Why We All Need Self Doubt (Even Medevac Helicopter Pilots)

Why We All Need Self Doubt (Even Medevac Helicopter Pilots)

As the pilot-in-command of a medevac helicopter, I am responsible for the safety and operation of everything related to the flight.

But on a recent flight, I didn’t feel “in command.” The flight wasn’t challenging because I encountered bad weather or because there was a problem with the helicopter. The problem was managing my emotions.

When you first start flying medevac, there is a lot of unfamiliar lingo used by the medical crew: elevated troponins, STEMI, Atavan. These industry specific terms enter my headset like new flavors and I roll them around my mouth trying to determine their meaning. Now three years later, I understand much of the lingo, but am still not fluent.

A Complicated Patient

Sometimes the words are common but are used in ways that are unfamiliar. Patients that are close to death are often called “complicated” or “really sick.”

Usually it takes  30-45 minutes for a crew to “package” a patient and get them ready for transport. For this particular call it took nearly two hours, a sure sign that the patient was very complicated. When the patient was finally ready to go, I helped load him into the helicopter.

The helicopter I fly, an Astar, is a small aircraft and it is often a challenging process to arrange all the IV tubing, ventilator, and medical equipment into the helicopter before we close the doors and depart. It often feels like we’re flying a Ford Festiva. The stretcher is next to me and the patient is propped up like they resting on a lounge chair at the pool.  The crew, a nurse and a paramedic, tend to the patient from the back seat.

As I helped load the patient, a man who was unconscious and on a ventilator, I gazed into the patient’s unfocused blue eyes. They were the exact same shade as my Dad’s.

After we lifted for Anchorage the patient’s condition deteriorated. His blood pressure slipped lower and lower.

The Patient is Going to Die

Through my headset, I heard, “He’s going to code if we don’t increase his pressure.”

Coding is the medical term used for cardiac arrest. In my three years of flying a medevac helicopter, I haven’t ever had anyone die in-flight. I’ve also never seen CPR performed in the helicopter. Ideally, the crew has the patient stabilized enough before we lift and during transport to avoid this. Today wasn’t going to be one of those days.

It is a 38 minute flight to Anchorage, but when things start going badly, seconds feel like minutes. I coaxed more speed out of the aircraft. The increase might shave a minute off the flight time. It wasn’t much.

The crew laid the patient down and the IV tubing and sheets were pulled away exposing his fleshy, no-sun-in a-while belly in preparation for chest compressions.

The next thing I heard, “His pressure isn’t sustainable with life. He’s going to die.”

I don’t panic in crisis. It what makes me good at what I do. But this time, I couldn’t do anything. I couldn’t make the helicopter go any faster. I couldn’t make his heart continue to beat. I could only sit and listen.

When my Dad passed away, there was time to make peace with his death. But in this case, there was no time to make peace with the death of a man I didn’t even know. The seconds ticked by, crew flooding his veins with chemical cocktails designed to restore his blood pressure, I was once again reminded that the gap between life and death is very, very small.

I can isolate the crew to cut out their conversation, but in a cockpit the size of a queen-sized mattress whether you hear it or not, it is pretty obvious what is going on. I’d rather hear what the crew is saying.

When people imagine flying a medevac helicopter, they often picture screaming, bloody patients. I’ve had those, but more often the ones closest to death are the ones who have been in the ICU for days, whose bodies are shutting down one cell at a time. They are alive but not living.

If you know my story, you know I’m okay with death. People die. I sometimes even wonder if we are doing too much to prolong life. And yet, I will be eternally grateful to the medevac crews who never gave up on my Dad during his two medevac flights. Having him alive for a few more weeks gave us the time we needed to say goodbye. I think of it as the last of many, many gifts from my father.

But in that moment, I didn’t want the patient to die. Not then. Not like that.

Beat by beat, his pulse began to increase. He moved away from the thin boundary between life and death.

After we landed, the patient was whisked inside. I stood there alone on the helideck, shell-shocked. I willed myself to compartmentalize and moved on auto-pilot to fuel the aircraft in preparation for the next flight.

Filled with Self Doubt

Finished, my own veins flooded with self-doubt:  I don’t know if I can do this.

What is the cost of compartmentalizing? What is the cost of being this close to death on a regular basis?

I felt a tiny piece of my soul crumble.

Nothing to do but keep moving, I went downstairs and grabbed an orange juice from the hospital’s EMS provider’s minifridge figuring a blood-sugar-boost might help. There was a paramedic in the office.

“Hey,” he said, “How’s it going?”

“Alright,” I said looking into his eyes.

What I wanted to say was, “I know what you’ve seen. I’ve seen it too. And I’m scared. I’m scared for that man and his family and for not being able to do anything. I’m afraid I can’t do this, even though it is a job I love.”

Letting Go of Compartamentalizing

Later that night, I finally had the opportunity to let go of the compartmentalizing and weep. As the tears flowed, I wondered, why was this one so difficult?

Was it because there wasn’t anything I could do?

Should there be a mechanical problem with the helicopter, I know my mind would be busy determining the best course of action, troubleshooting the problem, and flying the aircraft. I wouldn’t have time to worry about dying. In this reversed situation, the crew would be unable to do much besides sit and listen and hope the outcome would be alright.

Perhaps we are all just a passenger in life. Perhaps there is nothing to do ever.

Was it because the man’s eyes were so much like my father’s?

I still feel the loss of my Dad. It doesn’t hurt all the time like it once did, but it still can feel so crippling that I want to sink to my knees and sob. Sometimes I do.

