Not too long ago I came across a quote by an unknown author
that struck me as a rather important life lesson, and especially pertinent to
the work we do as pre-hospital medical providers: “Sometimes the most broken
people try to fix others because they cannot fix [themselves]”. It took a
little bit of time for me to truly appreciate this quote because, naturally,
like many others, I’m often in denial of that within myself in need of
fixing. But after absorbing the words I saw on the screen in front of me,
I realized that everyone is in need of fixing, to some degree.
No one is perfect. No one is unbroken. Everyone
has a past that has left them with a scar or two, physical or emotional.
Everyone has a present that is, in some fashion, etching scars into their
skin. Nevertheless, it is those scars
that led us to where we are now. It is our past that has brought us to
our present where trying to fix others is our passion. It is those scars
that attracted us to a profession in which we can help prevent, treat or heal
others’ scars. It is those scars that
brought us into the business of helping people, of healing people, of fixing
people. It is those scars that drive us to continue to do what we do. And, as with many in the medical field, I too
have an undeniable, unrelenting, nagging desire to fix people and things.
Aside from our superficial, yet deeply personal motivation
for pursuing a career in EMS, why do we have this urge to fix others? At what cost? And who are we really
trying to fix?
According to Messina (2008) this need to fix is a
“compulsively driven behavior to rescue or help another person, place or thing
to be the way you believe it ‘should be’”; or our “inability to accept people,
places or things the way they are and the chronic attempt at changing them even
if they are unchangeable”.
By this, I don’t mean that we live our everyday lives
working toward the goal of making people become what we want them to be, or how
we feel they need to be; rather, I mean we have taken on the responsibility,
the job, of doing what we can, of doing the right thing, in order to save
people from their ailments, self-inflicted or otherwise. In doing so, we interact with others in such
a way to gain insight into their behaviors. We utilize the attribution
theory, to some extent, to assign certain behaviors to either dispositional or
situational causes. In other words, we make a judgment: is this person
the way he or she is because of an internal desire, thought or personal motive,
or are their actions a result of their situation and surrounding environment,
such as socioeconomic status, upbringing, or home life?
We’ve all had those patients who, no matter how much effort
we put forth to fix their COPD exacerbations, we see them again the next week
for the same thing. This time, however, they know the protocol almost
better than we do, and definitely better than any of our trainees. They tell us what to do, how to treat them,
and what course of action they know will work best for them. No matter how hard we try to fix them, though,
we can’t. We can educate them, but they still won’t take their
medications as prescribed. We can administer albuterol, steroids,
magnesium and continuous positive airway pressure in the acute setting to help
them breathe again, but the hypoxia and feeling of impending doom doesn’t persuade
them to be compliant with their medications in healthy times. We can
fight for their life, and they still won’t fight for their own life.
Likewise, we’ve all had that friend or family member whose
life means more to us than anything else. We will fight for them, for
their success, for their happiness, and for their friendship. But no
matter how much effort we use to help them fix their own issues, they still
fumble just a week, a month, or a year later and need our help again. Or
we have that friend we wish we could help, but he or she won’t allow it.
Similarly, we have all been that friend or family member in
need of fixing and have either allowed it, fallen again and needed the support
once more, or we have been that friend who refused to allow someone to make an
impact on our life due to stubbornness or simply denial, trapping us into a
lifetime of enduring turmoil.
This brings to mind the Greek Mythology story of
Sisyphus. Sisyphus was a king who
conducted himself in a less than favorable manner. As a result, he was punished by having to
roll a boulder up a mountain forever. As
soon as he’d near the top of the mountain, the boulder would slip down the
hill, and his task would begin again from the base of the mountain. Thus, he was fated to eternal struggle; to
what has become known as a Sisyphean task: one that appears never-ending and
represents perpetual torment.
In his essay, The
Myth of Sisyphus, Albert Camus recognizes that Sisyphus is
considered the absurd hero of the story because he persistently started his
punishment from the beginning each time the boulder rolled to the bottom. But Camus (1955) suggests that instead of
viewing Sisyphus as a miserable mortal who would forever participate in his
routine in sadness, he should be viewed as happily undertaking the mundane,
everyday life allotted to him. And that
is what makes him a hero. That is,
instead of giving up, Sisyphus remains steadfast and inclined to complete his interminable
task that has become his life’s challenge, or his challenging life.
On a personal level, like many others, I am in need of
fixing. I do what I can to fix myself, but sometimes I fail. I can
try, but often, I don’t succeed. I'm human; by definition, I’m not
perfect. And so, over the last year I’ve
taken on an incredible challenge: transition into a person I’d want to
associate with and revert back to the person I truly am. I have not only
bettered myself physically, becoming a healthier and more active person, but
also have made strides toward bettering myself emotionally and mentally.
