You Must See Some Terrible Things

In reply to:

How do think being exposed with trauma/accidents at work effects your day to day life. Are you overly cautious regarding risks as you know what can happen? How do you deal with cycling on the roads? Does it worry you? I am thinking hard about whether I want to be a cyclist long term due to the risks associated with riding in traffic etc.

This is a reasonably common question put to me. One which I think deserves a post.

Of course having to deal with trauma affects how I approach life, but I think I am far from over cautious. Some things need to be explained before I get into my approach to cycling. With the disclaimer that I am not in any way saying there isn't a significant impact that trauma has on the patient, family, friends, bystanders and others connected, here is my answer.

Trauma to the people that I treat as a paramedic does not affect me in the way that a number of people believe it would. Of course there is an effect, but I wouldn't be very good at my work if it was too negative. Probably the most common question to ask an ambo is "you must see some terrible things?" The short answer is "yes we do." But, the terrible things are often not what people first think of. To me the terrible things usually involve the care or more accurately the lack of care that many people receive in different ways in their life. It is the social side of ill health that seems to have the biggest impact on how I feel.

How do I deal with traumatic injuries? Firstly I think I am just made a certain way. Blood and broken bones have never had an overwhelming affect on me. Some people may faint at the thought of blood. I would say I have always had a sort of curiosity about the human body. My interests have included how the body generally functions, responds to exercise, works in extreme environments and this has extrapolated out to when things go wrong.

When you deal with something most days it becomes normalised. Take a car accident for example. Most people will rarely if ever in their life have to deal in any way with a car accident where someone is seriously hurt. When they do it is an experience that is usually far removed from anything else in their life. There is usually a lot happening, the stimuli can be overwhelming coming from people panicking, someone calling out in pain, the mess of car parts on the road. This has a good chance of putting someone outside their comfort zone. They may not know what to expect from the scene, and they may not know what to do themselves. Paramedics on the other see these situations often, and as a result it is no longer an extraordinary experience. We expect certain things to be happening at the site of a car accident. A good part of the event may be within our comfort zone.

Importantly for me is that I can usually do something that will make a difference. From my point of view a trauma is broken down into easily manageable steps. "A" comes before "B", do this, do that and all supported with an ambulance full of equipment and drugs, not to mention the rest of the health system and other emergency services. The patient has pain, I can give them some analgesia. They have a haemorrhage, I can often stop it. They are having trouble breathing, then I have oxygen and other airway adjuncts to help. The ability to be able to respond effectively in these situations is a positive.

Another point of interest is that people love to talk. Even when seriously unwell, a good number of people enjoy a good chat. People live such a variety of lifestyles, have so many things important to them. Each day I learn something I didn't know or have a good laugh with a patient.

Back onto my approach to cycling on the roads. No, I do not believe working as paramedic has made me overly cautious on the roads. However, I do ride differently than I used to a few years ago. There are a number of reasons for this, but the main reason is I have simply grown up a bit. That feeling of invincibility you have when you are 20 years old gradually gives way to more awareness of your own mortality. This has been helped along by a few bike crashes, some involving cars, others not. Gone are the days when I would squeeze through gaps which aren't really there, push through a red light and simply go just because I have right of way. Arguing over who was right or wrong is kind of a moot point when argued through a breathing tube. My approach now is I follow the road laws and refuse to ride with those who do not. I ride assertively, taking my rightful place on the road, making it clear my intentions and maximising my visibility. This is very different to aggressive riding, where you force your position on the road. Deliberately block cars because you are allowed to. The difference is courtesy. Last is I try to ride smart. Looking and planning ahead. Do the driver's thinking for them, and assuming they cannot see you.

Yes there are risks to cycling on the road, but there are risks walking down the street or even sitting on your couch. We make decisions every day, often without realising it. These are often based on risk versus benefit, or even risk versus pleasure. There is a level of comfort for everyone that is individual. I feel the exposure to different aspects of people's lives, both good and bad that I have through my work helps add to my rich and interesting life. Yes it does affect me, it helps build on who I am.


  1. Sensible approach, unfortunately I have been put off riding on the road for good, did it daily when I was younger but now I am just too nervous of the risks. This is a great shame because living in Blackburn I could easily bike commute every day.

    My OH has been unlucky enough to require a ride in an ambulance twice in the last 3 weeks (both RTAs), all I can say is thank goodness for the job you do, thanks :-)

  2. Thanks heaps Jason for you thought thru response. I guess I am still trying to find that level of comfort with risks that I am taking. Your post has given me some food for thought. Cheers!

  3. This is another great post! About a month ago, I was ridden off the road TWICE in the same day by careless drivers. Fortunately, other than a few scrapes, no harm done. Well, except that I had been scared to get back on the roads. Getting back out there was the best thing that I could have done. I was more alert than I had been previously.

    Making ourselves "seen" and "known" is key. Just as important is following the rules of the road. Drivers are much more courteous when cyclists are courteous.


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