Stressed medic sits in ambulance

Coping with tragedy

Witnessing tragedy comes with the job for EMTs and paramedics. Don’t ignore its effects on your health. After responding to a multi-vehicle accident or a mass shooting, it’s not unusual for medics to have traumatic grief.

Dr. Kimberly Gushanas, a psychologist with UTMB Health, offers some tips to cope with the added stress of tragedy.


Start with intentionally slowing down your breathing.

“Sometimes when we are in ‘go mode,’ we tend to hold ourselves very tight, bracing for impact physically even when the stress is psychological,” Gushanas said. “That’s just our nervous system doing its thing, but we can regulate it. Sometimes the body is easier to regulate than the mind, so we start there.”

Focus on breathing slow and low—with the diaphragm—and try to keep a slow, controlled pace.

“Imagine breathing in through the nose, out through a straw,” she said. “You might even imagine an X-ray slowly moving down your body zapping any muscle tension it notices along the way when you breathe it out. We call this a body scan, and it’s easy to find videos to practice with online.”

Next, get your essentials met, Gushanas said. Do what you need to do. Did you eat today? Have you had any water? Do that.


Once you’ve covered the basics, Gushanas recommends a quick self-compassion break. “It’s important to have compassion for ourselves in moments like this because, as medics, you are trained to respond to others first. But you must also respond to yourself, or you can’t maintain that role,” she said.

Gushanas offered the following ideas for a self-compassion break.

  • Say to yourself, “Wow, that was really hard,” “That was stressful” or “I wish I could have done more.” Just acknowledging that you experienced suffering is enough without getting into it.
  • Remind yourself of your humanity.  “Suffering is part of life,” Gushanas said. “Yes, it sucks. And part of being human is recognizing that we all experience this and that doesn’t make you deficient or weak.” Tell yourself the truth: “I know I’m not the only one feeling this.” Or, “Anyone would struggle with this.” Or, “This is part of being a first responder. We do hard things.”
  • Offer yourself some kindness and validation. That can be physical comfort like a self-hug or a warm hand over the heart, or it can be words of affirmation. Try these phrases: “I can be patient with myself for a bit.” “I will get through this.” Or “It’s normal to grieve.”
  • Try loving-kindness meditation phrases if it feels right for you. Here’s an example.

May I give myself the compassion that I need.

May I learn to accept myself as I am.

May I forgive myself.

May I be strong.

May I be patient.

May I be kind.


Plan for how you’re going to decompress. “Recognize that it is not selfish to take a break, nor is it a sign of weakness that you need to,” Gushanas said. “It’s just a natural way to activate the parasympathetic nervous system.”

Find one small thing to allow yourself a moment of rest or distraction that is connected to something you value. Maybe it’s watching a YouTube video on that new DIY project you’ve been wanting to start. It could be reading a book or listening to your favorite standup comic. Maybe it’s blasting Metallica or Taylor Swift, going for a run, calling a friend who makes you laugh or having a 30-second private dance party. And remember that you really aren’t alone.

“Traumatic grief is common in first responders, and there are resources out there for you,” Gushanas said. “If you feel like you’re stuck without any idea of what to do next, that’s a great time to ask for help— just like people ask of you all the time. "