Cauterizing Empathy

In my early twenties I worked in Madison, Wisconsin as an Emergency Room orderly (nowadays called a “technician”). On my off hours I volunteered as a medic for a local ambulance service and was skilled at CPR.  So in the ER I was often called upon to help with resuscitation efforts in cardiac arrest cases.  Being a young guy, that was very exhilarating for me.

One night at the ER, the ambulance brought in 19-year-old boy who had been riding his motorcycle when a pick-up truck ran a red light and broad-sided him. I was assigned to start compressions on his chest while the nurses established IV access.

The boy was mangeled.  His arms and legs were bent at nauseating angles. And with every one of my chest compression, blood came from his eyes and nose. He had not worn a helmet and his skull had be shattered.

Suddenly I started recalling how  I found my best friend dead a few years earlier.  I thought of how this boy’s parents would be told tonight that their son had died. Tears started to roll down my cheek. My compressions slowed down. I wasn’t going to be able to continue — I was too sad. But I told myself, “Stop. Be strong. Keep pumping.”  So I shut down part of my mind to keep going.

The boy died, of course. But I remember that day like yesterday because that was the beginning of shutting down a very human part of my mind — a part I would shut down more and more easily each time in the years to come while I worked and lived in intense situations.

Several years ago I read a study that showed that many ER employees have many traits in common with soldiers with PTSD.  After reading the article, I read up a little more on PTSD and I understood a little bit more about myself.    This post was inspired by Joshua Allen’s post about suffering in his childhood with a crippling hyper-mirroring system which he learned to “cauterize” in order to survive a normal life.   His use of the term “cauterization” reminded me of exactly what I did in the ER that night. What I needed to do to work in Emergency Medicine wasn’t half as intense as what Joshua apparently went through and nowhere as deep as what soldiers in battle must do, but the process sounded similar.

Question for Readers:  Do you have any similar “cauterization” stories?


Filed under Philosophy & Religion

9 responses to “Cauterizing Empathy

  1. Yikes!
    The tragic loss of a couple pets comes to mind. And the necessary decision to end their suffering and “put them down.” Still tough to swallow. Very tough.
    Yet I wonder. Have hunters become cauterized to the pain and suffering of, say, a felled and dying deer? Or have they never learned to extend their empathy in that direction? Have they learned a different set of core assumptions about life and death on earth?

  2. I am not sure how hunters do on that number. Interesting question. I know for some the killing gets easier and for some it gets more difficult — but my sample size is small.

    Long ago it was discovered that armies lost soldiers due to hesitancy to fire again after they just killed one enemy close up. But desensitizing the with kill video games, the military has lost less soldiers to this initial-kill shock. Video kill games cauterize the mind too.

  3. Wow, I have to say your experiences were a lot more intense than anything I ever had to face. I’ve seen a couple of people get strangled and lose consciousness, people get cut open to the bone, severe drug O.D., and plenty of violent fights, but I doubt any of it was half as bad as you saw in the ER, and I never had much of a personal attachment. I started cauterizing at a very young age, so even in the intense experiences I witnessed when young, I just instinctively projected out of my body and watched my body from the outside (standard dissociative reaction). I was probably 23 before I was even capable of forming the sort of emotional attachments that you had.

    Interesting point about kill video games. I sometimes like to play the games with only my knife; running around and knifing the other players who have guns. My wife thinks it’s horrifying, but I explain that it’s not about gore — it’s about being able to keep your head on straight and focus; just like rock climbing. There is a guy on YouTube who records himself playing with only a knife, and the reaction of the other players can be quite hilarious. If they got emotional like that when rock climbing, they would fall off the wall.

    On the other hand, I still don’t understand why people watch gory horror films. It seems to serve no purpose. I can easily dissociate and feel nothing in a horror movie, at which point it is boring, so I have to assume that the people who watch the movies are doing it for some arousal they get out of it. I have good friends who watch the goriest films, so I don’t want to be judgmental, but I just don’t get it.

