I just did a call for a 25 year old woman hit by a car while carrying a 1 year old. We were the second ambulance on scene, the first having been dispatched from closer to the scene, and probably the 8^th emergency vehicle on scene taking into account the cruisers that all leave their districts for anything involving a child. When we got on scene the first crew was going through the motions of protecting the baby’s cervical spine. We assisted them, and then the baby, and my partner, went to my ambulance. The second patient wasn’t easy to pinpoint out of the crowd of hysterical bystanders. I assume some of these bystanders actually did know the patients, but its possible that this is not the case, as emergencies create a kind of need to be helpful and compassionate in this city. (Ha! A little urban EMS humor there!) Really, people just like to be involved in whatever drama is evolving around them, whether or not they are actually part of it. When we determined which woman was carrying the child-the most hysterical of the bunch-we began the process of securing her to the rigid backboards that we use to stabilize the spine of an adult. As all of this is happening, we are getting bits and pieces of the story from police, the woman holding the baby was walking across the street-the fact that she was wearing dark colors at night and no where near a crosswalk was not brought up-and she was sideswiped by a car traveling, appropriately, about 30 miles per hour. She essentially spiked the baby who landed some distance away. Throughout the time that I was in the presence of the patient, who was ultimately transported in the other truck, she was almost maniacal in her current concerns. She was screaming that her sister-the baby’s mother-was going to kill her, and she was screaming that her back hurt, but she was unable to give us any information about the baby, and furthermore, she wasn’t even the one to tell us that she is currently 4 months pregnant. We had to learn that from a bystander. The fact that the hysterical 4 month pregnant woman was also drunk and high was something we figured out for ourselves.

What bothers me about the call was the fact that this woman couldn’t pull herself together long enough to give us any pertinent information. The first words out of her mouth when emergency crews got on scene should have been, ‘I’m pregnant,’ and the next words should have been about the baby we are trying to care for. She was unable to control herself even enough to give us the baby’s date of birth. What gets in the way of a person’s ability to care for a baby in that situation? Even if it isn’t their child? We often go on scene and family members are so hysterical over their loved one that is still 100% alive, that they cannot tell us the patient’s name, much less lead us to their medications. Never in my life before EMS have I encountered this type of anxiety. This debilitating psychological, not medical, condition that hinders someone’s basic survival instincts. How do people function in life that way? How does their day to day existence hinge so precariously on the edge of complete catastrophe? How are people unable to distinguish emergency from non-emergency? And, in the event of an emergency, how are people, who supposedly care for the ones actually having the emergency, unable to keep it together enough to be helpful?

The idiocy that prompts someone to call 911 is baffling sometimes. I have had patients call for “the cotton from a q-tip stuck in his ear” (in the middle of a snowstorm), “the man that woke up with arm tingling” (after he slept on the arm all night), “the 45 year old woman with hiccups” and others just as insane. Every day I am astonished with the inability of people to care for themselves. Although these people have no idea what an emergency is, in my state-and in most states I imagine-I cannot refuse transport. If someone wants to go to the hospital because they brushed up against a cat and now think that they have fleas I cannot laugh in their face, well, not in good conscience, and I cannot tell them that the time that it takes me to bring them in, give report, and write up my paperwork is time that an ambulance in this city is otherwise unavailable for other, presumably real, emergencies. When that would-be flea victim gets to the hospital (5 minutes after the vehicle that their family took arrived in the emergency department parking lot) and they are incredulous that they aren’t immediately going into a bed, and that they are, in fact going to spend some hours in the waiting room, that is when I am repeatedly faced with reality. People don’t understand how to take care of simple things in life. People cannot look outside their world to make realistic comparisons. When flea-man asked why he wasn’t getting a bed and I said that the beds were all being used by elderly people with chest pain, or children with difficulty breathing, he couldn’t see what that had to do with him. He couldn’t possibly fathom why he should have to wait in line behind these people. Similarly I was once at a hospital giving report in triage for another patient that didn’t need to go to the emergency department when I overheard an irate boyfriend ask why his (seemingly otherwise healthy) girlfriend with abdominal pain was being made to wait for so long. His declaration was, “What if she got shot or something!?” and it dawned on me that having abdominal pain and having a life threatening traumatic injury were parallel on the scale of things that Someone Else Needs To Address Right Now for this gentleman. It seemed obvious to me, “If she got shot, she, you know, wouldn’t be in the waiting room.” I just couldn’t, and still cant, understand why he didn’t see that if she were experiencing a real emergency she would be immediately receiving treatment, in the EMERGENCY department.

