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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