A Pep Talk…

… for my friend, ex-girlfriend, blogchild, and fellow paramedic. You know who you are.

I know you're hurting now. I know you're having a crisis of confidence, and you're questioning whether you can deal with the emotional toll that comes with a career in EMS.

And I know it is in your nature to worry, and to question yourself, and to feel things too deeply, to empathize too closely. That quality has always been been your greatest gift, and your biggest curse. It drives you to be a better paramedic. It's the passion that fuels your patient care, your writing, your mothering, everything you do. It was also the thing that made dating you maddeningly frustrating at times, but make no mistake…

… it is a great, big, towering, incandescent gift.

Not everyone has it. I don't, not in the degree that you do.

And if it doesn't feel much like a gift right now, it's only because you spend too much time listening to the dark whispers of doubt. Take some time to quiet your soul, and you'll be able to hear the ones that whisper thanks and encouragement. One day you'll wake up, and discover that you've made friends with the faces that once haunted you.

Believe me, I know whereof I speak.

You are stronger than you realize, but when you feel as if you're not, know I'm only a text, email or phone call away. I'll be here for advice and counsel, crying shoulder, or the foot in your ass when you need it, just like I've been for the past five years.

I know you've read this before, but it bears repeating now. Here's your pep talk.


I've known you since you were in EMT school. You've been in this profession long enough to know where you rank – 4th from the bottom in the Bureau of Labor Statistics salary rankings. The only people paid less than you are pre-school teachers, dishwashers and meatpackers. The guy riding on the back of the garbage truck, or holding a sign at a highway construction zone, makes more money than your EMT instructor did. Likely, a lot more. And God knows you're worked at some festering scabs masquerading as ambulance companies. Some of those, you'd have been better off as a dishwasher or meatpacker

And none of those people are required to make life-or-death decisions. You are.

It is a profession where the line-of-duty death rate is comparable to firefighters and police officers. You wanted to be a flight medic one day, a career niche that is by far the most dangerous in EMS. Truth be told, it's the most dangerous profession in America, period — ahead of loggers, miners, and Alaska crab fisherman.

It is a profession whose divorce, suicide and substance abuse rates soar far higher than the general population. You're no exception, having already gone through your first ambulance-induced divorce before you even started medic school.

The average career expectancy of an EMT is five years.

Five years.

Many of your classmates will go on to jobs in nursing or other healthcare fields. Those that don't will leave EMS with a career-ending back injury – as you almost did – or leave EMS healthy but not whole; jaded and cynical, their idealism burned away in the furnace-like reality of our profession, faith in the innate goodness of man gone like so much ash and smoke up the chimney.

Yet somehow you made it five years, and you escaped their fate. You overcame the back injury, and despite everything you've seen, somehow you still find it in you to see the good in people.

Do you know how rare that is?

You've been disrespected by patients and bystanders who don't know any better, and belittled by doctors and nurses who should. And if you're still in EMS 20 years from now, there will still be doctors and nurses who belittle you, and patients who think are nothing more than the chick who drives the horizontal taxi. 

You have sifted through broken glass and twisted metal, waded through urine and feces and vomit, weathered heaping torrents of verbal abuse from the people you were trying to help, all for the prospect of a few dollars on payday, and perhaps…just perhaps…a show of gratitude now and again.

You've been doing this long enough to realize that what we were promised in school is a lie, if only a little white one. When you were green and idealistic, the romance and thrill of EMS was powerful. All of us were adrenaline junkies at some point, but there comes a time when even you outgrow your blog persona, and you were always more hand holder than adreanline junkie anyway.  

By now, you've discovered the hidden truth, the one that drives most people out of our profession:

We don't save that many lives.

Lifesaving may be what we train for, but the opportunity to actually save someone comes all too rarely, and when it does present itself, the outcome depends more upon luck and timing than our skills. In my career, I've had my share of code saves. Some of them even made it out of the hospital alive. Others hung on just long enough for their families to tell them goodbye. I've made the critical diagnosis, gotten the tough airway, turned around the crashing asthmatic, and stabilized the shocky gangbanger with multiple unnatural holes in his person. I've needled chests, paced, defibrillated, and cardioverted, and given countless drugs.

You will too, in time.

But, other than a handful of exceptions, I can't state with any certainty that my actions were the difference between life and death. In that handful of exceptions, all but one or two were saved simply by applying the techniques that any John Q. Citizen with a basic first aid course could have done. Ask TOTWTYTR or JB On The Rocks or PJ if you don't believe it's true. They'll tell you the same thing.

The reality of your profession isn't exciting rescues and cardiac arrest resuscitations twice a shift. Your reality is dialysis transfers and people who can't poop. It's toothaches at 3:00 am, and you have to maneuver your stretcher around five parked cars to get to the front door, and weave your way through five able-bodied drivers to get to the patient with a complaint so minor you can't believe they called 911 for it.

And yes, sometimes they will dump a burned little body in your arms, begging you to help when you know in your heart of hearts that nothing can be done. And you'll gamely try to do something anyway, because not to try is not to hope. And hope is what keeps us going.

And the stench of burned flesh will linger in your psyche long after it has left your hair and clothes, and when you hug your kids at night, you will wonder how long it will take for you to stop thinking about the child's mother, who can no longer do the same.

So why do I tell you this now, repeating things you've already figured out for yourself? If you didn't know what you were getting into then, you certainly ought to have your eyes open at this point. I remind you of this because, knowing you as well as I do, I know that these things are all you're seeing right now. What you need right now is to remember all the things that make this job worth doing.

You should bother because EMS is a calling. Even when you leave EMS, it never really leaves you. It's what Henry David Thoreau meant when he said, "Do what you love. Know your own bone; gnaw at it, bury it, unearth it, and gnaw it still."

You should bother because, even if we're not saving lives, what we do matters. It matters in ways unnoticed by us, to people you may not even remember tomorrow.

You should bother, because EMTs are privileged to play in life's great game. Too many unlucky people watch the action thunder by, stuck at a desk, or watching it on television at home.

You should bother, because it's the little things that matter. Most of your patients are ignorant of your skills. Few of them understand the technology you wielded so expertly. But they'll remember the smile you gave them, or the way you tucked the blanket in to ward away winter's chill, or the way you stood in the rain, getting drenched as you held the umbrella over them as your partner loaded them in the rig. They'll remember calm competence, and gentle speech.

And you do that better than most, you know.

They'll remember the joke you made to lighten the tension. They'll remember those things and more, and they'll remember your face long after you've forgotten theirs.

They'll remember you because, even though they were just another call to you, you were a major player in a defining event in their lives. They'll come up to you, years after the fact, and say, "I remember you. You take care of me when I had my heart attack."

And likely all you did was apply oxygen and take them to the hospital. Maybe you helped them with another dose of nitro or encouraged them to take an aspirin — really nothing they couldn't have done themselves. But you're the one they remembered, and you're the one they thanked.

You should bother, because in the tapestry of human existence, you get to contribute your own unique stitch. You get to make your mark in ways that cannot be quantified on a spreadsheet or a profit and loss statement. Not everyone gets to touch the life of another, but EMTs do.

You should bother, because when people are at their most vulnerable, they will invite you into their homes and tell you things they won't even tell their priest. And they'll expect you to make it better somehow. I'm not sure you understand now how profound an honor that is, but hopefully one day you will.

I think you have proven yourself worthy of that honor.

And you make me proud.



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