They're Killing Us

A year ago today, I watched my mother die.

An otherwise healthy woman, she unexpectedly started to suffer a decline in health early last year and by March, she was immobile, confused and emotionally volatile. I, along with my two younger sisters, cared for her at home. We did what we could, watching helplessly as she continued to deteriorate. The last 10 days were especially traumatic as her body refused to give up despite her inability to eat or drink due to her brain being decimated by the incredibly rare (1.4 in a million) sporadic Creutzfeldt Jakob Disease (sCJD).

It was last year today when I held her emaciated hand, watched her breathing slow and felt the last palpable beats of her heart. The woman who had given birth to me, had loved and cared for me for my entire life and who had become my close friend and confidant, finally ended.

I didn't - and still don't - know how to feel.

I feel compelled to share this here, not because I seek sympathy, but because how it affected me in subsequent months is relevant to the discussion currently raging on this blog and elsewhere. My Mum encouraged me to start this blog when she became concerned about ambulance cover in North Norfolk. I think that she would have been happy to help me make a point now.

Coping with Trauma

Due to the healthcare background shared by me and my sisters (a paramedic and a former care worker), we felt we could take responsibility for Mum at home in her last weeks. With superb support from the district nursing team, the GP and others, we did exactly that and I believe we provided Mum with a level of care that no hospice in the world could compete with.

But it left me tortured by the experience and constantly questioning the decisions I had made. For the last year, no amount of support or condolence was able to penetrate the darkest corners of my thoughts - I even found irrational cause to despise many of those closest to me. Compounding this, I found myself unwillingly mentally reviewing countless events from my ambulance career. Watching my baby daughters sleep triggered vivid, unwelcome images of ambulance attendances I'd previously been able to suppress.

I became inert, useless and negative. People made excuses for me, 'he's grieving, give him time'. I have been lucky to have a fantastically caring and patient wife and small children who are an uncompromisingly positive influence. I also benefited from a close relationship with my sisters - who also continue to struggle with the experience - and a network of tolerant friends. The birth of my second daughter last November was perhaps a real catalyst for my recovery (although it continues to sadden me that she and my Mum never met).

But not everyone is so lucky.

PTSD: Cautionary Tales Ignored

My point is this: although undiagnosed, I am fairly certain I was (and perhaps still am) suffering from PTSD. It impacted my ability to think objectively or contribute constructively to many aspects of my life for a long while.

The kind of emotionally traumatic experiences dealt with by front line ambulance staff undoubtedly has a long-term psychological impact, even if they successfully compartmentalise the memories in order to carry on. Only after my medical retirement due to injury did parts of my mind start to 'unwind' and release previously buried trauma. I know from personal experience that the damage caused can lay in wait and be triggered long after the actual events. This 'drip-drip' effect and any debilitating impact it has is largely ignored by current ambulance culture and even actively exacerbates it by forcing staff to work in such a relentless environment which allows no time to decompress or reflect.

Furthermore, a number of cases I have been made aware of recently which have resulted in staff suspension and an edict of 'no contact' enforced on colleagues can leave the individuals bereft of the support network they so desperately need. In many cases suicide becomes a very real concern.

It is heartbreaking to hear about the breakdowns and suicides of ambulance personnel who, having chosen to dedicate their working lives to helping others, are unable to help themselves.

Del Rutter-Wilton 'took his life in 2013 whilst suffering from work-related depression and PTSD.'
If compassion is truly at the core of healthcare, then those who govern and manage it need to be reminded of the fact. If they cannot find the means to provide a compassionate, supportive working environment to protect their own staff then they are failing in their role and should get out.

Because they're killing us.