Compassion Fatigue

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The Emergency

Brian checked his watch. 4:00 A.M., it read. Only three more hours to go, and then the day shift would be coming in.

The creature was still there, though it, at least, had not done anything new. No more knocking or waving at him either, which was a relief. But it was still staring at him, which continued to be unsettling.

It was getting to be that point in the night now when the calls died down. He’d handled a few more since wrapping up with Cathy, but now there hadn’t been a call in the queue for at least a half hour. It was something he noticed about people in crisis or even those thinking about suicide. No matter how bad life was, by four in the morning, most people were sleeping.

However, it had been around this time when his last very serious call had happened.

Brian hadn’t lied to Cathy when he answered her question, not exactly. HIPAA did legally protect the privacy of all the hotline callers, even postmortem if that was the case. That just wasn’t the real reason Brian didn’t answer the question. The truth was, Brian didn’t know. People who called the hotline did not want to die. If they truly did, they wouldn’t call, and nine times out of ten, that was the truth. Brian could count on one hand the number of times he had a close call with someone who may have died if he had not intervened. There was even less so, that he still didn’t know what happened to the caller when the call cut out.

But that was the thing. There may have only been a few of those calls, but there were, in fact, a few of those calls. Brian never forgot them; he was reminded of their voices just before he fell asleep every night. They were few and far between, sure, but they still happened.

Brian was laying his head down on his arms at his station. His eyes felt heavy, and not even the impending doom that the creature could bust down the door whenever it wanted could stop Brian from resting now. Maybe that was what it was waiting for, for Brian to fall asleep, then it would strike.

Strangely, Brian didn’t care about that, not anymore. He was too tired to care.

His eyes started to shut, when his headset started ringing again, and the call was answered automatically.

Before Brian could introduce himself to the caller, he could hear her voice on the other side. She sounded young, and she had clearly been crying. She’d clearly been crying a lot, before she’d called in. That was never a good sign.

“Hello,” Brian started, his voice still a bit groggy. “This is the Community Crisis Line, how can I –.”

Brian didn’t finish the introduction, she interrupted him.

I did it! I’m sorry, but I did it. I wasn’t thinking and it just happened. I don’t know what to do. I don’t know what to do. I don’t know what to do.

She was crying hysterically as she spoke.

“Hey, hey, it’s okay,” Brian said, “It’s okay, I’m here to help you now. What did you do? What happened? You can tell me.”

I cut – She was choking on her words and her tears. I cut my wrists. I was angry, I wasn’t thinking it just happened so fast! I didn’t mean to go so deep…

There is blood everywhere.

Brian felt a surge of panic yet again, but it wasn’t the first time he’d encountered a situation like this one. For both their sakes, Brian had to be the calm one; he had to be cool. He was her only hope, and he knew that. He didn’t get to worry about his own mental health right now.

He took a deep breath.

“My gosh,” Brian started, “You must be so scared right now. Let me help you, have you called 9-1-1 yet?”




The creature started knocking at the door to the call center again. Louder this time, and a lot harder. Almost as if the creature was kicking the door now. It was jiggling the doorknob again too, frantically.

No! No-no-no. I can’t call 9-1-1, I can’t afford a hospital stay right now! I don’t want them to send me into the psych ward for this again! It was an accident I promise! We can’t call them, please!

Brian had heard this excuse before, but he couldn’t help her without medical attention. He was just a guy on the phone in a chair, miles away from her.




“Look,” Brian said, “If it’s as bad as you say, then you are in danger. You could very well die tonight if we don’t get you help. I’m happy you called; it was the right thing to do. Let me help you now; I can call them with you.”

No! Please, don’t! I swear to God, I’ll hang up! Can’t you just walk me through how to tend to the wound?

“Ma’am, I’m not a medical professional –.”




What was that?

Brian muted his headset for a second.

“Stop!” Brian shouted to the creature at the door.

It tilted its head at him.

“Fuck off for just a second, would you?!”

Brian unmuted his headset.

“I’m not sure what that was,” Brian told his caller honestly. “Okay, let’s start with getting pressure on it, do you have a towel or anything?”

I can do that, yeah, hold on.

It had become clear to Brian that this would not be as simple as transferring the caller over to emergency services. He was going to need to think quickly, creatively, and on his toes. Normally, that was something that Brian thrived in doing. He hated these calls, but the challenge of saving someone’s life was why he did what he did. These, however, were not normal circumstances.




Not normal circumstances at all.

“I’m Brian, figured we may as well get to know each other,” He said as he pulled his cellphone out from his pocket, “What’s your name?”

Sara. My name is Sara.

Brian typed in S-A-R-A, into Facebook.

“Got a last name, Sara? Mine is Wilson, just like the guy from the Beach Boys.”

Sara giggled a little, effectively letting down her defenses, just as Brian had intended.

