Recently I was reading an excellent book from 2018 by Hans Rosling, with Ola Rosling, and Anna Rosling Roennlund titled Factfulness, It is subtitled Ten reasons we’re wrong about the world – and why things are better than you think. The fourth chapter is titled The Fear Instinct, and it begins with an essay on pages 101 to 103 titled Blood All Over the Floor:
“On October 7, 1975 I was plastering a patient’s arm when an assistant nurse burst through the door and announced that a plane had crashed and the wounded were coming in by helicopter. It was my fifth day as a junior doctor on the emergency ward in the small coastal town of Hudiksvall in Sweden. All the senior staff were down in the dining hall and as the assistant nurse and I searched frantically for the folder of disaster instructions, I could already hear the helicopter landing. The two of us were going to have to handle this on our own.
Seconds later a stretcher was rolled in, bearing a man in dark green overalls and a camouflage life jacket. His arms and legs were twitching. An epileptic seizure, I thought; off with his clothes. I removed his life jacket easily but his overalls were more problematic. They looked like a spacesuit, with huge sturdy zippers all over, and no matter how I tried I couldn’t find the zipper that undid them. I had just registered that the uniform meant this was a military pilot when I noticed the blood all over the floor. ‘He’s bleeding,’ I shouted. With this much blood, I knew he could be dead in a matter of seconds, but with the overalls on, I couldn’t see where it was coming from. I grabbed a big pair of plaster pliers [scissors] to cut through the fabric and howled to the assistant nurse, ‘Four bags of blood, O-negative, Now!’
To the patient, I shouted, ‘Where does it hurt?’ ‘Yazhe shisha… na adjezhizha zha …’ he replied. I couldn’t understand a word, but it sounded like Russian. I looked the man in his eyes and said with a clear voice, Bce Tnxo Tobapniii Wbenckaya Bojbhniia,’ which means ‘All is calm, comrade, Swedish hospital.’
I will never forget the look of panic I triggered with those words. Frightened out of his mind, he stared back at me and tried to tell me something: ‘Vavdvfor papratarjenji rysskamememje ej …’ I looked into his eyes full of fear, and then I realized: this must be a Russian fighter pilot who had been shot down over Swedish territory. Which means that the Soviet Union is attacking us. World War III has started! I was paralyzed by fear.
Fortunately, at that moment the head nurse, Birgitta, came back from lunch. She snatched the plaster pliers from my hand and hissed, ’Don’t shred it. That’s an air force ‘G suit’ and it costs more than 10,000 Swedish kronor.’ After a beat she added, ‘And can you please step off the life jacket. You’re standing on the color cartridge and it is making the whole floor red.’
Birgitta turned to the patient, calmly freed him from his G suit and wrapped him in a couple of blankets. In the meantime she told him in Swedish. ‘You were in the icy water for 23 minutes, which is why you are jerking and shivering, and why we can’t understand what you’re saying.’ The Swedish air force pilot, who had evidently crashed during a routine flight, gave me a comforting little smile.
A few years ago I contacted the pilot, and was relieved to hear that he doesn’t remember a thing from those first minutes in the emergency room in 1975. But for me the experience is hard to forget. I will forever remember my complete misjudgment. Everything was the other way around: the Russian was Swedish, the war was peace, the epileptic seizure was cooling, and the blood was a color ampule from inside the life jacket. Yet it had all seemed so convincing to me.
When we are afraid, we do not see clearly. I was a young doctor facing my first emergency, and I had always been terrified by the prospect of a third world war. As a child, I often had nightmares about it. I would wake up and run to my parents’ bed. I could be calmed only by my father going over the details of our plan one more time: we would take our tent in the bike trailer and go live in the woods where there were plenty of blueberries. Inexperienced, and in an emergency situation for the first time, my head quickly generated a worst-case scenario. I didn’t see what I wanted to see, I saw what I was afraid of seeing. Critical thinking is always difficult, but it’s almost impossible when we are scared. There’s no room for facts when our minds are occupied by fear.”
We can avoid being dumbstruck from fear by first having a disaster exercise. I blogged about that topic back on September 11, 2012 in a post titled Disasters and triage.
As a Boy Scout back in the early 1960s I was part of one of the exercises in Pittsburgh called Prep Pitt. At the Civic Arena I was made up as a casualty with a compound fracture of my forearm. Modeling clay and protruding chicken bones were used. I was sent to the emergency room at Children’s Hospital.
And when I was in tech school to be an Air Force Reserve medic in 1972, we had a plane crash disaster exercise. Three years later, I was at Greater Pittsburgh airport when the crash phone rang on a Sunday afternoon. An Air National Guard tanker was going to land on a wet runway with two of its four engines shut down. While we waited beside the runway along with the fire trucks, I sat in the back of our ambulance and thought I’m ready for whatever happens. Fortunately they landed OK.
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