When I first became an EMT, a friend asked me why I liked the job so much. When I come through the door, people look at me like I am an angel, I said. What is it like driving lights and sirens? Another friend asked. Awesome — I feel all powerful. I hit wail and the cars part for me like the red sea parting for Moses.
If you asked me then if there was anything wrong with what I described, I would have been seriously puzzled by the question. I didn't quite understand the true nature of the work.
When I became a paramedic I quickly learned to be a circus ringmaster, barking orders to partners, other first responders and even bystanders. All eyes were on me as I orchestrated getting vitals signs, med lists, moving furniture, putting on oxygen, getting an IV, delivering medicine, extricating the patients, even determining who could ride with us to the hospital. Eventually I brought that same leader of the band approach to running cardiac arrest (compressions, shocks, IV access, drugs, intubation, post-ROSC 12-lead, dopamine to support blood pressure, all seamlessly timed. I felt like a rock star. Driving home, I would go over in my head how well the calls went, how impressed people must be with me. Even if a call wasn't critical, I still strode in like I owned the world. I bantered with the other responders while making my way to the patient. How's the wife and kids? How about that car accident yesterday? Hope the Sox win tonight. I was a big city medic. Living the dream, as they say nowadays.
Of course, over time that changed. Work the streets long enough and you can't help but see the job for what it truly is. It isn't a TV show. It is not a play in which you are the star. It is just a system for getting sick and injured people to the hospital in the safest, calmest, kindest way possible.
My old teacher Judy Moore used to say the emergency ends when you arrive. It took me awhile to understand what she meant. But I learned. When you come through the doors, you don't bring the cameras in with you. The patient should be the center of attention, not the paramedic. Don't suck up all the energy in the room. Cut the theatrics, the commotion, and the self-importance. Converse with the patient. Reassure them. Be professional. Do what needs to be done without fanfare.
I see my old self in a few younger providers, but I don't say anything. They will learn. Even if they came first for the adventure and the lights and sirens as I did, if they stay long enough, they will stay for the human contact.
I remember when I was a young EMT at a car accident, doing my best to seize control. An older medic arrived in the second ambulance, and without saying a word, smiled wryly and somehow managed to make sereneness out of my chaos.
You don't need a cape to do this job. Drive carefully, speak softly, act calmly, be competent, be kind. Be a paramedic.