Running Toward Crisis
CONTENT WARNING: sexual violence, overdose, death, trauma.
Names and details changed for confidentiality.
As a teenager contemplating my career, I would plug personality traits and interests into computer programs. They would spit out “nurse” or “counsellor.” I would scoff at the computer screen and say, “This is useless; I don’t want to do these things at all.” Sure, I wanted to help people, but I didn’t want the responsibility of having to do or say the right thing in the right moment. “I’m not that person,” I would tell people. Yet for over a decade, responding to crisis and its aftermath has been a major part of my work life. Increasingly, it feels as well that crisis and despair are everywhere. Too often I have had to be a reluctant and barely competent leader intervening when no-one else would.
I am 19, living in residence at the University of Victoria, taking a city bus with my friend to go see the movie Save the Last Dance. At our destination, a commotion sparks as the bus rolls to a slow stop. An older man has stepped too soon off the curb and been hit by the bus, falling back towards the shelter. He lies on wet concrete crying out one large surprised “Oh” and three panicked small “ohs,” repeating this rhythm with increasing despair. “OH! oh oh oh.”
“Oh my GOD!” the driver says, and calls it in. Passengers getting off the bus stare at him horrified. He has smashed his head. It bleeds in fast-forward dark red drips onto the pavement. There’s a pool of it already as I disembark behind six adults.
I took First Aid in swimming four years prior but I am 19, so I am waiting for someone older to do something. No-one does. So I ask if anyone has anything to stop the bleeding. Someone hands me a handkerchief (rumpled but I pray clean). Maybe this is ill advised since an ambulance is coming but he is bleeding very fast, so I hold it against his head. Now I am the teenager telling an old man not to move because I remember the part of First Aid where head injuries affect the spine and so you shouldn’t move but I forget the part about how to move someone in a way that keeps the spine stable. He is uncomfortable in his position and onlookers tell me I should let him sit up. I say the part I remember of First Aid and I am the person stemming the bleeding so I am 19 and the boss.
Someone else tells me I should be careful about getting blood on my hands. I am not 100 on my HIV prevention facts, but I think him not bleeding unchecked into the pavement is worth what feels like a tiny risk. Blood starts to seep through the handkerchief. I increase pressure and ask him questions to keep him distracted. In mournful tones he says, “Oh this is terrible, terrible!” I assure him soon it will not be so terrible.
When the paramedic arrives, she smoothly moves him using the spine-stabilizing method and I feel both vindicated and embarrassed that it’s so simple — I could have moved him to comfort so easily had I recalled it.
I step back and watch long enough to be somewhat reassured he will be okay. It doesn’t take long for me to feel like a nosy onlooker and I have a film to get to, so my friend and I agree to move on. This is my first taste of being there for a stranger in crisis and never knowing how it turned out.
As we walk away, my friend tells me I was awesome, which is nice.
My hands are indeed a bit bloody, and the security dude at the door lets us in when he sees them. We get to the bathroom and my friend says, “Great way to get us in for free Audrey,” which literally hadn’t occurred to me. But it feels very nerdy to insist on going back to pay, so I agree to go right to the theatre. I watch Save the Last Dance totally distracted by the slowly subsiding adrenalin and increasing cortisol — anxiety about someone confronting us about the unpaid tickets.
My friend becomes a Shakespeare professor. A few years later, I start volunteering at a Sexual Assault Support Centre, and this leads me to suicide intervention, and health promotion in the youth homeless community. I did that work for over 13 years, finally taking a leave and then quitting last year.
In my mid-twenties, when people find out I support women who have been sexually assaulted, they spill their stories. I am only working part-time but already I feel overwhelmed by disclosures at my volunteer job and in my personal life. It feels like no woman I know has escaped violence. In a support group I co-facilitate, one woman cries recalling how her husband ripped her stitches only a day after she gave birth. One roommate tells me she was gang-raped by teenage boys at 15. The other discloses she was repeatedly abused by a private school teacher in whose home Children’s Aid Services had placed her. Some of the stories I hear during this time, and since, I can’t bear to repeat.
