Chapter 7 — The First Heartbeat

The following week, the Red Cross Club moved on to a new topic: emergency triage, also known as triage — a skill that Minh Vu introduced as "the most difficult psychologically, although not the most difficult technically."

"What is Triage?" Phong asked during Thursday's activity, when Minh Vu wrote the word on the whiteboard in capital letters.

"It's the process of prioritizing when there are many victims at the same time, but emergency resources are limited," Minh Vu explained, drawing a simple diagram with four different colors on the board: red, yellow, green, black. "For example, if there is a bus accident with ten victims, but there are only two first aiders and one ambulance, we cannot save everyone at the same time in the best way. At that time, we have to decide who needs to be treated first."

He explained the four-color classification system: red is a critical victim who needs immediate intervention to save their life, yellow is a victim who is seriously injured but can wait a short period of time, green is a victim with minor injuries who can walk on their own and can wait longer, and black is a victim who has died or is so seriously injured that they can no longer be saved with available resources.

The whole room was silent when Minh Vu explained the black color. This is the first time the club has touched on such a heavy aspect of first aid — not just learning how to save lives, but also learning to accept that sometimes, in the most dire situations, not everyone can be saved.

"I don't understand," Thien Kim said, her voice a bit more shaky than she wanted. "How can I decide to ignore a person, even though they are still alive, just because I judge that they are no longer capable of saving?"

Minh Vu looked at her and immediately realized that this was a question that touched on her core fear - the fear of helplessness, of having to face her own limits in a life-or-death situation. "This is the hardest part, just like I said," he replied, his voice gentle but serious. "But the triage system isn't about you 'ignoring' anyone. It's about making sure limited resources are used in a way that saves as many people as possible. If you're putting all your time and energy into one person with a very low chance of survival, while there are three others waiting with a much higher chance of survival, then prioritization is a way of respecting the lives of all four people, not abandoning anyone."

"But what if that person is someone you know?" Thien Kim continued asking in a lower voice. "How can I stay objective in that situation?"

Minh Vu was silent for a moment, as if he was considering his answer more carefully than usual. "That's why in practice, the person who carries out triage is usually not someone who has a direct emotional connection to the victim, if it can be avoided," he said. "But I'll be honest with the group — this is one of the hardest parts of this job, even for people with a lot of experience. No one who learns triage feels completely comfortable with it. What we're learning here are just the fundamentals, so that in the rare real-life situation where we need it, we have a frame of mind to rely on, instead of completely panicking and not knowing where to start."

That day's class ended with a simulation exercise: the group was divided into small teams, each team received a scenario with five hypothetical "victims" with different levels of injury depicted on paper cards, and had to decide on priority order within three minutes.

Thien Kim, working with Duc and Phong, carefully read each description card: one person had a broken leg but was conscious, one person was unconscious and unresponsive, with no visible breathing, one person had minor burns on his hand but was screaming in panic, one person had a bleeding wound on his thigh but was conscious, and one person had only minor scratches but was crying violently.

"The first person must be the one bleeding profusely from the thigh," Thien Kim said, her voice surprisingly decisive to herself. "Heavy blood loss can lead to shock and rapid death if the bleeding is not stopped promptly, but it is still possible to save it if treated immediately."

"What about the person who is unconscious and not breathing?" Duc asked. "Isn't that person the most dangerous?"

"It is truly the most dangerous," Thien Kim admitted, but her voice still remained surprisingly calm. "But according to the triage principle, if there is no breathing even though the airway has been cleared, and you only have limited resources with many other victims who also need to be saved, then... that person can be classified as needing to be re-evaluated later, with priority given to dealing with people with a higher chance of being saved first. This is the hardest part, but that's the principle."

She said it with a coldness of reason that made her feel a little creepy, but she understood the lesson Minh Vu had just taught — this was not insensitivity, but a difficult decision made to optimize the number of lives that could be saved in a situation of limited resources.

The person with the minor burns was screaming in panic, and the person with the scratches was crying, which the group agreed to be given a lower priority even though they appeared to be in intense pain — because the actual level of damage was not life-threatening, even though the emotions expressed seemed severe.

When the teams presented their results, Minh Vu and Ms. Hoa commented on each option, pointing out points that needed adjustment. Thien Kim's team was considered to be closest to the correct answer among the teams participating that day.

"The way the children handled the situation of the unconscious person not breathing was very good," Ms. Hoa commented. "Many people, especially beginners, tend to instinctively focus all their attention on the most critical situation, forgetting the bigger picture. The fact that they can consider that shows that they have correctly understood the spirit of triage."

After class, when everyone gradually left, Thien Kim still felt heavy in her heart because of today's lesson, even though she intellectually understood the principle behind it. Minh Vu, realizing her mood, proactively approached her.

"Are you okay?" he asked. "I know today's lesson is quite heavy."

"I'm fine," Thien Kim replied, but her voice wasn't entirely convincing. "It's just... I still have a hard time accepting the idea of having to 'classify' human lives like that. It sounds so cold."

"I understand that feeling," Minh Vu nodded, sitting in the chair next to her. "But I think, triage is not coldness, on the contrary, it is a form of profound responsibility. It requires me to make the most difficult decisions possible, not because I don't care about each life, but because I care about everyone, so I am forced to find a way to save as many people as possible, instead of letting my emotions completely control me."

"But how do you keep your mind clear to make such a decision in a real situation, when there is panic all around?" Thien Kim asked, her eyes still shining with worry.

Minh Vu was silent for a long time, his eyes looking far away out the window. "Honestly, I've never had to apply triage in such a serious situation," he said. "And I hope I never have to go through that. But I think, if that situation really happens, the most important thing is not whether I can stay completely alert or not — because let's be honest, probably no one can stay completely alert in a real disaster — but that I have a mental framework to rely on, so that I don't have to make decisions completely from scratch in the middle of a panic attack."

That answer, although it didn't completely erase Thien Kim's worries, made her feel somewhat comforted — because it was honest, without pretending to have a perfect answer, without pretending Minh Vu was someone who could face any situation without fear.

"Thank you for being honest," she said, smiling slightly. "I think, if I said I wasn't scared of situations like that, I wouldn't believe it."

Minh Vu burst out laughing. "Then you're lucky you didn't lie."

On the way home that day, Thien Kim thought a lot about the lesson of triage, about the thin line between trying to save everyone and accepting her own limits to save as many people as possible. She realized that this was perhaps the core lesson she needed to learn, not only in the field of first aid, but in life in general — that sometimes, accepting one's own limitations is not a failure, but a necessary form of growth.

That night, she wrote in her notebook: "Today I learned about triage — how to decide who needs to be saved before you can't save everyone at the same time. The lesson sounds cold, but I think it's actually very humane. Perhaps, accepting that you can't do everything perfectly, that you can't save everyone, is the only way you can truly help someone, instead of being paralyzed by desperately trying to do everything."