Choice

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As paramedics we’re taught that our safety comes first, then our partner’s, then the patient’s. But what do you do when you have two patients, both in critical condition, and one is a child—who we all tend to go the extra mile for whenever possible—and the other is your partner; not your work partner, but your life partner? That was the situation that fateful day in January when everything good in my life fell apart.

Alex and I were on our way back from skiing in the mountains. It was late, the roads were desolate, and we were tired and hungry, so we stopped at a Mom-and-Pop restaurant for a reprieve. We parked the truck in the lot beside the building. I remember seeing another car nearby with its headlights on, but I didn’t think much about it. When we got to the door, Alex said she had forgotten her phone, so she went back to the truck while I walked inside to get a table. I had just gotten to the hostess station when I heard this thunderous BOOM! The whole place shook like an earthquake. Pictures fell off walls, plates off tables; even a window shattered. Through the jagged hole in the distance, I saw flames shooting into the sky where once a small building had stood, and a cloud of dust blanketed the lot.

My mind immediately froze, which is normal, I know, for situations like this. Fifteen years as a first responder certainly had me see my share of calamity. But this situation was anything but normal, because Alex was caught somewhere in the plume.

I ran outside, calling her name. The wind was blowing, and as it covered me with dust, I could barely see. When the cold hit me face again, I opened my eyes. In a field of debris, I saw Alex lying twisted on the ground; close by were two figures. When I got to them, I knew immediately that the larger one was a “black” tag—a triage term for a person who is dead or highly likely to die. I ran to Alex first. She was covered in blood from a wound to the side of her neck; she was pale and without a pulse. A young boy nearby was also laying still, burns on both of his legs, blood coming from his ear, but moaning slightly, “Help me!”

How do you choose: A stranger or your loved one? A child with a faint pulse or the love of your life without one? The paramedic in me said save the boy—he was young, kids are more resilient; he had hope; he was a “yellow” tag (critical); Alex was “black.”

“This can’t be happening,” I yelled, trying to gather my thoughts, trying to keep it together. But the only thing I could think was that the woman I loved wasn’t coming back.

Despite the odds and protocol, I choose to try to bring her back to life. And again, despite the odds she survived. But our decade-long, loving relationship didn’t. In the months that followed, I grew angry, distant, and resentful. It doesn’t make sense, but it was as if every step toward health Alex made, took me one away from her. I couldn’t stop thinking about the little boy that I’d left to die. The local paramedics had gotten there within minutes, but said by then, he was nonresponsive too. They were working on both him and Alex as they whisked them away. But because she was medivacked to a hospital near where we lived, I never learned what happened to him; what’s more, I could never bring myself to find out.

I wasn’t mad at Alex, despite how I acted towards her. I was enraged with life. It put me in an impossible situation and said choose between your conscience or your heart. I’ll be honest, the whole thing tore me apart—and then I tore everything in my life apart, including the best thing—Alex.

The day I heard she got married, whatever was alive left in me died. And the day I heard she got divorced, a few years later, was the day I finally decided to find out if the boy had done likewise.  —He hadn’t. He survived.

So, I managed to contact him. I don’t know why exactly—maybe to ask for forgiveness for not trying to save him; maybe to try to close some existentially severed loop. He didn’t know anything about “my choice.” He was quiet and listened as I rattled on. When there wasn’t much more to say, he mentioned that he had recently gotten engaged.

“I wouldn’t have saved you either,” he said plainly. “Not if it was my wife.”

In a triage situation, you don’t have perfect information, and often there is no right or wrong answer. For all our “color” tags, there is a lot of gray. But as I’ve come to see, that’s just the way life works. And maybe that’s for the best, because it gives us a sense of freedom to choose some action in every moment, even when it doesn’t make sense or feel good. If we reject or question that freedom, then we reject life. In essence, we die.

—And after losing a decade of my own life to a living death, to being held hostage to bitterness and self-isolation, to thinking the world was a ball of meaninglessness that could give a shit about me or anyone I cared about, I now see there could be no greater thing than caring and choosing—very specifically, choosing love.

Next Vignette: Sealed

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