Paramedic – Choosing Hope

What do you do when the day comes that you never scripted for yourself? I always joked that the only way I was going to stop working as a paramedic was when someone dragged a wrinkly, gray little me off of the ambulance, kicking and screaming. Well actually, it wasn’t all in jest, I kind of really meant it. From the day I started my career in EMS, I knew it was what I loved and always wanted to do. I never imagined myself doing anything different from that point forward. I don’t suppose we often take the time to imagine our plan B’s when our plan A is what our hearts are set on.

My plan B is a whole other story, but as I’ve been contemplating that my future may look very different than I imagined, it has made me ponder what, if anything, I am leaving behind on my path through my A plan. I believe every person has the same deep-rooted need to know that they matter and will be remembered in their absence. Maybe most of us never pause to consider until we are faced with it, but I surely have found myself wondering what kind of legacy it is that I am leaving in my wake. If I take off my badge and bury my toes in the sand next to the ocean, will the patients I cared for remember me? And if they do, will it be in a good way, or should I have done things differently? After almost half my lifetime doing this gig, what do I turn to my partner and say on the day that I take my stethoscope from around my neck and pull off my polish-worn boots for the final time?

Admittedly, there is a long list of do’s and don’ts and tips and tricks for a paramedic to pass on to her successors. After all, there is a substantial history of education and experience, and trial and error that surely could give the incoming an edge by surpassing all of the “been there, done that’s.” After so much time of sifting through all of those valuable pearls of wisdom though, it was impressed upon me that anyone can work hard enough and study long enough to become a paramedic. Rather, it was my patients that taught me what I needed to know most about caring for another human being. So, standing at the vestiges of a life-changing career, the last time to turn to my partner, I would say this…

Never give up learning, changing, practicing, updating your skills so that you can provide the best patient care possible. More importantly however, never lose sight of the souls which reside in the people for whom you are caring. You can have the best technique, the greatest training, and the most up-to-date equipment, but if you are lacking in giving your utmost attention to the delicate soul which makes everything else in that body go ‘round, then you have failed. Though you may argue that some of them are not delicate souls, I assure you that every single one of the people you are called for have a soft and vulnerable inner being that is craving compassion, validation, and love. Yes, even the pungent, homeless drunk, and the gruff, arrogant abusive man, and the lonely, obnoxious woman that you’ve run on every shift for as long as you can remember. Do not presume to know their stories. Do not come to your own conclusions about how they got the way they are, because the truth is, they have endured whatever life-length of soul-battering their years have brought them long before you even met. They are still somebody’s daddy, sister, friend, baby girl, regardless of the appearance of the hard shell you see in front of you. Their tender inner voice is still begging to be valued, and to be understood.

The greatest achievements in my career as a paramedic did not come from a high test score, a record-setting scene time, or kudos from successful resuscitations. My most valuable triumph was from the tears that flowed when I stopped to embrace a woman standing alone in the chaos, moments after becoming a widow. It was from the giggles that erupted from beneath a blood-stained blanket because I was willing to make a complete fool of myself to distract a little boy who was having the most terrifying day of his life. It was from the marriage proposal I received from the homeless man whose stench was enough that my partner at the time had begged to drive so that he didn’t have to sit back there with him. It was in the transport that I got ridiculously behind on paperwork because I set it aside for a woman whose husband had died previously at the same hospital she was now headed for, and she simply needed someone to talk with her and speak truth and peace to her paralyzing fears. It was in the frail weight of the woman’s hand I held as we transported her to hospice for her final hours. It was in the grateful faces of the parents we stopped by to check on even though it meant re-living the moments in which I couldn’t do anything to save their toddler, the conversation with the defiant little boy who desperately needed someone to see past his attention-grabbing behavior and just hear him out, and the dancing that happened with a topless drunk woman who just wasn’t going to get on the stretcher until someone had humored her. I got through some of my toughest patients by always having the mindset that I should be caring for people in the same way I would want my own parent, grandparent, sibling, spouse, child, or other family member to be treated. It made a world of difference.

