Monday, December 6:
Johnny's Place, Middle of the Night
Wincing at the brightness coming from the overhead light in the bathroom, he closed his eyes and splashed water over his face. Drying his face, he contemplated the reflection in the mirror. "Not the smartest thing you've ever done, Gage," he said aloud to himself.
He turned on the television and adjusted the volume to a low setting. He idly flipped the channels for a few minutes. There wasn't much on at three in the morning. After watching disinterestedly for a while, he headed into the kitchen to put water on to boil, knowing he was going to need a lot of coffee. And aspirin. Upon seeing the two mugs and the jar of instant still on the counter, he winced, remembering the scene with Roy. He didn't understand the combination of anger and guilt he felt around his partner, but he knew it was making him act in ways he normally wouldn't.
Johnny sprawled in a half-doze on the sofa. Whether it was from so much coffee, the aspirin, the hangover, or stress in general, his stomach was starting to really bother him. Getting up, he rummaged in the refrigerator for something edible. Spying the few remaining cans of beer, he briefly entertained the idea of having a bit of 'the hair of the dog,' but rejected the thought. Showing up three sheets to the wind for his appointment with the shrink simply would not do. He was crazy, perhaps; stupid, no. Finding nothing in the refrigerator, he searched the cupboards, coming up with a can of condensed tomato soup and some crackers. It wasn't much, but it was something.
LACoFD Headquarters, Psychiatrist's Office, Mid-Afternoon
Dr. Wilson smiled warmly at Johnny. His eyes crinkled at the corners and his whole manner radiated compassion. He had helped this young man sitting stiffly before him work through few distressing work-related issues before. Paramedics tended to be perfectionists. While this tendency towards self-analysis did provide valuable feedback in helping them improve their skills, sometimes it had the opposite effect as they ripped themselves apart after making a mistake or experiencing a failed rescue. Dr. Wilson was aware that Johnny recently thought he had failed the paramedic exam and knew that it must have been a tremendous blow to his confidence and self-image. He also had received a brief summary sheet from Captain Stanley, noting his observations. "What can I help you with, Johnny?"
"Captain Stanley sent me here to talk to you." Johnny's voice and posture were defensive and angry.
Paramedics also tended to be control freaks. Paramedics had to be able to take control in chaotic situations in order to provide effective emergency care. Events that undermined their worldview of being in control were very distressing. "Yes. And?"
"I don't want to talk to you!" he blurted out. Immediately embarrassed, he broke eye contact and found something interesting to look at over in the corner.
"Most people don't want to. Given a choice between latrine duty for life and talking to me, they pick latrine duty every time." Dr. Wilson commented mildly, with a smile playing about his lips.
Disarmed by the gentle humor, Johnny smiled briefly, sliding his eyes back to the doctor's face. "I'm sorry." He heaved a sigh that sounded like it must have originated in the vicinity of his toes. "I don't think I really want to talk about anything." He had initiated his previous visits himself. This time was different.
"You're still pretty angry about the things that have happened."
"I'm not angry!" As soon as he said it, he realized what a silly statement that was to make to the psychiatrist. The expression on his face relayed the unspoken message.
When Dr. Wilson did not verbally respond, Johnny huffed softly. While he wasn't exactly thrilled to be talking all this out, he knew that the future of his career would depend in part on his cooperation with the psychiatrist. "Okay. I guess I am angry."
"Anger is a second emotion," Dr. Wilson said. He leaned forward, closing the gap between them. "Can you tell me what you're really feeling? What's behind the anger?"
The paramedic fidgeted, returning his attention to the fascinating view in the corner.
"Tell me what you're feeling, Johnny." Dr. Wilson's voice was gentle.
"Oh, shit. I don't want to do this."
Dr. Wilson leaned back, giving his patient more space. "I understand that you don't. Let's start with the easier stuff. Tell me how you're doing physically. How are you sleeping?"