It’s Sara Johnson, her voice was starting to sound fainter. Brian needed to work faster.

J-o-h-n-s-o-n, Brian typed into Facebook. Brian knew that he could make some assumptions about Sara just based on how the hotline worked. He knew she was most likely in the same state because the Hotline routes its calls by area code. Granted, she could be traveling, but usually, it was a safe bet that the caller was always in state and residing in their home area code. Meaning, Brain could narrow down her location to a very specific city. If he could just find her on Facebook, he would maybe be able to confirm her hometown.

“Sara, how are you feeling?” He asked her.

A little dizzy.

“Okay, then let’s keep talking, okay? What led you to hurt yourself tonight.”

Oh, there were a lot of things.

Her voice was starting to sound bizarrely calm. In a typical call, that was a good sign, but in a situation like this, where she was potentially bleeding out on the phone with him, it was anything but.




With each bash the creature made on the door, it started to open a little, breaking against its lock. The doorknob was shaking like crazy, looking like it would soon fall off of the door. The creature had all night to try and get in the call center, but for some reason, it had chosen now, of all times, to make its move.

Brian threw a notebook at the door and flipped the thing off. It started at him, but it didn’t go anywhere, not that Brian really thought that was going to work.

I just got fired from my job, my boyfriend left me. My mom was just yelling at me about how it was all my fault. Because I was always late to work and nagging my boyfriend. She told me I deserved this … can you believe that?

“That’s awful,” Brian said to her, “Where did you get fired from? Did you like that job?”

Not really, I was working at a local fitness center here in Madison. I didn’t make a lot of money there, but it was something to do, and I had free access to the gym.

Perfect, Brian thought to himself.

He found her. On Facebook, he saw the following information: Sara Johnson, 20 years old, works at Madison Health Center, in Madison, and goes to school at the local university too. Brian looked at her profile picture; it had recently changed. When he scrolled over, he saw that her former profile picture had been her hugging some guy. It was her alright.

The next part of this was going to be difficult for him to juggle, but it wasn’t his first rodeo. He just needed to keep Sara talking.

“Is this the first time you’ve ever tried to kill yourself, Sara?”

Brian muted his headset and dialed 9-1-1 on his cellphone.

Oh, no. Not at all. I was just in the hospital last week.

She started crying again.

That’s why I can’t go back there you see? I don’t want to go back there! It’s a horrible place, and I was there for the whole week last time, it was awful. The food and the crazy people. This was an accident! I’m not crazy.

Brian hated that he was doing what he was doing. There were many fears in the public about calling crisis lines. The fear of having the 9-1-1 called on you, just for calling, being the greatest reason, most people didn’t want to call a crisis line at all. But that was a misconception, and it was a very sensitive issue that Brian took incredibly seriously. In fact, calling 9-1-1 was the very last thing Brian intended to do on every call he had. In his mind, it was very simple: don’t be dying when you call in, and the crisis line won’t call emergency medical services.

But he could hear Sara drifting off in her voice. He couldn’t just let her die. It wasn’t his job to be there for Sara as she died, that was the true misconception of the crisis line. His job was to save lives at all costs.

“I hear you,” Brian said. “A lot of people I talk to hate the hospital too. It sounds like they really don’t help you there. We really try to avoid that if we can, I promise. I’m just worried about your safety tonight. It sounds like you don’t really want to die either.

What’s the point? What does it matter if I do?

Hello, 9-1-1, what’s the address of your emergency?

“What do you think? So far, you’ve given me a lot of reasons you want to die, but tell me are there any things you do have to live for? Tell me about those, if you’re going to die anyway, you may as well try to go out on some positive memories.”

Brian muted his headset.

“Yes, hello, my name is Brian,” he said into his cellphone. “I’m a crisis specialist with the suicide hotline. I have an In-progress situation, a girl has cut her wrists -.”

My cat. I really love my cat, I guess.

Okay, what’s the address?

“That’s great. I love my cat too, tell me the cat’s name.”

“I don’t have an address, I’m sorry. I just know her name is Sara Johnson. She used to work at Madison Health Center, she goes to school in Madison, and she was in the hospital last week for a suicide attempt. Let me give you her phone number…”

Gus, his name is Gus, I’m petting him right now.

“Aww, I love Gus. My cat is Tobey.”

Brain knew that he wasn’t giving the 9-1-1 operator much to go on, but it should be enough. Brian knew from past experiences on the phones like this one, usually they could do something with just a phone number, let alone a name and other identifying information. It would take time, but even in the worst-case scenario, the hospital would have her information.

We are familiar with her, Said the operator, we will dispatch a unit now. Thank you, Brian, you did great.

Two things happened then, neither were good, and neither of these were things Brian could do much about. They were both things that Brian had been dreading were going to happen eventually, and now he had just run out of luck.

The call with Sara dropped.

The creature burst through the door to the call center.

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