One of the most poignant things I learned was when I was still an EMT, working with a seasoned and soft-spoken paramedic partner. We were on a psych call where law enforcement had already been on scene for quite some time arguing with a combative man and trying to talk some sense into him. He had called for police because for whatever reason, this man believed that his garage was full of people who didn’t like him, and who intended to harm him. He refused to leave his house with all those people there, because he didn’t trust what they would do, and he was very agitated that the officers kept telling him no one was there. The police were visibly irritated by the time we arrived and had the man explain his predicament one more time. We peered into the garage, which was as we anticipated, empty. My partner spoke to the man for a few minutes while I did a few medical checks on him, and the man explained that he would be willing to go to the hospital for an evaluation, but not until the people in his garage were gone. *Cue eyeroll from our poor, exasperated law enforcement friends, * and then my partner did the most ridiculous thing. He walked out into the garage and started yelling at all the “people.” He told them they weren’t welcome there and needed to leave. After a moment, my partner turned back to our patient and asked if the people were gone. He said some had left, but several others were still there. So, we joined forces, my partner and I, and we yelled and shooed and stamped our feet in circles all over that empty garage until a look of relief washed over our guy’s face and he announced they had all gone running. We helped him lock his house up tight, and he then proceeded to very calmly and cooperatively climb aboard the ambulance with us to go to the hospital. I’m not sure the officers on scene said anything else to us, but I do remember their faces; the wide-eyed, bewildered, astonished, half smirk, half “what in the world just happened” looks that grew smaller in our rearview mirrors. That may have been the most pivotal day of my career in revealing to me how little about patient care is actually medicine, and how much of it is about caring for the human condition. Not everyone needs a bone splinted or a medicine given or a dramatic life-saving intervention, but what they all need is to be treated like they have value, every single one of them. The frequent flier you’re tired of seeing, the alcoholic who spits on you and calls you names, the suicidal patient you want to blow the shenanigans whistle on. They are all human souls with hurts and insecurities and fears and needs, just like you and me, and if you as a first responder can learn to care for the unseen just as well as the body, then that might be the most life-saving skill in your kit. Period.

Never lose sight of the privilege that it is for us to be invited into peoples’ lives, homes, communities at their most vulnerable moments. Never forget that taking the time to know their name makes them feel like less of a job and more of a friend. Never be too proud to humble yourself and chase away invisible people if that is what is going to make your patient better. Never forget that we all share the same emotions, and the people you are caring for need your kindness and compassion just the same as you need it from others. And most importantly, never grow so callous that you forget how to be soft.

“May I never see in the patient anything but a fellow creature in pain.”

~Oath of Maimonides

Now go, run, learn, excel, amaze, transform the world all with the fuel of 2 hours sleep, a cup of cheap gas station coffee, and an adrenaline rush like a rip tide. And don’t forget to be human.

Chances are many of you have already read this, but I’m going to re-post this here so that I may reference it in the near future with a pretty important post I have forthcoming. This was originally an essay I wrote for one of my nursing pre-req classes for school. The assignment was pretty vague; it simply had to be about a learning experience. Many of my friends and family stood witness to the deep shades of gray circles that took up residence beneath my eyes as I battled life, death, and sleepless nights, all for the right to trade my EMT patch in for one that says Paramedic. My learning is never done, but here are some of the initial boot-shaking things I learned about that sparkle patch in my earliest days.

I will never forget the very first call I went on as an EMT Basic student. Only a portion of the way through the semester, that first ride-along was to give me a taste of what I was working toward, and put me to the test to see if I had what it took. There I was, sitting in the back of the ambulance, my pockets stuffed with all the equipment and cheat sheets I thought I would need in order to save lives that day. A quiet voice crackled across the radio, and my life would never be the same. Adrenaline surged through my veins as we flew, sirens screaming, toward the victims of a car accident that had called for help. It was in that moment, trying to reign in my fear and excitement, that I knew this was where I wanted to be. That first call turned out to be a simple scenario that would come to be routine for me in the months and years ahead. but it was the steps in between that changed me and shaped me into the Paramedic I am today.

Becoming a Paramedic seemed a noble feat, a position that was cut and dry; you call for help, I come save your life, we all go home at night. Those tinted glasses of naivety blinded me from some harsh realities and some amazing truths those first few months, but time and experience cleared the lenses, revealing the gray that washes between the black and white. Within a week of testing out of EMT Basic class and receiving my license to practice, I got my first major trauma call. It was the Fourth of July and I was hanging out at the fire station with a bunch of fellow members that were barbecuing and enjoying the holiday. When the tones went out, I was hustled out to one of the responding vehicles and wished enthusiastic “good lucks!” My own pulse thumped louder than the sirens as I went through every mental checklist I could think of, certain I was going to have this one covered.