"Uh, not good. I can't sleep."
"Okay. And how about eating?"
"I'm not eating much either. I'm not hungry."
Dr. Wilson nodded. "And drinking?"
"Not much."
"How much is not much?"
Johnny winced again, his headache still not completely gone. "I had a lot of beer yesterday. But other than that, the only time I drank was the day after they first told me I failed the exam."
"Okay. That's good." Dr. Wilson smiled. "Well, enough of the pleasant chit-chat. Now the hard stuff. Tell me what you're feeling."
Folding his arms across his chest, lips quirked in exasperation, he began. "I feel like I've been taken apart and put back together wrong. This whole thing is so stupid. It should never have happened. How can they screw us over like this? They make us jump through these hoops and when they screw up all they can say is, 'Oops, sorry, here's your life back!'" His feelings of anger and betrayal spilled out into the room.
"I'd be pretty upset if this happened to me, too. You work hard, you do your best and you get slapped down for no good reason."
Johnny nodded. "Yeah. But it's more than that. It's not just 'work' for me. I don't do this because it's a job. This is my whole life. It's what I'm supposed to be."
"It sounds like your personal life and your professional life are one in the same."
"I have a personal life!"
"But do you have a personal identity apart from your work?"
Johnny looked like he was going to say something more, but he instead shook his head.
"Your value as a person is separate from what you do for a living. We men tend to equate our egos with our jobs. We are task oriented and it is often difficult for us to separate our personal value from our performance. You can help people regardless of what your job is. But the helping and the caring comes from here." Dr. Wilson indicated his heart. "It's who you are. It doesn't come from the job. It comes from you. It's all you."
Dr. Wilson let Johnny think about that for a while and then said. "Tell me about your first shift back at 51's."
Johnny sat back and grimaced. "It was terrible. It started out bad and just got worse. One of the guys pulled a practical joke on me. Usually I don't mind much, but that day it just got me. The day was basically pretty slow. We only went on a few runs. But I felt like I wasn't there. I mean, I was there, but I wasn't. I don't know how to explain it. The station felt so strange, as if I had never been there before. It didn't feel like home." He stopped talking, chewing absently on his thumbnail.
"And then what happened?"
A look of irritation crossed Johnny's face. "We got a call about 4:30 for a traffic accident. I've never seen anything quite like it. I don't know how one car got on top of the other like that. Anyway, my partner took the girl with the head injury. I got stuck with a real jerk. I, uh…"
Dr. Wilson carefully observed the paramedic trying to decide what to say. When it seemed like he might not continue, Dr. Wilson verbally nudged him along, "And?"
"I couldn't start the friggin' IV!"
"And you think you should have been able to?"
"Of course! My partner got it started on the first stick."
Dr. Wilson filed that last comment away for future discussion. "And?"
Johnny started talking to the corner. "I'm afraid I can't do it. Any of it. They gave me back my license, but it's like it doesn't matter. I can't do it anyway. I couldn't even go into Rampart for supplies. I felt like everyone was looking at me, wondering, is he really supposed to be a paramedic ..."
When Johnny didn't continue, Dr. Wilson began to speak. "I think you're having a normal reaction. You've experienced some severely stressful events in the past few weeks. You appear to me to be physically exhausted as well. This, plus the less-than-ideal conditions of that run, is coloring your perception of the events."
"What do you know about the run?" he asked apprehensively.
"Captain Stanley told me a little about the nature of the victim. I think you were doing well not to just stab him and be done with it. I might have." Dr. Wilson's eyes twinkled.
Startled by the incongruity of the notion, Johnny laughed, as Dr. Wilson had intended.
"You know the drill. What were the adverse conditions of the run?"
"Well, the victim was grossly obese. And abusive."
"Uh huh. Was not being able to start the IV significant to the outcome?"
Johnny hedged a moment. "No. I guess that really wasn't significant."