  

I have often thought about what I would do if my son really needed a trip to the emergency department. He has graced the halls of two separate community hospitals once each. The first was for shortness of breath and a cough that had me more worried than it would have if my husband hadn’t been on a 24 hour shift at the fire department. The second time was after falling and hitting his head just as I was picking him up from spending the day at my grandparents house. There was no blood, and the crying-which started immediately-stopped quickly, but on the way home I realized that he was having a difficult time looking to his left, and that he wasn’t as chatty as he normally was. I brought him to the ed that my husband transports to, which is also very close to our home, and he was discharged with a diagnosis of having had his bell rung. What if, I often ask myself, there were an emergency? Like he choked, or had an allergic reaction to something, an acute problem that would require a 911 call. How would I treat those paramedics that showed up, and, more importantly, how would they treat my son? Whoever would come-assuming this imaginary emergency happened at my home-would work with my husband, and reasonably could be my husband 2 days out of every 8. What if they wanted to start an iv on him? What if they had to use some invasive measure to protect his airway? I know what its like to be in the back of an ambulance as a provider with a child staring up at you from the stretcher. Its terrifying and all reason and logical thought disappear. If you are lucky, instinct, experience and training kick in and you operate on auto-pilot. If you’re like me and have almost no fountain of experience from which to draw, the call becomes a nightmare. You talk out loud, to your partner if you’re in a system large enough to be able to provide another set of hands on pediatric calls, or to yourself if you’re not. You repeat over and over every idea that comes to mind in an effort to not miss anything. With kids though, you’re almost always thrown through a loop. If its serious, and it’s a child, its not ever going to go smoothly. It’s a desperate feeling, and I don’t want anyone to have that feeling while escorting my son to the hospital. And although I scoff at disparaging remarks that people carelessly make about my profession, after all, medics have more responsibility than nurses (and less pay, less attractive hours, and less inviting work environments), if an ambulance comes for my child, I want the crew to consist of an emergency pediatrician, an anasthesiologist, and one of those rotten nurses that is horrible and mean to even the doctors, but has seen more in her career than anyone on the face of the planet.

Not all of these grossly negligent ideas about emergencies are the fault of the general public that we serve however. There are multitudes of commercials on television as part of one association or other’s effort to get the word out about strokes, or heart attacks, and the need for immediate response and the inclusion in that response of a call to your friendly neighborhood dispatch center. The message is, ‘an ambulance will get you in quicker’, the message should be, ‘a paramedic crew can generally tell you with a high degree of accuracy if you actually need an ambulance, and can certainly tell you if you‘ll end up in the waiting room.’ Another problem is the state run health care system of which I claim to be no expert at all, but which seems too often to make it difficult to find a primary care physician. Just education in general needs to be dispersed about the appropriate way to seek medical care-if a person really felt it necessary-for nonemergent medical problems. Perhaps a person could look into an urgent care appointment for their child with a fever. Or they could learn about the appropriate use of Tylenol and Motrin to control a fever. These people could utilize so many other avenues to solve their medical issues, but they don’t. Because they don’t have a car or cab fare?

 

My son has a diaper rash. In the grand scheme of things in the world, the irritated skin of a 16 month old’s bum is probably not very high up. But it makes me mad every time I change his diaper and he’s screaming and I’m trying my best not to hurt him. Sometimes I want to yell as his butt. Or at the germs that caused the stomach bug that caused the explosive pooping that caused the rash, “I have to go to work! I can’t take care of his bum! And no one else can do it the way I want it done! So just cut the shit (and I giggle at the pun) and lay off my poor kid!”

Then I go to work, and I place calls related to the rash. “How’s his butt?” I ask 10-15 times a day. “Did you put the lotion on? Like I showed you? JUST like I showed you?” and people sigh sometimes when I do this. They sigh, I guess maybe I would sigh too. Although, probably not.

That s a good look at what life is like for a mom. Constantly just asking life to take it easy on your kid. Just give him a break. Make it easy for him. Let him get through his time on this planet unscathed, happy, confident. And let him be a little whimsical. Let him laugh when things are funny, and roll with the punches that do come, and let him just live a good life. And please God, keep the friggen pedophiles and kidnappers away from him.

