It was a night of restless dreams. So when my phone blinked to life at 1:42 a.m., my eyes snapped wide open.
[ALERT] **VDEM** FRONT ROYAL SAR
VDEM is the Virginia Department of Emergency Management, the state authority in charge of all emergency responses, including incidents involving missing persons. In those situations, VDEM sends out an alert to local search and rescue groups like the one I had just joined.
Unlike the large bolus of basic science that medical school was crushing into my few empty corners of cortex, trouncing around the wilderness for missing persons felt like something real. Something even I could do to help. I wasn’t going to save anyone with my understanding of the Krebs cycle or my thin knowledge of deep cerebellar nuclei, so searching and rescuing was my chance to do good. It even dovetailed nicely with my motivation for studying medicine: to be there for someone on the worst day of his life (I felt that being lost and afraid counted as a pretty bad day). Of course, being a new member of the rescue group, I couldn’t just sprint into the darkness with nothing but my wits and a flashlight; I needed a more experienced, “callout-qualified” member to go with me.
[ALERT] Boots-on-ground needed. 73 yom has dementia and parkinsons w/ large search area. vdem onsite & requesting quick response.
It was 2:08 a.m. and still no one else had responded. I kept myself occupied with visions of charging through the Virginia underbrush, using my newfound skills in compass protraction to keep us on track. I would scan the darkness with the slim cone of my headlamp. I would see a broken branch or a bit of torn clothing, just like in the movies, and keenly deduce that a 73-year-old male with dementia and Parkinson’s had come that way. I saw myself doing a controlled slide down a wooded slope, kicking up leaves as I landed at the bottom. In my dreams, I found the man. In my dreams, he thanked me. He would always remember this day. The worst day of his life no more.
[ALERT] FRONT ROYAL. vdem requesting at least 20 bodies.
It was 6:21 a.m. and I had my pack ready to go. Hell, it was ready to go at 4:33 a.m. I had bottles for water and matches for fire. I had the colored tape we were going to use to mark clues (I really hoped I could find some good clues). I had the five trash bags to make an emergency shelter if things got bad and we had to spend a night outside. Whistle? Check. Food for 48 hours? Check. Knife? Yeah, I had two. I sat there in the living room feeling really ready and really foolish all at once, like some kid stood up on his first date. I called James, a senior member of the rescue group who was guiding me through training process, to ask if he was going.
“Yeah, but not until 11. I need to run dispatch, but you can go.”
“No one else has responded.”
He told me to sit tight. He would shoot me a text on his way out the door. Over the next five hours, I made sure to review my training materials. How to triangulate the position of a downed plane. How to make a litter system out of one-inch tubular webbing. How to clear a safe landing zone for a helicopter. It was all so cool. I never thought I would learn how to clear a helicopter landing zone. Back in class the next week, everyone would ask me about my weekend. I would tell them about the restaurant we went to, mowing the lawn, and casually mention that I had also cleared a helicopter landing zone. Luckily, my phone winked again, saving me from the torrent of haughty daydreams.
hey, it’s james… Heading out now.
It was 11:03 a.m., and 39 seconds later, I was in the car racing towards the highway. I had over a hundred miles to drive and I was shooting for under two hours. It would be tight, but I could do it if the lights swung my way.
Two hours later, I was less than fifteen miles from the house. It might have been construction or a multi-car pile-up or an escaped unicorn. All that mattered was that I was stuck. I listened to music to keep my psych going. I tapped my fingers on the steering wheel, hoping to drum up the motivation to maintain the tectonic pace. I thought about what I was going to do when I got to the command center. I would be smooth. Act like I’d been there. Say something like, “Hey, chief, what’s the status?” I had always wanted to call someone chief.
And then my phone woke up one more time:
[ALERT] **VDEM** FRONT ROYAL OPERATIONS COMPLETE. FOUND STATUS 3
Now,when a missing person is found, he will fall into one of three categories. Status 1 means the individual is ambulatory. He may have some injuries but is able to evacuate under his own power. Status 2 means the individual is not ambulatory, requiring assistance to be extricated, for example, by litter or helicopter. Status 3 means the individual is euphemistically unresponsive.
Sitting there in the gridlock, I could feel some emotions starting to bubble up, but the one that burst foully out of my mouth was sheer frustration. I had waited all night to get rolling, but was unable to do so. I had trained and prepared and waited in grueling traffic for two hours, only to be turned around. I could have saved him. I could have. I. Me. It was a spectacularly selfish moment.
Only when I had pulled off the highway and was heading back home did the last bit of that message start to sink in. Status 3. The guy was dead. This man, crippled by Parkinson’s, his brain demented and disintegrating, had died. This father or brother or husband. I didn’t know what he had died from, the message didn’t say. Heat stroke? Or maybe it was just his time. My fiancée said that animals did that. Just wandered into the woods when they felt their time coming. I thought about the people who loved him and checked on him enough to notice he was gone in the middle of the night. And I thought hard about what was really driving me to do good. At that particular moment, it was novelty and excitement. Search and rescue in flashing lights. Vegas style. Even more than that, I liked that it was something unique, something not many people could touch; a precious sculpture behind thick glass.
The parallels with medicine seemed obvious. Complex surgeries, cutting edge technologies, innovative therapies — they all seem so cool. But what happens when we’re mired in four thick years of basic science and clinical fumbling? What if that traffic jam stretches so far past the horizon that we forget where we were going in the first place?
Since the day of the Status 3, I’ve interrogated myself and I’ve felt guilty, and I think that’s okay for a bit. The important part was processing those feelings and finding a deeper meaning within. Through that interrogation, I was shoring up my resolve for the next operation. Reminding myself that what I really wanted and needed — out of search and rescue, out of medicine — was to be there for someone on the worst day of his life.
Author’s note: Names and identifying information have been changed for the purpose of publication.
Medical Student Editor
Georgetown University School of Medicine
Daniel graduated from Tufts University in 2004. His subsequent pursuits included everything from cell cycle research to manufacturing shampoo. Medically, his interests lie in emergency and wilderness medicine, infectious disease, and health care sustainability. Daniel is medical student at the Georgetown University School of Medicine, Class of 2017.