I make mistakes, but I learn to hold space for people, to listen without advice-giving. I offer some useful insights, help people make connections and value themselves a bit better. I didn’t think I could do this work at all, yet here I am doing it.
Between community education jobs, I work at a young men’s shelter and a drop-in for homeless youth as a regular youth worker. It’s serving meals, chilling with some wonderful young people, and crisis management. It’s like being a crisis responder where there are lots of downtimes, but then you have to leap to action. We’re not paid even close to police, paramedics, firefighters, or ER staff. But at least we get to engage with the youth when they’re well, too. I explain that loudly to a rude paramedic who comments, “I don’t know how you do this” in front of a room of homeless youth. We had called for help when we were unable to rouse a teenage girl who had tried to drown traumatic memories in alcohol. After that we agree to only call if she has a weak pulse.
At work my colleagues and I try to get a belligerently drunk 19 year old to settle in his room for over an hour.
At home I call 911 three times when I hear my neighbour screaming insults, threats and obscenities at his girlfriend.
At work a young gay man from Columbia cries in my lap about his grief, despair and desire to die.
Over dinners or drinks or coffees, my friends and I struggle to talk about anything other than these young people and our frustrations in the system.
A young man goes missing for two weeks and is found bloated in the local river. It’s not unusual for people to come and go at the shelter, so we take a bit too long to catch that we haven’t seen “Jeff” in a week. His friends persuade us to be concerned. We start putting the pressure on police to investigate him as a missing person. They don’t seem to care much, but a kayaker calls it in. I didn’t work with Jeff as closely as I did others; I don’t think I meant much to him at all. But he meant a lot to his group of homeless friends that I’d known for years, and this grieves me deeply still.
Soon after, I quit my job, move to Toronto, and start a Master’s degree. I hope to shift into community education work in less sad contexts. Over the next year, so much of my academic writing and my personal time is spent trying to process and recover from these experiences. It helps a little.
But crisis continues to follow me.
I call 911 when I hear a woman screaming “Help” in my high-rise hall. All the police can find is a purse with the lipstick fallen out.
50 cars pass a guy having some kind of seizure at the wheel, honking horns in aggravation. This time my mom intervenes and I back her up. I always thought my Mom had the character for being cool in a crisis, but I didn’t. Yet here I am again, helping in a crisis.
I don’t call 911 when I see a middle-aged alcoholic passed out against concrete and an uncomfortable twist of metal because I can tell he’s the kind of guy who would rather wake up with bruises and sunburn than have yet another interaction with police, paramedics and ER staff. I didn’t intervene and yet the image of this guy passed out, sunburning by the second in 35 degrees, is blazed onto my memory. What more is there to do for him?
I want to be useful, and I want a good résumé, so I update my First Aid. But I am still sad, and burned out. So when a man drops off his treadmill across the room from me at the Y and starts seizing on the floor, I say to myself, “If no-one else does anything I will help.”
I count to ten. Yes I literally count, by elliptical strokes.
Adults closer to him surround him but just stand there, gaping and gasping. Waiting for someone to act. Someone runs for staff, at least. I yell “Protect his head!” across the room. “Just gonna get a few more ellipses in,” I think. Nothing. So I maneuver off the elliptical and run across. The man is stuck awkwardly between the wall and his treadmill, his head smacking against the corner of the machine. He is bleeding. I haven’t figured out what to do yet with his awkward position, so I just put my hands around his head so that it smacks against them instead of hard surfaces. A competent staff runs up and pulls the machine away to get to him. Derp. It looked so heavy but moved so easily. I stand back and wait for a second to watch her stabilize his head properly. I’m like, “This is being handled” and go back to my workout.
I crashed my finances to get away from crisis work, but in Toronto it feels like people look at your résumé and go, “Okay this woman works in harm reduction, homelessness, youth. Now for forever more, she must continue to do precisely that.” I get a job running a peer program in a shelter where the most mentally ill and addicted youth end up in Toronto. I work there for five years.