 

I used to be fine letting my life run in accordance to the time clock. I’m still young, only 26, and when I was 23, what else did I have besides my future husband-who I worked with-and the occasional family time? I would feel rotten if I called out to address car issues, or to take one day off in 2 weeks. Now, when babysitting schedules are messed up, or one of my little guy’s famous 103.4 fevers strikes, it doesn’t cross my mind to go into work. I couldn’t care less. Its not that my work ethic took a hit along with my body image and disposable income, its just that my mom ethic supersedes all other areas of my life. I call off work when I think my husband might be too tired to take care of the baby, or when I haven’t seen my mom except to pick up my son in weeks. I call out if I think he is running my grandparents a little too ragged one week. I try not to tell my family these reasons, but I think they know, and I think they know that any opportunity to be the person looking after my little one is appealing to me, even if he is cranky and even if, especially if, he has a diaper rash.

My supervisors at work, although they spout off the usual lines about ‘taking care of the family’ that must be taught at a Management For People Who Barely Exist In The Real World seminar, have noticed my lack of 40 hour work weeks, and my immediate use of any and all paid time off and vacation time upon it being credited to my employee number. I’ve been spoken to more than once, and have politely smiled and nodded and acknowledged my evidently cardinal sins, but I know that if I had to choose between working my 40, and leaving my son high and dry, well, it doesn’t even seem like a ‘choice’ really. In my defense, I don’t collect health insurance or any other benefits from this company, we take care of those things through my husbands work, so the only reason that I’m obligated to work 40 hours a week is so that I can keep my shift as a full time medic. But really, I’m a full time mom.

When I am at work though, my partner and I do very well. We’re not lazy, we do right by our patients, but as new medics, we’re not crazy or over zealous. We did a cardiac arrest not too long ago, completely straightforward, we had enough help and an easy extrication, really the perfect situation-the kind of situation that rarely ever happens in EMS-and after the call we learned that the basic crew that was on scene before us, and stayed with us to help throughout the call called us ‘code ninjas.’ Silly as it may seem, as a pair of new medics, that kind of compliment, and from a coworker, is tantamount to a gold star. I sometimes feel that the type of employee that I am while at work makes up for the fact that I haven’t worked a full work week since coming back from my extended maternity leave. There are people at my company that are negligent, and borderline abusive to patients, and people that steal from other employees. Its probably not the best personal policy to judge yourself only by the actions of your peers, I mean, I do have higher standards for myself. Sometimes though, when I let it get to me that I have become less an employee of my company and more a manager of my home I have to use these rationalizations to remind myself that although I’m not as committed as much as I used to be, I am still committed more than most.

I did a call once as a basic with my husband-then boyfriend-for a lift assist. We do these types of calls all the time, just running into a house for a person, usually elderly, who, quite literally, has fallen and cant get up. I would almost rather do a call that ends in transport than a lift assist, even though I think most of my co-workers would disagree. Its not that I’m not strong, I just am not great at figuring out how we are going to get a naked, mildly obese elderly person out from between the toilet and the wall. Its just not my forte.

This particular lift assist was at an address that we had heard go out earlier in the shift, the crew that responded to it cleared from it without transporting, so en route we assumed that it was going to be more of the same. When we got there we had to walk along a thin path cleared through mountains of debris, trash, and animal excrement to reach our patient. This man had been sent home from a rehabilitation facility the day before. He was in the rehab recovering from a stroke that had left him almost entirely paralyzed on one side, unable to speak or communicate with any reliability; completely unable to care for himself. The woman taking care of him-we never found out if he was married to her or not, was also wholly incapable of caring for herself, much less this patient. The patient had slid from the bed-the only otherwise clear surface in the home-to the floor. We got the patient situated in bed and as we really began to notice our surroundings, we knew that we couldn’t leave this man here to be cared for. It wasn’t the mess of the house, which was substantial, that was the real problem. It was the mindset of his lady friend. She wanted what was best for him, she wanted to be able to ensure his health and wellbeing on a day to day basis, but she was unable to provide that wellbeing herself.

These are the situations that really upset me at work. People that are trying to do what’s best and failing. People that for whatever reason are incapable of caring for their loved ones, or people that just don’t know any better. I see this a lot because in the city I work in, in part, I think, because there are so many people that don’t speak English. I’ve responded to houses where there are children that are deathly ill but aren’t getting the proper medication because the parents couldn’t read the directions to follow them, or simply couldn’t afford them. This woman though, she really upset me. I remember seeing in her face just pure hopelessness. I sometimes feel like that woman. As if someone could come into my house at some point and see the mess that I allow to exist in our space and realize that I am not capable of caring for my son, my husband. We don’t live in filth, and my kitchen is clean almost every night when I collapse into bed, but in my head, my life is like that woman’s house. Its cluttered, and messy, and it rarely makes sense, and if a stranger were to judge it, it would certainly be found lacking. That’s just how it feels. And some days, I look at my surroundings, at the bills that I can’t organize-or even pay sometimes-and the laundry that I haven’t been able to get to, and the work and babysitting schedules that I cant get straight, and I feel hopeless too. I feel like I am just living moment to moment, occasionally getting a lift assist from friends or family, and that at any moment someone is going to say, ‘No ma’ma, this really isn’t an appropriate situation for your son to grow up in, so we’re going to give him to someone more able to care for him. Like maybe wolves.’

