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Five questions with Edmonton inner-city nurse Matthew J. Douma

Douma says that one thing he’s learned in his work is that quality of life is, ultimately, what really matters.

JASON FRANSON

Can you tell me a bit about the work you do, in specific this work around resuscitation?

As a novice resuscitation scientist, what we do is look at what people are dying from, why they are dying from it, and then what makes that situation potentially salvageable. Then we aggressively target whatever the underlying pathology is. The best example I know of is that the leading cause of potentially salvageable death on the modern battlefield is something called dismounted complex blast injury, basically where an IED [improvised explosive device] blast shears someone's legs off at about the level of their pelvis. Controlling the bleeding from that sort of injury is very difficult, so what my colleagues and I do is try to develop strategies for stopping the bleeding and saving the life.

What got you interested in resuscitation science?

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One thing would be seeing people die and not having the adequate tools, techniques, manoeuvres or interventions to prevent their sudden deaths. I've worked in prehospital care as an EMT. I've worked in the emergency department as a registered nurse, and in the intensive-care unit, and it was seeing that there are things to learn, potentially life-saving techniques, from each setting and wanting to take the best available evidence and techniques from one setting and apply them to another.

Are there things you wish everybody in the world knew, simple things that would make outcomes different in life-threatening situations?

The medical interventions that are most likely to save people's lives are often the most basic and easiest to do. Calling 911, putting someone in the recovery position, performing high-quality continuous chest compressions, calling for an automated external defibrillator as early as possible, or if someone is bleeding, applying pressure. These basic first-aid manoeuvres save a tremendous amount of lives, and often it's the reluctance to render aid in the prehospital phase that is an unnecessary or preventable cause of mortality. Basic first aid should be taught in high schools, right after sex ed. Simple things: What to do when someone's choking, what to do when someone's not breathing and doesn't have a pulse, what to do when someone is bleeding to death. Four hours of basic life-support training can empower you with the skills and knowledge to save a life, and in most cases, it's going to be the life of a loved one, someone in your home, a friend or family member.

Have you learned anything about the nature of life and death from being there at this critical instant?

Absolutely. It reminds me that you can't take life for granted. Death is – oh, man. I don't want to get morbid. What have I learned? Really what matters most would be the quality of life. You're not guaranteed its duration, but you can have a lot of control over the quality of the life you live.

A lot of people live with a real fear of death, a real discomfort with death. You work so closely with it. Are you afraid of death?

I might be afraid of dying needlessly. That's a legitimate fear. But fear of death, absolutely not.

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This interview has been edited and condensed.

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About the Author
National Reporter

Jana Pruden is a reporter for The Globe and Mail, based in Edmonton. More

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