Dr. Wilson noted the emphasis. "But something else was?" When there was no answer, the doctor posed the same question a little differently. "Was this other thing significant to the outcome?"
"No. I guess not. It turned out okay."
"So, what would you say to another paramedic who had the same experience?"
Johnny opened his mouth and closed it again, narrowing his eyes in annoyance at the doctor.
"Don't like that question, huh?"
"I'd tell them to blow it off."
"Good advice." Dr. Wilson was smiling.
A wry smile appeared on Johnny's face as the absurdity of his thinking became apparent.
"What about Saturday's shift? Can you tell me about that?"
"Oh, it was just more of the same. I found myself waiting for my partner to take the lead. He … it's … uh … " Deciding to switch topics, he addressed the event that had precipitated Captain Stanley's sending him to the shrink, saying, "About the little girl. I might have done that anyway. I just couldn't let her die! There were a bunch of children that died in a fire that happened while I was at 127's. I just couldn't …" The warning warmth that often presaged tears flooded his face. He swallowed and asked, "Can we talk about something else?"
"Okay." Dr. Wilson knew that just about all emergency and rescue workers found dealing with the injury and death of children particularly distressing. Johnny's previous visits had been the result of some failed rescues involving just that. They could talk about this issue another time, if necessary. "Going back to your other experiences on the last two shifts, after all you've been through lately, it's quite normal to feel like you can't do the job. To tell you the truth, if you didn't feel a little shaky, I'd be very surprised. These feelings will pass. Rest and time will help the most. Often it's best to take a break from analyzing these events over and over. Let them go."
None of these ideas were new. But in times of distress, most people needed to be reminded of principles they already knew.
Johnny was leaning his cheek against the knuckles of his left hand, drumming the desktop with the fingers of his right.
"So, what else are you still angry about?"
Johnny stilled for a second, looked at Dr. Wilson, then his eyes slid away to the corner again as his fingers resumed their drumming.
"Do you know?" he gently persisted.
"Yes, I know!" Johnny replied with some aggravation. He stared down at the desk, willing his fingers to stop moving. His foot took up the rhythmic slack. "I … uh … I'm mad at my partner." Two spots of color appeared on his cheeks. "And that's just..." His eyes bored a hole right through the drywall in the corner. It was hard enough to admit these feelings to himself; sharing them with someone else was even worse. He feared rejection if anyone else knew of what he saw as the hidden corruption in his soul. The only thing that made this revelation possible was his past experience in being able to trust the doctor, plus the knowledge that he wouldn't have to see or work with him, day-after-day, shift-after-shift.
"So, you're mad at your partner, and you're mad that you're mad." Dr. Wilson summarized for him. "What's the first emotion?"
"I hate this," he muttered softly. "Uh…" He thought over the past weeks and the interactions he'd had with Roy, arriving back to the moment in Cap's office when he had first heard that his partner had passed the exam while he had not. "I think I'm jealous," he admitted with surprise and embarrassment.
"That's a normal reaction. Especially when it concerns something you deeply care about. Your partner has something you think you lost and want very much. You see him as being a successful paramedic, while at the same time experiencing trouble seeing yourself in the same light."
"Yeah, but I shouldn't feel that way!"
"Why not?"
"It's … it's … I shouldn't feel that way! He's my partner!"
"You feel guilty about the way that you feel. Ashamed about being jealous." Dr. Wilson named the emotions.
"Yeah."
"Quite a nice catch-22 you have set up for yourself there. Well done."
Johnny smiled faintly, his eyes darting over to Dr. Wilson before fixing on the corner once more.
"However you feel is the 'way you should feel,' Johnny. Your emotions are valid. While it's true we can sometimes learn more productive ways of reacting to or thinking about situations, our feelings arise from our thoughts. Until we change our thinking, we can't change the way we feel."
Johnny pondered that for a while. "So, how do I change my thinking?"