After that call I filed an elderly abuse/neglect form, our state’s way of allowing mandated reporters to report unsafe conditions. I never found out what came from all of it, but I assume that once a social worker set eyes on the complete chaos of that home no one would allow that woman to care for that patient. Its just worse when people are trying their hardest and failing than when people are in tough spots because they don’t try. It reminds me of me, all the time, just trying my hardest and not getting anywhere.

I took a whole year off when I had the baby. Since I’m now fulltime and trying to balance baby and work, I understand how lucky I was to have the opportunity. It was fairly easy for us, since I work private EMS and at my company, there are always bodies to fill the seats. My husband also had just gotten hired at a fire department when the baby was born and since his schedule at the fire department was so condensed, he had a lot of days to work at the private ambulance companies. I used to find myself feeling trapped being at home with a newborn baby, about 40 minutes away from my family, with my husband never home. I would go for quite a while without speaking to another adult, or leaving the house, or having visitors. Every time-or maybe I mean both times?-I got to leave the house by myself I felt guilty. Guilty and afraid that my son, my whole world would die, or be neglected while I was gone. He never came close to a life threatening situation, and I learned that I have to redefine my meaning of the word neglect. Because by my standards, everyone neglects my little boy. Even me.

Once, when I had been back at work a few weeks, I noticed my son hitting himself in the head. He actually did this two or three times over the course of a few days. The behavior disappeared, and in fact, I’m now fairly convinced that he wasn’t hitting himself, but he was listening to the sound of things when he tapped on his ears, that kind of oceanic whooshing that you wouldn’t notice unless you were really immersed in the moment, or happened to be a toddler. My next shift at work I was feeling pretty anxious about the emotional damage that I was clearly inflicting on my son. It was a logical pattern of thought. I go back to work, he starts hitting himself, eventually he’ll be setting fire to public property. I shared this sentiment with my twenty something, single, childless, male partner. He said, ineloquently, but in no uncertain terms, that if my baby was having a difficult time being without me now, it was due to the disservice I paid him by staying with him for a year after his birth. I cried. Not because I agreed with this idiot, but because there are people out there in the world that think that parents and children should be separated. That a child shouldn’t feel that their mother will always be there. What kind of life is that! Did this person say that because he was male? Would any woman ever agree with that statement? Would any woman who carried and nursed and became completely consumed by their little creation agree with that? I hate to think so.

The thing that I don’t think men understand is the symbiosis of the mother child relationship. My son came into this world needing everything that I had to offer. There was not one day when I had energy stores left over that I did not completely lend to him in some fashion. There wasn’t a single moment when I thought about putting him on hold. In the same way, I was his entire world. Although he was the direct recipient of all of my efforts, I was also the direct recipient of all his. I am the first person in the world that my son made eye contact with, and also the first person that he recognized. When he cooed, it was to communicate with me. Although he now communicates with others, and lives to please everyone, at the heart of his human interactions is his desire to affect me.

A lactation consultant whose advice I sought in those early days said that my little one doesn’t know that he and I are not the same thing. He doesn’t know that I am a separate being from him. She said that it was my job to teach him that, and to let him down gently. I wonder if she knew that I knew that this lesson would take a lifetime.

