1 00:00:00,824 --> 00:00:04,517 I've been a critical care EMT for the past seven years in Suffolk County, New York. 2 00:00:04,517 --> 00:00:06,359 I've been a first responder in a number of incidents 3 00:00:06,359 --> 00:00:09,677 ranging from car accidents to Hurricane Sandy. 4 00:00:09,677 --> 00:00:11,421 If you are like most people, death might be 5 00:00:11,421 --> 00:00:13,389 one of your greatest fears. 6 00:00:13,389 --> 00:00:14,810 Some of us will see it coming. 7 00:00:14,810 --> 00:00:16,809 Some of us won't. 8 00:00:16,809 --> 00:00:18,913 There is a little-known documented medical term 9 00:00:18,913 --> 00:00:20,859 called impending doom. 10 00:00:20,859 --> 00:00:22,186 It's almost a symptom. 11 00:00:22,186 --> 00:00:23,919 As a medical provider, I'm trained to respond 12 00:00:23,919 --> 00:00:25,741 to this symptom like any other, 13 00:00:25,741 --> 00:00:27,282 so when a patient having a heart attack looks at me 14 00:00:27,282 --> 00:00:29,510 and says, "I'm going to die today," 15 00:00:29,510 --> 00:00:33,236 we are trained to reevaluate the patient's condition. 16 00:00:33,236 --> 00:00:35,382 Throughout my career, I have responded 17 00:00:35,382 --> 00:00:37,328 to a number of incidents where the patient 18 00:00:37,328 --> 00:00:38,965 had minutes left to live 19 00:00:38,965 --> 00:00:42,090 and there was nothing I could do for them. 20 00:00:42,090 --> 00:00:44,876 With this, I was faced with a dilemma: 21 00:00:44,876 --> 00:00:48,588 Do I tell the dying that they are about to face death, 22 00:00:48,588 --> 00:00:51,615 or do I lie to them to comfort them? 23 00:00:51,615 --> 00:00:53,808 Early in my career, I faced this dilemma 24 00:00:53,808 --> 00:00:55,366 by simply lying. 25 00:00:55,366 --> 00:00:57,295 I was afraid. 26 00:00:57,295 --> 00:00:59,635 I was afraid if I told them the truth, 27 00:00:59,635 --> 00:01:02,976 that they would die in terror, in fear, 28 00:01:02,976 --> 00:01:06,182 just grasping for those last moments of life. 29 00:01:06,182 --> 00:01:08,950 That all changed with one incident. 30 00:01:08,950 --> 00:01:11,799 Five years ago, I responded to a motorcycle accident. 31 00:01:11,799 --> 00:01:14,601 The rider had suffered critical, critical injuries. 32 00:01:14,601 --> 00:01:17,432 As I assessed him, I realized that there was nothing 33 00:01:17,432 --> 00:01:19,399 that could be done for him, 34 00:01:19,399 --> 00:01:22,664 and like so many other cases, he looked me in the eye 35 00:01:22,664 --> 00:01:27,076 and asked that question: "Am I going to die?" 36 00:01:27,076 --> 00:01:30,582 In that moment, I decided to do something different. 37 00:01:30,582 --> 00:01:33,462 I decided to tell him the truth. 38 00:01:33,462 --> 00:01:36,556 I decided to tell him that he was going to die 39 00:01:36,556 --> 00:01:39,820 and that there was nothing I could do for him. 40 00:01:39,820 --> 00:01:43,596 His reaction shocked me to this day. 41 00:01:43,596 --> 00:01:45,501 He simply laid back and had a look 42 00:01:45,501 --> 00:01:47,927 of acceptance on his face. 43 00:01:47,927 --> 00:01:49,630 He was not met with that terror or fear 44 00:01:49,630 --> 00:01:52,010 that I thought he would be. 45 00:01:52,010 --> 00:01:55,222 He simply laid there, and as I looked into his eyes, 46 00:01:55,222 --> 00:01:57,950 I saw inner peace and acceptance. 47 00:01:57,950 --> 00:01:59,688 From that moment forward, I decided 48 00:01:59,688 --> 00:02:04,402 it was not my place to comfort the dying with my lies. 49 00:02:04,402 --> 00:02:07,147 Having responded to many cases since then 50 00:02:07,147 --> 00:02:09,655 where patients were in their last moments 51 00:02:09,655 --> 00:02:11,511 and there was nothing I could do for them, 52 00:02:11,511 --> 00:02:13,150 in almost every case, 53 00:02:13,150 --> 00:02:16,484 they have all had the same reaction to the truth, 54 00:02:16,484 --> 00:02:18,550 of inner peace and acceptance. 55 00:02:18,550 --> 00:02:20,972 In fact, there are three patterns 56 00:02:20,972 --> 00:02:25,247 I have observed in all these cases. 57 00:02:25,247 --> 00:02:28,903 The first pattern always kind of shocked me. 58 00:02:28,903 --> 00:02:32,840 Regardless of religious belief or cultural background, 59 00:02:32,840 --> 00:02:35,675 there's a need for forgiveness. 60 00:02:35,675 --> 00:02:37,221 Whether they call it sin 61 00:02:37,221 --> 00:02:40,090 or they simply say they have a regret, 62 00:02:40,090 --> 00:02:42,503 their guilt is universal. 