"Sometimes getting another viewpoint helps. Sometimes just talking about it is enough. Paradoxically, you begin by accepting your feelings. Once you've acknowledged them, you are free to change your thinking about people and events. In the case of your partner, you might begin to see that his success in no way diminishes you or your successfulness as a paramedic. Competition with other people is generally not healthy, notwithstanding the prevailing attitudes of our society."
Dr. Wilson waited, giving the paramedic time to digest the idea.
"What else are you still angry about?"
Johnny's face displayed a mixture of amazement and irritation. "What makes you think I'm still angry about something?"
"To use a metaphor you're familiar with, the fire ain't out 'till it's out. Anger is the fire. I can sense you still have some hot spots."
"You can be pretty annoying with this second emotion crap!"
"So I've been told." Dr. Wilson chuckled.
Johnny talked about the situation at 127's with Toby Barnes. "He was on me from the first moment he laid eyes on me. I've dealt with prejudice before, but this guy just never let up. Little things. Little digs. I didn't realize it at the time, but I think he even tripped me in the hall at a fire scene." Johnny paused, lost in the memories. "I don't understand why someone like that wants to be a firefighter, when he so obviously doesn't care about other people. He didn't care about any of the victims. He didn't even care about Alan Cooke. He's the paramedic who was injured in that Thanksgiving Day pile-up. When he punched me, it really hurt," he said, absently stroking the small scar by his left eye. "It doesn't, now. But the things he said … they're still with me."
"Yes. Words are often more painful than punches. So, what's the first emotion?"
Just thinking about Barnes made anger flare. "There is no first emotion! I hate him!" Several different expressions played across his face. He felt sick with the realization. "I guess that doesn't make me any better than he is."
"Do you need to be different than he is?"
"Yes!" he said fiercely. "I don't want to be anything like him!"
"If you want to be different, forgive him."
"What!"
"Forgive him. Harboring hatred can cause as much, if not more, damage as the original hurt. Forgiveness allows healing to begin. And forgive yourself. Forgive your mistakes. Love covers a multitude of faults. There just ain't no other cure for being human."
Johnny sat back in the chair, arms loosely folded across his chest. The intensity of the feelings he had experienced during the last hour had left him drained.
Dr. Wilson also sat back in his chair, granting Johnny more personal space. His eyes conveyed acceptance. "We've covered a lot of ground today. There is a lot to think about. If you remember nothing else, remember this: Things will eventually get better." The doctor considered the young man sitting before him. "You're scheduled to work tomorrow, right?"
Johnny nodded, anticipating that he would not like what was coming next.
"I'm recommending that you take the shift off." Raising a hand to stop Johnny's protest, he continued, "You are physically and emotionally exhausted. You won't be doing yourself or anyone else a favor by working. You need some time to recover."
Reluctantly, Johnny had to agree with the doctor's assessment.
The doctor escorted Johnny to the doorway and shook hands. Eyes crinkling at the corners, he took a minute to review basic stress relief measures, such as adequate food, exercise and rest, ticking them off on his fingers as he spoke. "I know you already know all this, but it's my obligatory, parting advice. You need to eat. Make it something besides donuts, burgers and fries; grease, salt and sugar are not considered three of the four basic food groups. Eat some fruit and vegetables. Cut down on the beer; hops is not a vegetable. Drink lots of water. Go running or fishing or hiking or play tennis. Whatever you like to do. And get some rest. Now, I don't usually say this, but a dead tuna looks better than you, my friend. If you still can't sleep on your days off, call me and I'll write you a 'script for something. Most of all, give yourself some time. And give the events of the past few days a rest. You've been trotting them around twenty-four hours a day and they're dog-tired. Don't make snap judgments about your life, abilities and career based on the fact that you couldn't start an IV on a screaming, fat man. Call me if you need me. Here's my card. And if I don't hear from you by Thursday, you'll definitely hear from me."
Johnny's mouth had dropped open in disbelief during the course of the good doctor's advice. Then he started to laugh.