Along with all this mutual pillaging of energy and ability is a passive sense guilt on my behalf. My husband said things like, go out, go to a movie, go get a massage. I never did, because I couldn’t yet. I couldn’t accept his “permission” to do these things, because it seems that I didn’t have his permission to not be in charge of dinner, or bath time, or child care arrangements for the week ahead. He never helped me feel like I can temporarily walk away from these responsibilities, and yet, remain in the home. In truth, I don’t think he quite understands what I meant when I-usually while yelling and crying-brought this fact up. Why do I have to leave the comfort of my home to relax, to take some time off? He’s happy to make arrangements when he’s home alone with the baby, which is usually once or twice a week, while I’m at work. The problem is that he’s never in charge when we’re both home with the baby, and although I live to spend time with my son, you can’t just live that way, you don’t grow as a human being by being so immersed in another person’s needs. How can I possibly explain the significance of that to someone that’s not going through the exact same thing? The mommy is always in charge. What a tremendous burden. If the mommy wanted to go to the grocery store alone because she hadn’t had the chance to sing along with the radio in a while, and well, because, lets face it, the grocery store is always easier alone, that’s kind of taboo now isn’t it? Of course it is. The mommy belongs with the baby. And the mommy feels lucky, and almost as if she’s tempting fate by loving someone else so much, but at the same time, why does the mommy have to ask the daddy if he minds being in charge of the baby so that she can roll all the windows in the car down and feel like a person out in the world on her way to do her errands? Why isn’t it the obvious solution to the problem of, ‘how am I going to get my errands in today?’

On my way to work I listen to whatever I want on the radio. In fact lately, it hasn’t even been music. It has been what ever news talk is on NPR. I frown appropriately at the dropout rates in urban areas, and I plan, in my head of course, how to encourage my son on his journey through the maze of education. Its all kind of fake on my part though. What I really want to do is listen to the kind of music I liked in high school. I want to feel like the person I was before I had a child, when I was a child myself. Sometimes I successfully stifle these urges, and I live my ‘wife mother’ life as though it’s the only thing that ever mattered. Sometimes, I am able to remind myself that while ‘wife mother’ matters most, and is the only thing so far that will matter forever, there used to be other lives that mattered, other student, daughter, world person, worker lives that mattered. Its hard to remember that its ok that there is a ‘before my son and husband’ time. This is probably only true because how do you not feel like a rotten person when you’re fondly thinking of the days before you had to do all the laundry and when you could go out and do anything any time you stuck a fancy. Sighing as I remember eating out because I hadn’t felt like grocery shopping. Cringing because I know that if there are groceries to be bought, I’m going to be the one to buy them, and you can bet that I’ll be entertaining a toddler as I do it.

When I am home, I get anxious about things that need to be done, and at the same time I am desperate to mother my son. Its not as easy as just being a mother though, I long to just be content sitting on the floor and teaching through playing, and I feel guilty when I cannot wrap my mind around that particular task. I cuddle my son in a way that would be violent if it weren’t done with the love of a mother. I gather him up into my arms and press my face into his neck, smelling him, kissing him, literally trying to melt into him. This makes me think that the lactation consultant had it backwards. Its me that has to spend a lifetime learning that this little one and I are not the same thing, he already knows that he is a person on his own, and I will never be that way again.

You’re reading my blog. You should know my deal.

I am a paramedic. I know, I’m a rock star. Feel free to pay your taxes directly to me. I also happen to be a mother of a 2 year old, and a wife/daughter/sister etc. If you asked me how I identify myself I would probably say mother first, but no one pays their taxes to mothers, even if they’re rock star moms.
My world for the last two years has been about balancing work, and my little man and just trying to make some headway in life. I’m 27, but I feel aged. Hell, some days I feel weary, weathered, and just beaten. But most days, I’m happy to do a job that provides some sense of personal gratification, and of course, any one that has kids knows the sense of accomplishment that can be had from simple at home things-like getting crayon off the wall, keys out of the toilet, or quarters out of the dvd player.
It’s those weary, beaten days that are getting to me. I am trying to put myself in position for a promotion. My dreams are laced with visions of white shirts with ‘Operations Supervisor’ patches. I have interviewed twice, and have been turned down twice, the first time totally understandable, the second time I was robbed (I’m trying to hold on to my anger about it, but in reality the guy that got it isn’t doing half bad). I’m learning a lesson that I probably should have learned before now, and that is that sometimes, wanting something doesn’t mean you get it. Not like I was a spoiled kid or anything, I didn’t get every single material thing I asked for, but I have gotten every thing that I really wanted-jobs, positions, scholarships etc. To be perfectly honest, I’m not really used to being told ‘No.’ I’m also not used to losing. And yet here I am, going to work day in and day out looking at the guy that beat me out of the job and comparing myself to him. I think I fare pretty well in the comparison department.
Without going into my EMS life too much, let me tell you that I have two career options at this point: 1. Get a promotion to Operations Supervisor, or 2. Stay exactly where I am-a street medic-for the next 30 years or until my back gives out. (for the sake of simple reality, I have left out the possibility that I may win the lottery, go back to school or get abducted by aliens.) There are no small steps upwards, no Lieutenant or Deputy Chief spots awaiting me in the world of private EMS. Just the road, or off the road. I could move to another company, and perhaps even move to a higher position at another company, but my company has the golden rings. My company has the 911s.
All of a sudden, at 27, I’m looking down the barrel of my entire working life. Let me tell ya folks, I wasn’t ready for this.