Now, don’t get me wrong, it hasn’t been an easy road and I’ve hit multiple
speed bumps on the way: socially, emotionally and physically; nonetheless, the
journey I set out to trek seems worthwhile, despite the trials and despite the
grief it has caused.
Elizabeth Kubler-Ross (1969) describes the grieving process
in five stages: denial, anger, bargaining, depression and acceptance. Kubler-Ross (1969) notes that these stages do
not have to occur in the above order, nor do they have to occur at all. The author also explains that each stage is
not bound to a specific timeframe. While
these stages are generally relevant to loss by way of death, I’d like to
attempt to use them in analyzing the following situation, starting with what I
wrote above: that like many others, I was initially in denial of that within
myself in need of fixing.
As a generally calculated individual, I have been surprised
by the things with which I’ve been confronted that I didn’t, and probably
couldn’t have planned for during my personal evolution. For starters,
emotionally, I have allowed barriers once erect to fall to the ground. As
I’ve shed weight in the form of fat, I too have shed weight in the form of
emotions. In fact, as difficult as it is to admit, for the first time in
a very long time I can honestly say I feel again, both positive and negative
emotions; I can truly empathize and sympathize with and for others. I can genuinely smile, laugh and cry again,
all of which I’ve done in the past year.
I learned this through various experiences, including thoughtful
introspection and interpersonal interactions. When I first started exercising
and working toward bettering myself, I received a lot of flak from the people I
once considered close to me. I was told by many that I became a bad
friend as I ditched them for the gym and my trainer, one of my closest friends.
Many things from my past resurfaced, both internally and externally, which
taught me that no matter how difficult a physical feat getting healthier can
be, the social and emotional aspects of getting in shape, too, are difficult. Alas, the depression kicked in.
I’m not really sure why my physical transition became a
threat to anyone else, or how any person, whether a friend or an acquaintance
could possibly see a downside to my becoming healthier. Despite opposition, I continue to grow.
In spite of what people think and say about me in my pursuit of happiness, I
continue to try to better myself; to fix myself. Despite some of the
immaturity, bullying and down-right viciousness, I’ve continued to try to put a
smile on my face, keep it moving, and persevere. In the face of struggle, I’ve chosen to
proceed in happiness rather than in sadness, even though there was, and still
is, a lot of sadness and hurt.
What this has uncovered, at least from my somewhat
belittled perspective and perhaps for many of you, is something that I believe
has afflicted our profession for some time; a pandemic issue that we are all
aware of, but somehow haven’t taken a stand against. Something that, conceivably, if unfixed, can
ruin our profession, or at least prevent it from progressing to the greatness
it deserves: dirty politics.
In a profession that theoretically attracts individuals who
are innately good, who try their best to help people they’ve likely never met
or whom they might never meet again, it is, instead, one littered with
individuals who, while potentially excellent practitioners of pre-hospital
medicine, lack the interpersonal skills and emotional intelligence quotient to
recognize that we are not here only to help fix our patients, but also to help fix
ourselves and our colleagues. We are here
to fix each other, our team.
In an age where mental health issues and emotional
well-being are common conversation topics, less stigmatized than even five
years ago, where multiple organizations and movements exist to promote personal
health, mental and physical, for pre-hospital providers and other public safety
workers, it is unfortunate that in many cases, we ignore the needs of our co-workers.
And for what? Personal gain? Status? Ego? Reputation?
I'm still not quite sure. The way I see it, the stronger our
workforce, the better care we, as a cohesive group, can provide for the people
we serve. The more mentally and physically healthy our workforce, the
more meaningful our service becomes, to us, our peers in the medical field, and
most importantly, our patients and their families.
Linking this to a relatively current incident, there have
been a set of viral images floating around the internet that depict a
pre-hospital provider giving the middle finger in front of dying patients. Much of the commentary surrounding this
circumstance relates to how awful an individual she is. Many people have nothing but harmful things
to say about her. However, one of my
respectable and noble bosses very astutely pointed out that instead of berating
this provider for her actions, why hasn’t anyone stepped up to ask her what’s
wrong? Why have many assumed she is an
evil person, and that’s why she did what she did? Why are we perpetuating the evil by
portraying her as evil? Don’t get me
wrong, I do not, in any way, condone her actions; however, we as a group of
pre-hospital providers, all too familiar with the effects of burnout, should,
instead of pointing the finger at her for doing something terrible, ask her why
she did it? Why don’t we ask her what
bothered her so much that she felt she had to do that? Or simply ask her if everything is okay?
So in this era of understanding, why is it that we allow
the bullies and the childish gossip-mongers to continue to do what they do?