63 00:02:42,503 --> 00:02:43,899 I had once cared for an elderly gentleman 64 00:02:43,899 --> 00:02:46,317 who was having a massive heart attack. 65 00:02:46,317 --> 00:02:48,443 As I prepared myself and my equipment 66 00:02:48,443 --> 00:02:51,368 for his imminent cardiac arrest, 67 00:02:51,368 --> 00:02:55,721 I began to tell the patient of his imminent demise. 68 00:02:55,721 --> 00:02:58,719 He already knew by my tone of voice and body language. 69 00:02:58,719 --> 00:03:01,385 As I placed the defibrillator pads on his chest, 70 00:03:01,385 --> 00:03:03,289 prepping for what was going to happen, 71 00:03:03,289 --> 00:03:05,817 he looked me in the eye and said, 72 00:03:05,817 --> 00:03:08,517 "I wish I had spent more time with my children and grandchildren 73 00:03:08,517 --> 00:03:11,588 instead of being selfish with my time." 74 00:03:11,588 --> 00:03:13,920 Faced with imminent death, 75 00:03:13,920 --> 00:03:16,854 all he wanted was forgiveness. 76 00:03:16,854 --> 00:03:18,742 The second pattern I observe 77 00:03:18,742 --> 00:03:21,030 is the need for remembrance. 78 00:03:21,030 --> 00:03:23,287 Whether it was to be remembered in my thoughts 79 00:03:23,287 --> 00:03:25,001 or their loved ones', they needed to feel 80 00:03:25,001 --> 00:03:27,150 that they would be living on. 81 00:03:27,150 --> 00:03:29,474 There's a need for immortality 82 00:03:29,474 --> 00:03:32,118 within the hearts and thoughts of their loved ones, 83 00:03:32,118 --> 00:03:35,391 myself, my crew, or anyone around. 84 00:03:35,391 --> 00:03:38,282 Countless times, I have had a patient look me in the eyes 85 00:03:38,282 --> 00:03:42,220 and say, "Will you remember me?" 86 00:03:42,220 --> 00:03:44,672 The final pattern I observe 87 00:03:44,672 --> 00:03:47,900 always touched me the deepest, to the soul. 88 00:03:47,900 --> 00:03:51,440 The dying need to know that their life had meaning. 89 00:03:51,440 --> 00:03:54,222 They need to know that they did not waste their life 90 00:03:54,222 --> 00:03:57,170 on meaningless tasks. 91 00:03:57,170 --> 00:04:00,319 This came to me very, very early in my career. 92 00:04:00,319 --> 00:04:02,408 I had responded to a call. 93 00:04:02,408 --> 00:04:04,332 There was a female in her late 50s 94 00:04:04,332 --> 00:04:06,390 severely pinned within a vehicle. 95 00:04:06,390 --> 00:04:10,068 She had been t-boned at a high rate of speed, 96 00:04:10,068 --> 00:04:12,500 critical, critical condition. 97 00:04:12,500 --> 00:04:14,740 As the fire department worked to remove her from the car, 98 00:04:14,740 --> 00:04:17,707 I climbed in to begin to render care. 99 00:04:17,707 --> 00:04:20,767 As we talked, she had said to me, 100 00:04:20,767 --> 00:04:23,980 "There was so much more I wanted to do with my life." 101 00:04:23,980 --> 00:04:27,832 She had felt she had not left her mark on this Earth. 102 00:04:27,832 --> 00:04:29,789 As we talked further, it would turn out 103 00:04:29,789 --> 00:04:32,197 that she was a mother of two adopted children 104 00:04:32,197 --> 00:04:35,312 who were both on their way to medical school. 105 00:04:35,312 --> 00:04:37,382 Because of her, two children 106 00:04:37,382 --> 00:04:40,100 had a chance they never would have had otherwise 107 00:04:40,100 --> 00:04:42,321 and would go on to save lives in the medical field 108 00:04:42,321 --> 00:04:44,683 as medical doctors. 109 00:04:44,683 --> 00:04:46,472 It would end up taking 45 minutes 110 00:04:46,472 --> 00:04:48,339 to free her from the vehicle. 111 00:04:48,339 --> 00:04:52,569 However, she perished prior to freeing her. 112 00:04:52,569 --> 00:04:54,661 I believed what you saw in the movies: 113 00:04:54,661 --> 00:04:55,945 when you're in those last moments 114 00:04:55,945 --> 00:04:58,857 that it's strictly terror, fear. 115 00:04:58,857 --> 00:05:01,535 I have come to realize, regardless of the circumstance, 116 00:05:01,535 --> 00:05:04,448 it's generally met with peace and acceptance, 117 00:05:04,448 --> 00:05:08,140 that it's the littlest things, the littlest moments, 118 00:05:08,140 --> 00:05:11,704 the littlest things you brought into the world 119 00:05:11,704 --> 00:05:14,633 that give you peace in those final moments. 120 00:05:14,633 --> 00:05:16,665 Thank you. 121 00:05:16,665 --> 00:05:20,319 (Applause)