The fun thing about being a part time medic is the ability to not work for weeks at a time with no negative employment ramifications at all. Of course the bank account ramifications prevent that from happening, but its nice to have the option. The less fun thing about being pt is the epidemic spreading across the nation even as we speak, folks-lock up your children-NEW BASICS! Ah, what a short period of time it took for me as an infant medic to begin complaining about the very people occupying the job that I was performing not 4 years ago! And of course, as always, I really don’t mean to offend, and if you’re reading this, you’re probably an experienced basic and probably a great one! The kind of basic that makes me sigh in relief when I see you on scene. Its not likely that you’re a NEW BASIC. I’m fairly certain that my company has tripled our work force in the last 3 months with slightly gawky, socially awkward, too afraid to ask questions and too stupid to admit they don’t know everything basics. When I was a new basic, there was a certain hazing period that we all went through. Nothing malicious, nothing dangerous. Just some good natured being completely ignored and knowing not to speak until spoken to. Now it seems that the influx of NEW BASICS has overwhelmed our ability to properly put them through the paces and we have given up, only muttering a few choice words about the names we’ve never heard of before on the strength report and assuming the worst of all of them as one. Please don’t imagine that I have forgotten the learning curve involved with joining the world of EMS, quite the opposite in fact. As a new medic I rely on that learning curve not only to not look like a jackass at the hospitals, but also to keep my job. Maybe I am being too harsh, but when I’m the only medic, with 3 basics at a trauma code and I ask for someone to set me up a bag and a bp cuff is placed in my hand…..I get that warm and fuzzy feeling inside that alerts me to the fact that my head is about to explode in anger

It is nice however to be A MEDIC, in a culture of NEW BASICS. Do you remember who that awe-inspiring medic was to you? Mine was Beth. Beth was a very small, very funny, very badass medic who was full time when I started as a basic. she was my FTO on more than one occasion, and I remember watching her stairchair a hugely pregnant woman down a flight of stairs, crushing her hand between the stairchair and the banister, never flinching. I also remember her telling me to check said pregnant woman for crowning…She went part time a few years back when she got a fire job, and I miss seeing her all the time. When I do see her however, its different now that I’m a peer. But I remember what it was like, to feel looked upon with favor, to feel included in the conversation by a medic that you respect. I’m trying to be that to these tiny little basics. I’m trying to be someone for them to look up to, and I’m discovering that its not easy. Its not easy to feel so rushed, so relied on, so stretched thin by a system that constantly outgrows itself, and still make nice, and exude teachable moments to these kids that are surely as scared as I was 4 years ago.

***note from the author*** this was written long ago for a blog that sadly, perished in a horrible fire. While that blog smoldered this piece rose from its ashes, a blogging Phoenix, that needs to be shared, even though it is out of order and somewhat random.

I think its fitting that my first real blog entry is being composed on a day when I needed to use my hard earned pto to just not be in the ambulance.

Ive had a heavy feeling of dread heading into work lately, and it seems to be more than the 8 month old medic jitters. I’m sure that more than one person in my inner circle will tell you that I would benefit from some type of anti-anxiety medication, but I cant wrap my mind around needing drugs to do my job. After all, its just a job. Of course, tell that to the sheer terror that seizes my diaphragm when my truck number booms out of the dispatch speaker while I’m riding in the passenger seat. I have come to look forward to sitting in the truck after my tech and opening up the computer to write my pcr. This glorious time of day is the best for one simple reason; in this moment, I am the furthest away from my next tech.

The strange thing is, everyone in my ems support group keeps telling me how good I am, and how I know my stuff, and ‘when you need it, it comes back to you’. The people in my non-ems support group tell me that I do important work, and they would never be able to do this job-as if its easy for me. At the end of all that supporting, I usually am left wondering how I fooled everyone without even trying, and also, why no one is listening to what I’m really saying, and what I feel. The truth is, I’m not ready for this responsibility. I’m not trained enough, and I’m not good at a lot of key things (ie, ekg interpretation, med doses, anything involving breathing). I’ve intubated twice in the field, both times successful flukes, and I can’t push a med without double checking the dose and indications in my protocol book, and not because I’m a ‘better safe than sorry’ girl, but because I don’t know them. I’m sure I used to, in fact I had to in order to pass my medic program and to pass the state test, but it doesn’t ‘come back to me’ when I need it most.