A couple years after the incident at the Y, a young man joins my harm reduction leadership program. His peers embrace him despite his constant inebriation. He always seems to have a beating energy of loneliness, often pursuing connections with young women in awkward and inappropriate ways. At 22, “Ethan” is so addicted to alcohol that his withdrawal symptoms include seizures. He starts his day with a beer or a benzo to prevent serious symptoms. One day, he doesn’t have enough, and he drops in the backyard of the shelter during the smoke break of my training session.
Ethan’s seizure is violent and his head is already split open when I arrive on the scene. In First Aid, they suggest putting a pillow under the head of a seizing person. Where is a pillow when a kid drops on ice and concrete outside? I put my arms under his head so that his head bangs against my arms and not the ground. Paramedics come and take him away, but he’s back and drunk again within a few hours. His blood in my sweater washes out.
Ethan dies a week later from an opiate overdose; a naive friend thinking he could get his friend off alcohol by offering an alternate drug. His friend describes seeing his dead body carried by paramedics down the stairs, tongue hanging, lifeless, colourless. The memory of that description does not wash out.
That month turns out to be one of the worst months of my entire life. Shortly after Ethan’s death, a young woman overdoses in the middle of a workshop I am running. One second she’s talking and the next second she’s blue. I run for help, but freeze when I return. I can’t compute that another tragedy is unfolding after such a rough two weeks with Ethan. My colleague takes the lead of the scene when she arrives. My heart seems to skip a beat when my coworker feels for “Dakota’s” pulse and shakes her head at me. She and the youth ready and administer a shot of Naloxone to Dakota’s leg. Then my coworker says, “We have to do compressions.” And I am the one close to Dakota’s chest, and I am the adult here, and the one getting paid: it is me that has to do it.
A fabulous team of colleagues and peer trainees takes turns to do compressions, administer more Naloxone, talk to paramedics, and comfort youth. After one colleague takes over compressions, I allow myself two minutes to cry in my office before returning to help again. It takes the ambulance 10 minutes to get there, and Dakota comes around moments before their arrival.
Not long after that, “Mckenzie” from that same group calls in a panic and asks for me. When I hear her sobs through the line, I run with my coat still open. I run in the cold trying to think of what to say to her when I get to her. I have no idea. What do you say to a girl who is only 20 and thinks of jumping in front of a train every day, and has just witnessed a young man follow through on that very fantasy?
How can I help her face her mortality and this gruesome tragedy at the same time?
She reaches for a hug exactly like a drowning person reaches for a buoy. It was a beautiful synergy where the only thing I had to offer was the very thing being sought.
Dakota manages to keep herself on the planet for another two years, and makes a major impact in the harm reduction field in Toronto in the meantime. She overdoses in an alley, which had always been my fear for her.
Mckenzie re-emerges after maybe three years, staying at the shelter for one week. None of the new staff remember her. She is a mess, unable to stop herself from blurting out trauma after trauma. Listening is like trying to process each carriage as a train whips by at high speed. Her stories are dismaying, but it also grieves me to see how my colleagues looked at her. They didn’t know her when I knew her.
When Dakota overdosed, Mckenzie had dragged her frozen colleague out of the room to protect her from seeing more tragedy. Now, there are glimmers of the girl I remember in her pride over her tattoos. She shows me a design she drew that incorporates a butterfly and the “four directions” in Anishinaabe culture. The next day she disappears again.
I may never know if she got her tattoo.
I became more experienced. I know when I can de-escalate an angry person and when I need to call police. I have used my body as a human shield to protect youth, even though we were told not to engage physically. I prevented crisis well by being kind and attentive. However, every crisis felt new, and hard. There are rarely good solutions. I always felt like I was watching myself from a distance as my body did the work, shocked that I was the person dealing with these terrible moments.
Thankfully, most of the time, I worked with other brave souls who also chose to go towards crisis, and not just spectate. I was not alone and for that, at least, I am grateful.
I start 2020 hopeful to manifest an income from my own ideas, in my own terms. I will no longer do crisis work, but I will continue to hold space for people’s stories.