This month a great swathe of the paramedic community will be mourning the loss of one of it paragons, Roland Furber. By all accounts and testimony seen by this author, Roland was instrumental in the founding and forging of the paramedic profession, an extremely altruistic man and a stalwart believer in principled hard work. For the JPP this last month has seen the loss of perhaps its most eminent board member and for the College of Paramedics, it's President and one of its ‘founding fathers’ and for paramedics, a veritable patron of their profession.
The issue of mortality is a difficult concept for anyone to grasp and perhaps impossible for us to truly come to terms with. Unfortunately for those in the profession, paramedics are expected to experience and endure this morbid certainty on a regular basis, witnessing the end of life in immediate and unadulterated poignancy, often involving individuals who have been killed by blameless accident and unhappy chance. As a consequence, many in the profession are perpetually reminded that they too are subject to this fragility and to the plethora of means by which they could have their lives taken away, all the while being expected to remain unwaveringly focussed on treating the patient at hand. As paramedics, you are no more or less aware of the fact of death than any other professional. After all, everyone knows they are going to die even if they haven't fully come to terms with the fact—however, as a member of the emergency services the inevitability of death is impressed on you with far greater regularity than almost any other profession, and the psychological repercussions from witnessing both the fragility of the human form and the seemingly utter randomness of accidental death is a weighty truth to carry as part of your working day. It is certainly a key difficulty to overcome for members of the profession, and one which is arguably neglected and kept ‘out of mind’ as much as possible during pre-hospital practice, an issue explored by Brady (2013) further in this issue.
However, this is not to say that the profession is to blame for its methods of dealing with the phenomenon—indeed, as a species, and especially as a nation, we can be quite useless at dealing with such emotional and psychological discomforts, foremost among them the concept of death. Moreover, those who are unable to endure visceral and lucid reminders of their mortality will find it difficult to remain in the paramedic profession altogether. The UK may be forging ahead in policy and practice with such issues as mental health and the ‘right to die argument’, both in the media and in Parliament (BBC, 2012) but many still seems to hold on to an archaic notion of deliberated ignorance when it comes to discussing and debating morality. The argument this author would purport to paramedics is, therefore, not to strive toward the pretence of being ‘OK’ with the certainly of death—for such a sagely notions are beyond the hopes of many and certainly of this author—but rather to be ‘OK’ with the notion of addressing the fear of death and presenting any anxieties to friends and colleagues in an ordinary and informal manner. Death is unknowable by its nature and therefore a certain level of anxiety is justified; but it is also ubiquitous, and therefore any fears we may have concerning its nature and process (though we may not agree upon their specifics) we may certainly empathise, and through empathy hope to dispel some of the fear that you, as paramedics, must overcome every day.