I keep waiting for someone to notice my lack of proficiency, but no one does, quite the opposite in fact, I keep getting the accolades of a seasoned medic, all the while watching myself be mowed over by my equally new, but infinitely more assured partner. I have become a medic who is constantly looking for a second opinion…

My medic instructor always said that we have to be like ducks; cool, calm, and collected above the water, but paddling our asses off under the surface. Its about presenting a good show, because, in my system at least, most people that call 911 aren’t all that sick. I reassure myself while being driven to a call lights and sirens: ‘this is nothing’ or, ‘it was just a seizure’ or, ‘she “can’t breathe” because she’s vomiting’. Whatever the call is, I downgrade it to its lowest possible acuity and then subtract 10 more points for EMD errors. I don’t do this to be a better medic, I do it so that I can get out of the truck on scene. So that I can physically unclip my seatbelt, open my door, grab my gear, and make patient contact. I boil it all down to that one, very simple step:

Get. Out. Of. The. Ambulance.

There have been mornings where it takes every fiber of my being to convince myself to get out of my car in the parking lot. Twice now I have been unsuccessful in that task, twice I have been so overwhelmed with the endless patients, sad stories, ill-cared for children, and sometimes even my rotten coworkers, that I have been unable to pull myself together for a shift. I call them mental health days, and today was one of them, but they’re not really mental health days, because I don’t recover. I don’t FEEL mentally rested at the end of that time off. I feel drained, I carry the weight of the current ‘tough call’ with me to all of the next ones, until I find a new tough call to outweigh the previous one. I’m not tough, I’m fundamentally not like the women that I know and admire. I have dozens of calls hanging off me at any given time, almost tangible in the way they drag me down, and break my stride.

Sometimes I think that my career as a road medic was meant to be short lived. I am interested in the business side of things, and I’m not averse to putting on a white shirt. I want to be in EMS, I just haven’t figured out a way that my anxiety will allow me to be in this field.

Before you start sending me links for office jobs, let me assure you that the possibility that this horrendous feeling will fade has not been lost on me. I understand that there is a period of time (I’ve been quoted 2 years by several different people) during a new medic’s career where the light at the end of the tunnel IS actually the train barreling down on her. I know that one day I could get into the truck with all the lightheartedness and confidence in the world. I just cant picture that day right now.

Let me say that I have rattled this all off and am posting it without thinking too long about it. Not that I mean to make an excuse, I truly believe everything that I’m saying, but just that I needed to work up a bit of courage to post it….

Its hard being in a male dominated profession. I’ve said this to my non-ems female friends and I usually get a chorus of, “yeah, what a burden, to be around all those men in uniforms, boo-hoo.” And we laugh, and I-a married woman-shrug off the musings about turnout gear, and the finer qualities of a man carrying a gun, and I still insist that this world is difficult for a woman.

Let’s get beyond the whole ‘I can do anything you can do better’ plane of thinking for a minute. If you’re reading this, you probably already know that women are as capable of excelling in EMS as men. And if you’re a man reading this, I have to say, this one isn’t really for you.

Its for the Ladies.

Here’s the real problem with working in EMS-and I imagine the same could be said for fire, although I have no first hand experience there-there is no room for your gender identity. I’m still getting my mind around this ladies, so bear with me, but when I leave work, and I shed my ill-fitting, made for a man EMS pants, and my boots, and my bulky job shirt, and I’m a mother to my son, I feel feminine. I feel capable and tough, but there is still an inherently female undertone to the way I walk about in the world.
At work, there seems to be two main groups of women, those that fit in with they guys, and those that chase the guys. Good care providers? Sure. Fun to be around for 12 hours? Sometimes. But like me? No.
I’m bordering on insulting here, and I don’t mean to be. Let me stress that I chased an EMS guy relentlessly. It turns out that he was the only EMS guy I ever chased, and I married him, but I used everything I had to land him-not like I had to beg or anything, I mean, I’m not a troll…..but I was briefly sucked in to that world of feeling the need to prove my intrinsic womaness, in a world where I dress in practical, unflattering clothes and deal with things that are decidedly indelicate. And that’s what gets me. The need to prove myself in the context of gender. Why do I feel that need? Why do I need to be a woman at work? I guess maybe part of the reason is that there are so many Men at work. And not men, little ‘m’, but Men, with raw steak and big trucks.
My work life is dominated by alpha males. Not just guys that are friendly and do their job well-although there are those too, and they’re a breath of fresh air-but men that prove their manliness in every interaction, during every call, and in countless ways that could be featured in a comic strip. Why?
And is my feeling of gender neutrality related to the fact that most of what I’m exposed to is super macho or feminine wiles?

