Crisis

I am who you want in a crisis. I stop, listen, see, and act. My anxiety disappears, I do. I will gather the children, I will have my gas mask on, I will run for the Defibrillator, I will run toward the victim, I know. I have. I do not quite remember when I knew this of myself, during my first resuscitation in nursing school? The first car accident I was in? The next day I will fall apart, but in that critical hour, I will stand.

I believe in triage, although trained, it was always very right intuitively to me. Save who you can, do what you can, move on. Brutal choices, no looking back. Simple choices, action. Still, it took me longer than I thought reasonable to automatically prioritize breathing, a common failing. A year working surgery-recovery to thoughtlessly, automatically, pull out the O2, pull up the jaw to clear the airway, check breathing first and always. I think the reason may be deeply ingrained genetic history. That if a person is not breathing, until modern times, they were not salvageable, so the ingrained human reaction is to go on to the next and staunch bleeding- which is survivable under rough conditions.

Two stories from the first week of hurricane suffering: patients in a nursing home abandoned to the flood, and an ICU nurse, for days, manually breathing for a patient on a ventilator. The first is condemned as heartless and selfish, the second as noble and right. To me, in my darkest hours, I know the first is the sadly, selfishly human survival action, and the second foolish and wasteful, if admirable in impulse. The staff (with the culpable owners off elsewhere) could little have saved disabled elderly, had little choice or resources to do else. The second, who could have eased suffering among others, chose to focus on one who would not survive anyway. Survival is not pretty, and those on-the-ground choices are not always how we want to see ourselves. Altruism is the high risk gamble, the ideal we want others to embody.

So, most of us save the young who will be strong and carry us along, and one will save the oldest member whose grandmother told him about getting to the next valley that may not be flooded. The ghosts follow along, for good or ill.

And the criminals? The ones shooting at the rescuers? Some were shot, some slipped through to safety as well. We want to be innocent, but it is not necessarily a survival trait.

We are thousands of years of disaster and war and each other. We panic and kill, rescue and defend. We are the genes of the survivors, mostly the pragmatic and brutal, a scattering of the lucky and altruistic.

No wonder we want a god to forgive us.