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Life Lines Articles - Disaster First Aid

Humility In The Face Of
A Fatal Trauma

©by David Baum
Reprinted by kind permission from

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February 25, 2007 - I was on the scene when a woman died after being run over by her own car in the parking lot of the grocery store near my house. I never saw her face, but I held her hand briefly while she was pinned under the car, unconscious and dying. She had left the car in neutral, the police determined, when she walked around back to get something from the trunk. The car rolled backwards, knocking her down and pinning her underneath. The car dragged her 25 feet across the parking lot until it hit another car and stopped.

I was in the grocery store when I heard the commotion outside. I ran out to where a crowd was standing. The woman's legs were sticking out from under the front of the car. I dived underneath the car with a flashlight. There was no blood. I could see her body but not her head or neck, because her chest was pinned under a metal cross-bar. I called out to her, but there was no response. I saw her abdomen rise and fall twice. I thought she was breathing, but I think now this was "agonal breathing" a bodily reflex that sometimes occurs after the heart has stopped. I went around to the side of the car where her arm was sticking out, but I still could not see her head. I held her hand. She was completely relaxed and unresponsive.

In the crowd, there was a woman who had first-aid training as a school-teacher. She finally thought to check for a pulse (which I had not thought to do), and there was none. By this time a large crowd had gathered; they lifted the car and pulled the woman out. The school-teacher gave her CPR until the medics arrived, but she died soon after.

I worried in the weeks after the event that I had not done enough to help this woman. Maybe we should have lifted the car sooner. The official advice is to leave an injured person where they are, and we could hear the sirens of the medics on their way. But if I had felt for a pulse right away, I would have known she needed CPR. My training and experience were inadequate to the situation. Or maybe the woman was killed when the car crushed her chest, and there actually was nothing we could have done to save her.

This incident, and my own recent injury after the snow storms (moving a fallen tree that was blocking the road) has changed my attitude about first-aid training and about emergency preparedness in general. I realized that I have been practicing to be a hero, to be someone who can respond to an emergency and make everything okay. But that's not a healthy (or realistic) attitude. First of all, if you respond beyond your training, you can get yourself injured. Second, some things are just not okay and there's nothing you can do about it. I now believe he proper attitude is a profound humility.

There's no way to know what kind of disaster or trauma will come upon you, and there's certainly no way to know whether you will be able to respond adequately. The outcome is not under our control, and the best we can do is to follow our training, however much or little that may be. Sometimes we can help a lot, and sometimes the patient dies.

Humility does not equal hopelessness, however. At the scene of an emergency, the people who are there -- both victims and bystanders -- take a lot of comfort in the simple fact that someone is trying to help. Our job is to pay attention to the world around us, prepare as much as we feel is suitable, and respond as best we can. Diligence and good will are the true attributes of a hero.

David is a volunteer neighborhood organizer for disaster preparedness & response in his community in Bellevue Washington who chronicles some of his experiences in his blog called GreenHammer.net. This is his second contribution to Life Lines "Real Stuff From Real People" monthly column. We would like to share some of the comments from his Blog readers:

"I think you very well described what every medical professional must try to come to terms with. In the end, all we can do is our best. You did that. I applaud your humility and your honesty." --Tom, DVM

"An exceptional piece of writing, straight from the heart. Thank you. In a few paragraphs you have contributed volumes." -- Grace, RN

"... the feeling of humility results even when the outcome is favorable. I've participated in several life-threatening experiences. In two of them, for sure I saved a life. The other two are unknown -- a helicopter took one victim and an ambulance another. It's peaceful and gratifying to know I did what I could, and my actions made things better. In each case I was emotionally upset afterwards. In all cases there was a feeling of gratitude at being trained and available to assist another human being." -- Easy Hiker

"I pray that if my death isn't in my sleep, or surrounded by loved ones, that someone holds my hand, just like you did with her. I wonder if this poor woman might have passed no matter what might have been done differently. But, because of you, she wasn't alone." -- Sherri

The moral of this story? Do what you can, and know that you have done the best you could.

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