Do women that work in offices, that wear cardigans and heels think about this stuff? Do you? Am I completely alone on this?

Once I overheard a guy that I work with having a casual conversation with someone about his wife, who had just had a baby. He was asked if she was going back to work, and his response was an emphatic no. He said, “…are you kidding me? She’s a basic. I don’t want her on the ambulance. She’s going to eventually go to school for [insert female dominated profession here]” Is that how men feel? When I work with a man that happens to feel protective of his female partners-is he fighting the urge to step in front of me and protect my-my what, rosy view of the world? Honor? My virgin eyes?-from the veritable shit show before us? And if he is DOES THAT REALLY BOTHER ME?

There it is folks, there’s the root of it. The message that I’m sending that could send the women’s movement straight back to the 1950s. Do I really mind being a member of the “diminutive” sex? No. I don’t. But, and here’s where things get all jumbly in my mind, I’m good at my job, and I can absolutely do my job without the assistance of a member of the male species, but at the same time, I want help to be offered. As if help, or assistance, or protectiveness from the male half of the partnership isn’t offered, then I’m less of a woman, and more one of the guys…and being one of the guys is not what I want……and chasing the guys is not how I want to prove my femininity. So what else is there?
I’m not so foolish as to believe that I’m writing without ramifications here, I am more than aware that some women have to fight, tooth and nail to be tolerated, much less respected in their fire house or station. And that, folks, is complete shit. Gone are the days where scantily clad calendars hang in the day room, and the boys club should take notice of the rising number of female leaders in fire and EMS. I’m not saying that I’m on track here, or I’m starting some radical new wave of thinking for the women’s movement. I’m just saying, this is how I feel. Where does this come from? And how do you feel?

The desire to share stories about calls is deeply rooted in most medics that I come across. I, evidently, am no different.
Dispatched priority 1 for the “machete fight” (at 9am on a Sunday-who busts out the machete on God’s day!?), coming from across the city, no other trucks available. Ops supervisor on scene prior to our arrival. I pulled on the street and passed the victim, lying prone with the supervisor holding a trauma dressing on his back. My partner, with the door open before I put it in park says, “Oh Ang, he’s in a bad way.”

Her first clue was the ever expanding pool of blood…..

We walk up and the supervisor-never the calmest tech in the world-rips off the trauma dressing to reveal a foot long laceration almost down to the bone. Patient transported, chatting with my partner during the clean up, when all of a sudden, it hits me,
“I know we’re medics and all, but I feel we should have some more warning when someone is about to show us that kind of gore….”

Dispatched some priority for a rehab patient with headaches and general get-me-outta-here-itis.
Giving the CMED report to a secretary (isn’t that a great idea?) and said the patient was in rehab status post fall and deteriorating. Three times this ever-increasingly angry secretary asked me if the patient sustained any injury from the fall. Three times I explained that the fall was not recent, I finally just hung up the mic. On arrival at the hospital the secretary pulls me aside to tell me that she was trying to get to the root of the problem, and that when the chief complaint is a fall, they expect a report of injuries. I did not explain to her the meaning of ‘status post’. It bothers me to this day that I didn’t.

The stories that I generally share always end with me feeling pretty uncomfortable actually; getting ‘spoken to’ by a secretary who doesn’t understand the idea of being in rehab status post fall? Really?

I can do better.

The desire to share stories about a child is deeply rooted in most moms I come across. I, evidently, am no different.

My son is 21 months old. There is only one story that I can tell you that captures his personality perfectly.
At our local YMCA there is a program called Tumble and Play for toddlers. They open the gym up, set up all kinds of mats and big ramps, put out balls and hula-hoops and play music. It gives parents a little while to exhaust the children, while simultaneously feel like they are out of the house and with other adults. One day my little guy saw another child trip and fall and immediately begin crying. The mom knelt down and comforted the hysterical toddler. I turned my head for one second, and when I turned back, my son, this little boy with my knees, my round face, was attempting to become part of the embrace with this mother and her child. He had this look of concern on his face that I will never forget, as if he were saying to me, “Mom. Something here isn’t right, I’m gonna see if I can do anything to help, ok?” My son, my whole world, my very reason for putting one foot in front of the other, HE is a true care provider.

Do you hope your children follow in your footsteps?