Choosing a Powerful Story

Here’s what I decided: I want to be a pilot that feels.

I don’t ever want to get to the point where I’m so calloused I no longer feel. Because although I may feel intense sadness, but I also feel intense joy. With this job, I’m more grateful for life than I’ve ever been.

Self-doubt and fear and sadness are my own internal gauges. So are happiness and joy and delight. Emotions are indicators that we are living.

Fewer emotions = less alive. (click to tweet

We may have moments where we think we can’t do something. But we can and we do.

  • We do achieve our dreams.
  • We do manage the loss of a loved one.
  • We do things that once seemed impossible.

But it isn’t always easy or comfortable.

Earlier I said, that the problem with the flight was managing my own emotions. I’m changing that story, managing my emotions was the best part of that flight.

Being close to death makes me more alive. I want to be close. Close to life, close to death, close to you. Living.

 

 If this post resonated with you, please share it. What are you close to in your own life? Post a comment.

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Comments

  1. Dow Mattingly says:

    This is a magnificent real life story, and what makes it so good is that you convey your thoughts and emotions in such a way that I felt your emotions, and could picture myself as you. It made me think of how life is too short to not embrace the natural cycles of joy and sadness, of life and death, and strive to share with others in this energy. Daily. In every way I can.
    You are a really good soul, and your writing is good too.
    Thank You for sharing.

  2. Your story moved me to tears. You are a beautiful writer, Lorena.

  3. Kevin McKennon says:

    Lorena. What an incredible piece of writing. It hit me squarely in the chest. My father passed on September 14th. It was an incredibly difficult experience, but one that makes me realize how lucky I am. My father chose to turn off the life support LVAD device that was keeping him alive. He made that decision with sound mind and all of us around him to support his journey to the afterlife. I can’t imagine bearing witness to someone crossing over in the back of an AStar. I miss my dad every day, and I know you feel the same void with your own father. I am blessed that I was able to be with my father under calm circumstances, and to participate in a decision with him to say goodbye and move on our own family terms. I cannot imagine losing my dad without that calmness, and to watch someone you don’t even know face death in your helicopter? You are a truly great soul on this planet. What you do is remarkable, and your article was truly an inspiration to myself. Thank you. Kevin.

    • Kevin-
      Thanks for sharing your story. I’m so glad your father was able to make that choice for himself while surrounded by family. I only hope for the same grace and dignity when it is my own turn. Losing someone isn’t something we ever get over, but the sucking ache eases. Be well, friend. Lorena

  4. Thanks for sharing, I ride in the back of a Bell 206 as a nurse full time. I am thankful and humbled by the opportunities that I have been blessed with. This job keeps us cognizant of how fragile and precious life truly is—and for this I am gracious. Keep up the good work.

  5. Mary Ann Melville says:

    I, too, felt I was with you in that A-Star, staring into my own father’s blue eyes. I worked as a flight paramedic in Washington, DC for 9 years; although, we were blessed with a couple of BK’s. I know how our pilots picked up on our medical terminology and it became a running joke with some, “I knew you were gonna use a 7.5 tube to intubate him after the versed and fentanyl.”, a pilot would boast.

    We had many, many sick patients that were flown by our program and that came through our trauma unit; we got through it as a family, and our pilots were an integral part of that family. Thank you for your thought provoking story and excellent writing. Thank you for reminding me of my wonderful days as a MedSTAR Flight Paramedic and all the pride, as well as the highs and lows that went with that job title. Thank you for the work you do. Keep up that work! Wishing you many days of “Clear And Visibility Unlimited”!

  6. Paul Minelga says:

    I flew Medevac in Germany for two years. It brought back lots of memories, both good and not-so-good. Good read…thanks for taking the time to write it down.

  7. Mel Hughes says:

    I have been flying EMS since 1984. I think you will find that by embracing your life, as you have, will only make this experience richer. I hope your career will be as full and sustaining as mine has been for me.

    Mel Hughes
    Life Force 2
    Sparta, TN

  8. Nils Strickland says:

    Great story and insight into a challenging profession.
    I’ve been doing the same since ’93, so you know of which you write.
    Funny…I was being interviewed by a local TV station recently and the reporter asked me for my most memorable flight. Unfortunately, I recall the difficult calls above all others. Its the parents of patients I remember most.
    You write well, Lorena. I hope to see more when you finish that book.
    Keep your turns up and fly safe.
    Nils.

  9. David Tetley says:

    Thank you for sharing your thoughts. I am one if those medical crew members and this article has had a really impact on me. It made me sit and think about my own feelings on life and my behavior which likely modified by being close to death too often. So thank you. And thank you for being there with us. Fly safe.

  10. I really enjoyed this story! A great reminder as a flight nurse that the pilots have emotions too and are a great component of the team. None of us would be able to do what we do if it weren’t for each person and what they bring to the table. Very moving that you are so compassionate about what goes on “in the back”.

  11. Peggy Jones says:

    Dear Lorena, what an amazing article. It was so awesome to read the words you wrote and to hear it from your viewpoint. Thank you for sharing this! Peggy

  12. Very nice article. Thank you for sharing. So many elements resonated with me. I’m asked often what would be the best job I could ever have as I pilot. I simply reply, “I already had it, as a Medivac Pilot flying in Alaska.” No other flying job is more rewarding than helping to save peoples lives.
    Sincerely,
    Eric Boyd
    ExpressJet EMB-145 FO
    ’07-08′ Sitka Alaska Based Guardian Flight BE-200 FO

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