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A few years back, Travis Ogden’s ambulance crew raced to revive a 4-year-old who’d drowned, the color starting to return to her lips as they rushed to the hospital. Normally, their arrival would mark the end of the run: What happens beyond the emergency room doors by and large remains a mystery.

But that day, Ogden’s crew couldn’t accept that reality. They cleaned the rig and restocked its medical supplies in slow motion, trying to stick around and find out whether she survived. When a doctor walked over to her family and knelt, they quietly realized she hadn’t.

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“Unless there’s something super dramatic like that, we don’t get to know,” said Ogden, an EMT in Homer, Alaska. “It’s like going up to a concrete wall and chucking a note over and walking away. It’s brutal.”

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