I took in a sharp breath as we pulled on scene and I took in the horrific sight strewn across the road. First glance told us all this was a bad one, but two things changed me that afternoon. The first was as I walked up behind the car that was being cut apart to free the mangled driver. On the shattered glass of the rear window was a faded Star of Life sticker, clinging to the broken shards. That was when reality whispered that it could happen to anyone, even those you know and love.

The second sight that sent my thoughts reeling was the driver of the other car, standing unscathed on the side of the road, frantically pulling empty beer bottles from his floorboard and smashing them on the side of the road, trying to cover up what he had done. Is this real life? Innocent people crushed by the weight of others’ deliberate poor decisions? Why is it the bad guy makes it out ok, and our young friend is left clinging to life? This was not the heroic glory I was expecting to feel.

As my career progressed, my eyes were opened to the other truths that had been so buried in the myths I believed as a child. My parents taught my siblings and I the value of 911. We learned the dire situations that would require you to dial that number, and held sacred the seriousness of that action. Bleary-eyed and hungry after marathon dashes from call to call though, I learned a surprising practice that was all too common in the real world. 911 was a convenience, not a privilege. People called for us for scraped knees, for cracked calluses, and for feeling anxious. They met us in their driveways with suitcases packed, standing next to the family car that seemed in perfect working order, even in the ER waiting room where they felt the wait was taking too long. We raced through red lights, risking our lives and the others around us to arrive to find patients who had run out of medication and would like a ride to the emergency room; but don’t worry, your tax money will pay for it. This was shocking to me, but as much as we all hate it, there are enough loopholes in the system that this will continue to happen day after day. And we thought it was about saving lives…

In spite of the grueling demands on my body and mind, I continued to further my knowledge by moving on to pursue my EMT Intermediate license, and eventually my ultimate goal of becoming a Paramedic. Years of class and hundreds of hours of clinical time later, I reached the top. My patch sparkled with the golden threads that signified my new standing, and my mind was packed with the maximum ability to perform all the skills and give all the medications I possibly could. This is it I thought. Now I can really help people. That’s what we believe; we learn as children that when there’s an emergency, the firemen and policemen and paramedics come and fix everything for us. That is where the harshest reality brought me to my knees. I was educated and rehearsed to handle every situation. I could perform every life-saving skill in the book. What I had forgotten was that it’s not always up to me. The limp body of a two-year-old boy was hurriedly lifted onto my stretcher. As my ambulance went lurching and squealing off to the hospital, my hands took over as my mind calmed into the rhythmic muscle memory I had practiced so many times . I stabilized, supported, breathed, and provided everything I possibly could for this young life. My prayers surrounded each breath I pumped into his tiny lungs as he clung to life. I watched each miracle flutter of his heart struggling inside his sunken chest, and kept on begging for one more beat, one more beat. Later I stood at his bedside next to his parents, tears blurring the features of the cheesy grin that gleamed back at me from a photo of him taped to the headboard above his breathing tube. He held on for a week, and then he was gone. All the fancy treatments in the world couldn’t save him. I cried. I cried because he was innocent. I cried because the faces of his family were etched deep into my memory. I cried because I, the Paramedic, was supposed to have saved him, and at the pinnacle of my experience and knowledge, there was nothing I could have done.

My road to Paramedic was long and not as straight as I had imagined. It was disappointing on numerous occasions and heartbreaking on more days than I can count. I have learned that there are only few things that are black and white, and people aren’t who they pretend to be. I have learned that innately good people sometimes die, and people hellbent on being hellbent sometimes live. I have learned that no matter how capable I am, there are times when nothing I can do will help. Most importantly, I have learned that where I am willing to change, I will grow. Being weak will make me strong, being wrong will show me right, and being willing to change and learn will keep me from growing hard. There will be call after call that leaves me scowling, but in the midst of them, there will be times when I really do make a difference. And that, my dear friends, is what will keep me coming back for more.

PLEASE LEAVE ME A COMMENT, IT LETS ME KNOW YOU’RE LISTENING!

Category: Paramedic

Paramedic Drops the Mic

Not All That Glitters