Tactical Pause

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Once upon a time, out near Texas somewhere, I was conducting a training exercise. It was a an IED response/mass casualty lane and one of the casualties was going downhill fast (there was a malfunction when the lane trainers had set it up and it was dying a lot faster than they had planned). My fellow medic was held up with other events taking place on the battlefield, and the only help I had was the junior weapons sergeant, the new guy on the team. He had arrived only a few weeks prior and we had not had time to cross train him on emergency medicine, so I had to coach him through saving the other patient’s life, while simultaneously working to save the other one, which was rapidly tanking.

At one point I had to do an emergency cricothyrotomy, and my hands were shaking so badly I couldn’t hold the scalpel still. This is a problem when you are about to cut into someone’s neck. I stopped what I was doing, sat back on my heels and looked around, and took a deep breath. Then I made the cut, inserted the cric and went on with saving the patient.

The battalion surgeon had designed the lane and was overseeing the patients, and he gave me some feedback later that I will never forget. He said, “I saw you stop treating the patient for a few seconds to take a deep breath. I liked that, it was absolutely the right answer. Your patient can survive 3 minutes without an airway or 30 seconds with massive hemorrhage, but he won’t survive even 3 seconds if you lose situational awareness. Never be afraid to take that tactical pause if you need it.”

unsplash.comIn other words, the best medicine in the world is useless if you are getting shot at and don’t notice until too late because you get tunnel visioned.

I was thinking about that this morning at Holy Hour because it has been a heck of a weekend. We got back from vacation at 2:30 A.M. on wednesday, with Evie sick. I had National Guard drill thursday through sunday, Kathleen got sick and still had to work nights, and her parents (who were watching Evie over the weekend) also got sick, but still agreed to watch baby girl while we were out. We had two major projects going on at the unit, both involving a ton of organization and logistical planning, both happening at the same time with limited man power and time to support it. Oh, and I hadn’t done any of my online college classes for the week, and they were all due, and we had not had a chance to go shopping for groceries for next week.

You know the kind of week?

So at 7:30 on sunday we finally all got home, with a couple of hours of weekend left in which to eat some supper and read some Winnie the Pooh, say goodnight prayers, and go to bed, before getting up to do it all over again today.

At Holy Hour this morning my mind was just a flurry of disorganized activity. Between work, PA School, National Guard, Korean, saving up for a new house and all our long range plans, we have a lot on our plates. My mind was full of spreadsheets, powerpoints, schedules, calendars, medicine, anatomy and physiology, Korean language study and this awkward, comical drowning feeling. You know the feeling when you wake up in the middle of the 100 meter butterfly at the olympics, but you only know how to doggy paddle? That’s the feeling.

I explained all this to Jesus, who already knew it, and He worked with me to kind of put it in perspective. Right now, all our plans and work and school are geared towards a couple of years from new when I graduate as a Physician Assistant. Then I can start working, but hopefully Kathleen and I can both cut back our hours so we only work a few days a week and can spend the rest of the time doing things as a family. It’s a good goal, and I think Jesus approves of it, but like any goal it comes with its own set of traps. The incredible amount of work required to make that happen can threaten to crowd out the reason for doing it in the first place! How ironic is it to sacrifice relationships for the sake of those relationships?

All the work in the world, done for the sake of the Kingdom, is going to be a cruel joke if I get to judgment and God shakes His head sadly at me and says, “Well, that’s great and all, but who are you? I don’t know you, because you don’t know me.”

All the financial stability and academic success in the world, achieved for the sake of the family, will be a mockery if two years or ten years from now, Evie doesn’t know me or I don’t know her; or if she is more attached to the nanny or her grandparents than to Kathleen and I; or if Kathleen and I have a great professional working relationship, but don’t really know each other anymore. It’s that old Martha/Mary thing again. Work is great but critical relationships are the better part, and the moment the work starts degrading those relationships it is time to reevaluate it’s place in our lives.

That is why the tactical pause is so important in life as well as warfare. It is a chance to step back for a second, take a deep breath and think about what we are doing. I don’t know how many times I have seen myself and fellow medics get tunnel vision and get so focused on treating one particular symptom or injury that we completely missed something obviously going on with the rest of the patient. We need to be able to back away from the immediate crisis, long enough to see whether it really is a crisis at all, in the grand scheme of things.

Does this intervention really need to be performed right now? Can it wait? Is there something more important? Am I sacrificing my patient’s long term survival chances because I am getting sucked into starting an IV?

How is my relationship with God? How is my relationship with my family? Is the work I am doing for them keeping me from being present and knowing them? If it is, then it needs to go. You can’t get time back. No amount of available then can ever make up for absent now.

Morning Holy Hour, date night, and evenings with Evie are not to be sacrificed. They are the things we sacrifice for.

Ryan Kraeger

Ryan Kraeger

Ryan Kraeger is a cradle Catholic homeschool graduate, who has served in the Army as a Combat Engineer and as a Special Forces Medical Sergeant. He now lives with his wife Kathleen and their two daughters near Tacoma, WA and is a Physician Assistant. He enjoys reading, thinking, and conversation, the making and eating of gourmet pizza, shooting and martial arts, and the occasional dark beer. His website is The Man Who Would Be Knight.

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