There is definitely a shortage of "Practice Standard for Trauma Work". As I bring ACEs Awareness to the field, I know that most will find the clinical setting of the past. One without ACEs science.
Two weeks ago Saturday, I responded to a motorcycle accident. Five men raced down a local road on crotch rockets. The lead bike reached an estimated speed of 150 mph. By a stroke of misfortune born in hell, a turkey vulture flew out and knocked the bike out of control. The driver's first strike of the pavement was marked by a single one inch piece of red thread embedded into the pavement from his hoody . As he tumbled a few more single strands. And then 2, 3 strands and then patches of threads from his tumbling. This continued for over 300 feet. The bike continued for another 300 feet from where he came to rest in a ditch. His best friend cradled his head in his lap. The best friend, the godfather to the unborn child the victim's fiancée has been carrying for 7 months. I worked the cardiac arrest on the scene and the medics continued on the way to the hospital.
I can't imagine what the four remaining riders witnessed. Their friend tumbling down the pavement for such a long way. All of their hands were holding their friend as the body was going through end of life. The remaining dozen turkey vultures were watching from the peak of an old barn in the distance. How can they make sense with what just happened? The best friend was the only one able to speak English. He wanted to know if his friend was going to make it. He wanted to know why this happened. All this while he looked me in the eye for answers.
"High risk behavior" I said. "You and your friend have had a tough life. A tough childhood." His eyes,with a head nod, acknowledged my explanation. Overwhelmed from grief, he trembled. I approached and I held him in a hug. Police gathered statements and as the riders left the scene, they shook my hand and thanked me for the empathy I showed them.
Was it appropriate? Knowing what I know now from ACEs, I know not to ask "What's wrong with you?" I know to ask "What happened to you?" Most people don't go 150 mph. Especially a road they are not familiar with.
So yesterday, two weeks later almost to the hour, I'm driving down the same road. Four Hispanic adults were on the road. My gut told me that they were family. I took a deep breath and turned around. Sure enough. The mother wanted to see the spot were her son came to rest. I showed her. A women spoke English. She relayed my condolences to the mother. I relayed to this women the distance the accident covered. She was on a witch hunt to find blame with the survivors. Again I bring in high risk behavior and its roots with trauma. They didn't know the speed of the vehicle. She understood me and she was pondering the new information. I don't know if she bought it.
"One person caused this accident. No one else," I said. I told her to put a crucifix on the end of a grape post and to get off the highway. It was getting dark.
What does this have to do with the present thread? None of these people will receive any relevant counseling because of the shortage of therapists. And I think it's safe to say especially Spanish-speaking therapists. Not even for ambiguous loss let alone the relevance of ACEs and generational behavior.