  4. @ JS
    Nah, your experiences are unique. There are lots of folks like me.
    But the video kill games stuff fascinates me a little. I have absolutely no interest in it. But I love knife fighting and have trained in it with Aikido and have protected myself in two actual potentially deadly knife fights using that training. I enjoy fighting though I don’t do it nowadays. Yet I would not do it in a game. I like skiing, boarding, kayaking and biking but I do not enjoy doing them on a game. So I wonder what temperament aspect makes folks like me vs other folks. I wonder how such a temperament would affect their philosophical/theological tendency? Hmmm, that would be fun to know. We can see how “paranoid”, “angry” and such affect theology, but what about virtual violence.

  5. PS — I watched the video you linked and listened to a commentary. Being untrained, I can barely tell what is happening in the video.

  6. ministering to people in the ER as well as the staff, i can totally relate. one really sticks out besides the dr from alt. medicine is the devil.

    man comes in to the ER, side-swiped while riding his bike on a country road. wife was there with him, she is a doctor and is enroute to the ER. guy was lucid and communicating but that started to deteriorate and speech became confused and then devolved into grunts. dr’s concluded that it was the brain swelling after a few C-T scans and such and decided to push him in another room and wait for the swelling to go down, since it was a busy day in the ER and we had something like 5 traumas. (granted this is my untrained observation and understanding of the situation).

    anyway, i take the wife back to see her husband and i notice something is weird. seems like he has broken out in hives. turns out he had vomited and was covered in it. no nurses or doctors around monitoring the patient, they were too worn out or distracted by the other 4 traumas or something. when i alerted the staff, they acted like it was an inconvenience for them and scolded the wife for starting to clean him up and for placing him on his side. i was floored by the lack of compassion and humanity shown by the staff in that moment.

  7. Tim Smith

    I cannot imagine what my reaction would have been if it were I trying to save that mans life but I can hope that it would have been to keep pumping. I vividly remember an episode from my childhood days when a friend of mine flew suddenly over the handlebars of his bike. We were traveling fast downhill engaging in the old ‘ look Ma no hands’, trying to see who could hold out the longest from having to hand steer his bike. When I managed to stop and return to where my friend was I noticed a quarter sized piece of his skull, hair side up, lying on the road. He had also broken his collar bone. Only after walking him about a half mile to his house and handing him over, so to speak, to his parents, did I become shaky and nauseous. This is not the same as an ongoing measured attempt to cauterize empathy since it was a unique singular event but it answers to that need to, as they say, ‘get a grip’. More difficult to deal with is living with an alcoholic father where to cauterize emotion is to survive. A person cannot even really know themselves in such an atmosphere because everyone else is also scrambling to maintain their sanity. Writing this now is cathartic, yet I feel exposed in a way. So be it! I said it!!

  8. @ Zero
    I was trying to explain why police, nurses, doctors, firefighters, soldiers and many more may seem callous because of what they have had to turn off to serve. Sometimes the result is burn-out, sometimes efficiency and skill. For those who have never been there, they will not understand the dilemma. One has to be the person with the final responsibility to really understand.

    @ Tim
    I liked your phrase “Get a grip” — great when it is voluntary.
    Learning to get a grip is important but the loss is sad.
    To choose and cauterize one’s empathy is one thing.
    But to have your freedom to enjoy a childhood taken away by a drunk is a whole new horrible cauterization.
    Thanks for the note.

  9. no, i totally get that. that was the first time i came face-to-face with it. i didn’t understand it for what it was at the time and it affected me deeply. not only with the relations with the staff, but also with that particular patient. i really failed that couple that time out. others, thankfully stepped in, but i was seen as complicit in the lack of empathy and i felt it too.

    from that point forward i made sure to check in with the staff during a particularly busy/hard day and keep them in mind too and help them center and know that i saw what they were going through. it was both burn out and efficiency that day which i also learned from this experience that sometimes it’s hard to tell the difference between the two.

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