I live in a small town, a good, quiet place. I read the journals and see what you city/suburban EMS and firefighters deal with and I do not envy you. You see the worst of human nature daily. We here are at a distinct disadvantage in that we live in a small town. A small tourist town. When we roll on a call there's a better than average chance we'll know our patient. An acquaintance? A friend? A loved one? Yes, the chances are very good. It's part of the job. What do you do?

YOU LET IT GO. . .

Roll on a tone, 11:30 PM, an MVA/OUI and arrive to find a life long friend with his head pinned between a tree and the vehicle he was thrown from. No chance he's alive. Red and blue lights illuminate the operator, the drunk, head hung in shame. He, too, grew up with me. Loyalty, pity, anger, grief. Which to show? Which to hide?

LET IT GO. . .

The day after Christmas, a ten in the evening rescue. The girl's in her thirties, young, beautiful, vivacious. Every day you can remember she had for you a wave, a smile and a kind word. Storming up the stairs you find her resting peacefully but not resting. The needle and belt on the table tell the story as you start CPR, your partner readies O2 and defib. Frustration as you feel your compressions break ribs in the frail girl. Someone called 911, traced from a bar. Another user who'd been there, wanted to be safely away before calling. Lost minutes. Lost life. Thirty-one years old. Frustration, anger, grief.

LET IT GO. . .

Interrupted afternoon with the family. Hit the lights and head for an injured child. Ten year old girl playing on the family yacht, fall down stairs, obvious deformity of right forearm. Brave little thing, bites her lip as we pump up the vacuum splint. Her eyes fix on the salon door awaiting the comfort of mom. Mother is too busy with her lunch in a world class restaurant to be bothered. Let the nanny handle it and abruptly hangs up the phone. That little girl was the best patient I ever treated, so quiet, good listener, not a tear. Anger, contempt, frustration, pity.

LET IT GO. . .

Transport, 1:00AM, routine turned personal challenge. An infant with a genetic heart valve defect. Thin thread of life glowing faint green on the EKG. I look down and see my own little girl, ages only days apart. Mother in the jump seat staring unblinking at the child who'd only months earlier filled her womb with new sensations. Those fixed eyes trying desperately to give this little one the strength she obviously lacks. Frustration, helplessness, yearning.

LET IT GO. . .

6:15AM, no problem for a morning person. MVA, a popular one here but rarely urgent in the way of personal injury. Not today. Bad intersection, no signs, two car collision, roll over with entrapment. Cap on the pickup sheared, jagged fiberglass, occupant pinned half out of the vehicle. His arm is penetrated by the jagged fiberglass, grating, cutting. The other driver, a nurse, sees the signs and goes shocky. Short handed extraction, scoop and go. He lived but lost his arm. He once made his living with his hands. Pity. . .

LET IT GO. . .

Mid-afternoon, yet another MVA. Our least favorite kind, head on. A young woman, oblivious to the intentions of the oncoming van, never had the time to react. Not even a skid mark. Six people to extricate her. Her eyes seek mine, that of a long time friend, looking for an answer to a one word question. Why? She's fractured two cervical vertebrate, not from striking the windshield but the A-pillar. The van driver never signaled, sped up, turned across her lane. No drugs, no alcohol, just arrogance. The loudest voice on the scene is that of the ignorant van driver whining about how he'd get to work. No concern for the girl he'd just put in the hospital. Anger, concern, more anger. . .

LET IT GO. . .

People on vacation often feel their time is more important than our job, or the law. One day a woman learned a new respect for the law. I was driving the rig responding to a full code. A street a little too narrow and this woman on an errand she felt more important than ours. She did, unfortunately, obey the speed limit, oblivious to our lights and sirens. I will remember always her eyes in the rear view mirror as we followed her in to her driveway. She lost her father that day. We were minutes too late to be of any use to him. More frustration, more anger, even more pity. . .

LET IT GO. . .

Child abuse through ignorance. Not illegal but it should be. We see it all the time. Mom and Dad passing on that vacation absent mindedness to the little ones. Only in them it manifests in to dangerous disregard. A matter of time, short time. Two in the afternoon a tone, bike accident. First sight on scene is a hysterical mother, an expressionless father, a very small motionless form and a mangled bike. Bad. A seven year old girl, helmet unsecured, open skull fracture, unresponsive. Load and go…fast. Two shaken parents give details to an officer. Riding bikes, wrong lane, ignore the large stop sign (we don't have to we're on vacation). The driver on a through street could not have seen them through the hedge. Happened in 92'. The girl has yet to wake from the coma. Much anger, incredulity, grief. . .

LET IT GO. . .

But we don't. We don't let it go, not completely. We can't . In the field we can't let it show. Remain composed, for the victim and friends and loved ones. We show strength that is not always ours. Courage we don't always feel. Aloofness which is always a lie. You see we are, after all, human. We hurt, laugh, cry, love and hate. We feel, just like our patients, grief, loss, shame and guilt. We do not, however, feel just our own. The cries. The pleading. The tears. The faces. They don't come off with the uniform. We can't let them go completely because we're caring human beings. If we weren't we would not have chosen this career. So what happens to all these feelings? When we go home to our lives, we take a piece of each of them with us

AND THEY MAKE US WHO WE ARE!