Why do we allow such behaviors and verbal or emotional assaults to
continue to bring down our own? To bring down OUR workforce? In a
profession that is supposed to attract innately good individuals, why have we
allowed our profession to be consumed by some who are incapable of expressing
that innate gift of kindness and caring?
Why have we allowed our profession to be consumed by some who are not
just incapable of fixing and of being fixed, but who alternatively cause damage
and create the very scars that brought us into this line of work? And then there was anger…
And what have we become?
Who have we become? How have we
been changed?
Messina (2008) explains that when we become overwhelmed by
our compulsive desire to fix others, we subsequently become incapable of
emotional detachment; thus, we will be unable to walk away from someone we know
needs help, our help, or anyone else’s help.
Furthermore, we will lose sight of our own needs, our own wants, our own
desires; our self-identified physical and emotional characteristics in need of
fixing.
But how do we walk away?
Or how can we walk away? As part
of my challenge over the last several months, I’ve decided to rid my life of
toxicity and toxic people. I’ve cut off
ties that I previously couldn’t fathom severing. I’ve removed certain people from my phone,
stopped saying hello to them and even do what I can to avoid them
altogether. Now, I’m not preaching that
avoidance is the key to being successful in such a mission; on the other hand,
when communication is unproductive or impossible, and all avenues to decrease
hostility or toxicity have proven fallible, distance is what I’ve found to be
effective. And yes, I’m happier as a
result, even though it took some time before I could accept that fate.
Messina (2008) adds that in our fight for someone else, in
our pursuit for their happiness, we allow them to become dependent on us,
incapable of fixing or even making the attempt to fix their own wounds. And then we continue to fight for something
or someone that we cannot control, who we cannot change. We begin to fight a losing battle against our
self, and only our self because no one else is fighting. We begin to bargain.
And so, I offer a different set of questions related to
Sisyphus’s heroism:
Why did he not walk away from the challenge? How could he not recognize that his task was endless
and that his efforts would be fruitless?
Perhaps Sisyphus is stubborn, or in denial. Perhaps he was fueled by his anger with the
gods and the underworld or by the fact that his task could never be
completed. Perhaps Sisyphus didn’t want
to be a quitter; he bargained for a better outcome. Or perhaps Sisyphus just accepted his depressing
fate and continued to push forward, despite opposition, or in spite of
opposition.
Still I have a hard time believing that anyone, including
Sisyphus, can truly be happy without attempting to alter the mundane, to affect
change, to create their own happiness.
And not through acceptance of the routine, but by crafting a routine, a
life that is fulfilling; a clever method of pushing the rock over the mountain
top. I have a hard time with accepting a
task as inflexible, unchangeable, or futile.
I have a hard time accepting that some are capable of accepting as final
that which they know they can change and that which they know if changed would
create a world of happiness. I have a
hard time giving up, unless I’ve tried everything in my power to make a
seemingly losing battle meaningful, until I’ve exhausted all options, or until
I can prove to myself, without a shadow of doubt, that my continued effort
would be wasteful.
A lot has happened over the last year and it affected me in ways I
never could have imagined. I lost friends
who I thought were close friends but turned out to be less than acquaintances. I lost a lot in investments I made and
continuously bought into over the last several years. And despite my overwhelming desire to fix
messed up relationships and situations, I’ve decided that in this specific
situation, with these specific relationships, I needed to give up. Instead of persevering as Sisyphus and
accepting a losing fight, I chose to continue my walk up the mountain, leaving
the boulder at the bottom where gravity dictates it should stay. I’ve accepted that which I cannot fix.
And I’m not accepting it in a way that makes me a quitter; I’m doing it
in a way that proves I’m a winner because I tried. I did everything I possibly could and
realized there was nothing more I could do to fix this except move onward toward
affecting change on a global level by taking a stand against bullying, trash-talking,
pitting people against others, back-stabbing and ultimately damaging
individuals who we are supposed to help, fix and heal.
Messina (2008) concludes that we must learn to “accept the belief that
others must accept personal responsibility for their own lives and actions.” Not everyone has to be Sisyphus, forced to fight
for an unattainable goal. In fact, we
shouldn’t want to be the absurd hero. We
should want to be the hero who refuses to accept the status quo and takes a
stand against that which can be changed.
And we should want to be the hero who can happily accept that some
people or situations are unchangeable.
That at some point, our efforts become futile, rigor mortis sets in, we
can no longer try to fix the unfixable, and we must subsequently let the
boulder roll to the bottom of the hill so we can keep moving forward a few
pounds lighter.
"God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference." -Reinhold Niebuhr
"God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference." -Reinhold Niebuhr
References:
Camus, A. (1955). The myth of Sisyphus, and
other essays. Vintage.
Kubler-Ross, E. (1969). On death and dying.
New York, NY: Macmillan.
