locked her car on the side of the road, and she walked to our truck, still wearing the purple rock climbing shoes.
My partner stayed in the back with her and I drove us to the hospital.
After the run was over, my parter told me that she had a plan to hang herself later in the night while her family was sleeping once she got back home. The only reason she was out of the house at that time was because she wanted to get in one last climbing session.
I don’t generally know what happens to patients after we hand over care at the emergency department, and this run is no different. Really, I don’t know what happened to her more than a few hours after we dropped her off, but I do know that she called her family and was being connected to the right resources for help. I also know that her parents were in the ER with her when we came in later that night with another run.
This is the first time I have ever publicly told this story. I’m not telling it to toot any horns or for high fives or any of that other nonsense. I didn’t even do the paperwork for it; it was my partner’s run, I just drove the truck.
Here is what I do know, though: This was nothing short of saving a life and arguably miraculous.
I have seen many things since I began working in EMS. A lot of it sucks. Most of it sucks. The world can be—and often is—a terrible place where terrible things happen frequently to all sorts of people. I’ve seen extraordinary acts of cruelty and abuse from one human to another, awful tragedies striking families unexpectedly, vehicle accidents, bar fights, overdoses, heart attacks, debilitating strokes, death, childbirth, magnificent acts of bravery, kindness, and benevolence between strangers, and a lot of the stuff in between.
After being exposed to the array of things we’re exposed to, most of which being incredibly unfortunate to those whom we are caring for, when something legitimately good happens, we in EMS should treasure it and talk about it.
This was one of those things.
Additionally, I said those 1100-ish words to provide more context to say this:
As EMS providers, the words we choose to say, or not to say, have direct consequences involving our patients. When we talk to patients, what, when, and how we say something is often just as important as what we don’t say, regardless of if we elected to not say something because we didn’t think it was pertinent or if we didn’t say something just because we didn’t think to say it. It still has an effect on the patient.
We have to do suicide prevention training in Indiana before our next EMS recert. I was working on this post before I knew about it, but I find it intriguing how my writing of this and learning of the training happened to coincide.
For that particular patient, my partner asked the right questions at the right time and it positively impacted her life and, at least for that night, prevented her from ending that life prematurely.
I often wonder how many other patients I’ve had who should’ve been asked if they had any thoughts of self-harm. However, I know all of my patients are going to be asked those questions from now on as part of the basic interview and assessment. And this suicide prevention training was fantastic.