“Realities of a Ride-Along,” and Mental Health in Medicine

UIWSOM students take steps to mentally prepare for traumatic experiences in the medical profession

By: Kaitlyn Hennessey

“Put your notes away and double glove,” she was told. Uncertain of the circumstances, she followed the paramedic’s orders. The ambulance arrived at the scene with police officers all around, body bags laying on the ground, helicopters flying off…she stops. The sinking reality sets in, as she thinks to herself, “I am the least qualified person here.”

Kaylyn Snook, now a second-year student at the University of the Incarnate Word School of Osteopathic Medicine (UIWSOM), found herself in the aftermath of a mass casualty shooting. She wasn’t a certified EMT at the time. Like all of her classmates, Snook was completing her EMT ride-along, a required training for first-year students at UIWSOM in the EMT certification process.

The EMS unit she rode in was called to transport a victim of the shooting to a nearby hospital. It was an older female, she had four bullet wounds, two to her leg, one on each arm. Snook was told to check her vitals, pulses, and wounds. She performed these tasks in the routine way she’d learned, but this time it was different. This was not a case study, this was a real person in Snook’s care, someone who may not make it through the rest of the day.

Snook stopped to take a deep breath while sharing this story. She spoke from a student-led panel discussion at the UIWSOM campus. The event, “Realities of a Ride-Along,” took place on Thursday, September 20. On one side of a conference table sat Snook and three other second-year medical students – Shelby Valero, Michael Walston, and Rami Alattar. Each of these individuals shared a traumatic experience during their routine EMT ride-alongs.

Across the table from Snook and her colleagues, were first-year medical students about to embark on their own EMT ride-alongs. This discussion is the first annual event meant to prepare the first-years for what they might see during their first emergency medical experience.

Behind the four students on stage was a projected image of a buttercup plant, surrounded by a red circle with a backslash, universally symbolizing the word, “No.”

The old saying “Suck it up, buttercup,” was not welcome here. Dr. Hans Bruntmyer, a professor at UIWSOM, opened the event with a familiar quote to his students – “It’s okay not to be a buttercup.” He uses these words to remind his students the importance of personal mental health in dealing with traumatic situations in their patient’s lives.

It took time for Snook to feel the sorrow associated with her EMT experience. The perceived expectation to be tough, guided her response to this event.

“Vulnerability in the medical field is difficult but necessary,” Snook encouraged the first-years. She and the other students on stage shared ways in which they coped with the shocking events, and how first-years can mentally prepare.

Shelby Valero helped treat a patient that was ejected 150 feet from his vehicle – it was the first deceased body outside of the cadaver lab that she had witnessed, and it was a gruesome scene. She advised the first-years preparing for their ride-alongs with three suggestions. One, “Do whatever you need to do to quietly center yourself before entering a traumatic situation.” Secondly, “Always remind yourself that it is [the patient’s] emergency, not yours.” As medical professionals, staying efficient during the emergency means staying focused, but to deal with the trauma later, Valero finally suggested, “find a form of release.”

Release came for Valero when she decided to mourn the death of her patient. For others participating in the panel discussion, sharing their experience with close community opened the pathway towards healing.

“There is a culture that healers cannot be wounded,” Dr. Stacy Waterman, a counselor serving the UIWSOM campus, said. “We need to remove the stigma that healers don’t need help.”

As emergency physicians, and former military combat doctors and professors, Dr. Robert Allen and Dr. Bruntmyer have seen their fair share of trauma. Their goal is to prioritize mental health awareness at the medical student level by teaching them to share their experiences. The hope is that students will enter their practice knowing healthy ways to cope with difficult experiences. “Realities of a Ride-Along,” is the first in a three-part series focusing on mental health preparedness for challenging experiences that come with becoming a doctor.

The next event in the series will help prepare second-year students before they enter their rotations, focusing on the transition from the classroom to the real world. The final mental preparedness event will be right before the medical students graduate and will discuss what it is like to be responsible for their patient’s treatment.

“Know that you are human,” Dr. Bruntmyer said in his closing statements, reminding the students that he once forgot this, telling himself he was okay with the trauma he saw until apathy almost drove him out of practicing medicine. Bruntmyer stepped out of cultural pressures in the medical field, offering students permission to express their experiences and remember that “It’s okay to not be okay.”