I search for the darkest place, the most remote location, just to be, to exist; no real thoughts running through my mind. I have no intention, no idea of what I want, all I know is, I must be alone. In this antiseptic environment, the closest location I find to privacy is a staff bathroom in the EMS room, which is a single use restroom, smelling so clean you know something dirty went down in there recently. The likelihood of being interrupted in the next five, ten, twenty minutes is extremely high, as patients get wheeled into the emergency room by incoming ambulances with paramedics who haven’t urinated in hours, but have drunk enough coffee to put an elephant into SVT. I go into the room and lock the door behind myself, fingers quaking as I try and push the sticky button in, which is almost broken from thousands of uses. In my remote sanctuary, where I feel alone, I lean against the wall and slide down to the floor, sobbing uncontrollably, my patient’s blood still painted all over me, hiding in spots I haven’t even found yet.
It isn’t like a movie. I don’t leave a smear of red sticky blood along the tan tile which is halfway up the wall. No, the crimson matter is dried to me, now harder to get off in the thick clots that hug my skin than cement that has cured on my pale epidermis. My dark blue uniform hides all the clots and splatters, streaks and smears that cover me. No, I did not roll in the blood. I had no choice but to bear hug the unconscious patient, who was covered in his own fluid, and lift him onto the stretcher; I drew the short straw having to cradle the patient’s torso, instead of lifting from his legs.
“Macho, macho man. I want to be a macho man.” Yeah, that is what we all think. We are men, men playing Russian Roulette, each waiting to see who will drop out first, as the cylinder spins around, the hammer clicking with a flinch at each pass of the gun. It is not intentional, or cruel, but if one of us falls, it tends to cascade, bringing us all down to earth. We keep our emotions bottled up, so we don’t infect the rest of the crew. In this day and age you would think such idiotic primordial instincts would be wiped out, but instead, I sit on the floor of a hospital bathroom, where hundreds of feet caked with blood, vomit, and shit had trudged through, and sob uncontrollably, the strain catching up.
No one will ever know what it truly feels like to work in an ambulance until they have. No profession can come close. I acknowledge there are many occupations that are filled with stress. In this job though, we sit there, in a box screaming down the road at high speeds, weaving in and out of traffic, delivering patients to the hospital, just that alone is enough to turn us into alcoholics. Don’t let me fool you into believing every patient is critical, hell, most of our patients don’t even need to be seen at the hospital. But for those who are critical, it can be a hairy ride. To sit there, by yourself, and watch someone die, to fade away, wink out of existence, when you have done everything in your power, and you cannot do anything more; it’s heartbreaking. The monitor doesn’t make a long trailing beep that breaks the air. Fuck, that would be comforting, at least something would break the silence. Instead it is as if the air has been sucked out of the box, and you are left floating in a vacuous space. You are left alone with a corpse for the rest of the ride, and it feels odd. Yeah, we try and resuscitate the patient, but only if it is cardiac arrest. Patient’s having traumatic injuries, well, you bled out. There is nothing to push through your arteries by performing CPR. Fluid, such as blood, has to be present in the venous system for that to work, and well, that all escaped through those holes in your body, you know, the ones that aren’t supposed to be there.
As paramedics we move like specters through the world, as if existing between two dimensions. People never believe the stories I tell them, and then I think they really didn’t want to know once they’ve heard it. I have learned to answer questions vaguely about what I do. What good comes from telling people there are heroin dealers in their quaint town? Or better yet, tell them about the kid who died in your arms on the way to the hospital. No, we exist in a dimension that only those that work in police cruisers, ambulances, and fire engines see. Hospitals see this terror as well—and not to lessen their jobs—but most of the time we clean them up, or the patient’s home is the true horror scene. Nothing gets to you as much as wading through someone’s home who is a hoarder, and you are waist deep—keep in mind I am six foot four—in trash that is now stuck to your clothes till you get back to the station. Those disgusting days stick in your memory.
Sitting in that bathroom, my feet splayed out in front of me, I compose myself, knowing I’m rolling the dice on a filled bladder or backed colon eventually needing to be emptied. As I dip my forearms under the faucet, the water turns rust red, and I lather my skin with the foam soap, the aerated cleanser frothy underneath my palms. Splashing cold water on my eyes, I rub the red circles, as if this action will somehow cause them to disappear.
On a call of this nature, this critical, it takes us over an hour to get back in service. My report now pages long, and the ambulance, stretcher, and multiple pieces of equipment doused and scrubbed, we head back to our station. In those moments on the road, we speak volumes with silence, and the words we do speak, are laced with pain and emotions of which we are too careful to show. And in the end, to comfort ourselves, we use clichés, “someone’s gotta do it.”
Having worked in the business of Fire/EMS for sometime now, first and foremost I will say PTSD for first-responders is a real thing. I encourage you to seek help if you need it.
I would disagree with you strongly. As medics we don’t exist between two dimensions, but the one and only of reality. It has always been the same. Yes television, media etc. have made the reality of running such emergencies too clean and too pretty; but our job has never changed. Myself and my teammates have comforted many patients after scenes that have given me the 1,000 yard stare and said “it’s just not like it is on TV”.
It’s not a cliche, someone does have to do it, that someone is us. It’s not a phrase of comfort but of conviction. At the end of the day it is the best job I’ve ever had, and my teammates will agree.
I can sympathize with the alarm you answered. I can’t stress enough, there is no shame in seeking help.
Hell I’ll even talk to you if you need it. Stay safe.
Thank you for your support. That is a wonderful part of fire departments and ambulance services, we all understand the trauma we incur from our profession, and empathize, even if it is half a world away or in the town next door.
I understand PTSD is a real, concerning, and legitimate problem for first responders. In my masters program, I wrote papers on PTSD in our profession and the ideas of mental health concerning first responders. I read an interesting Ph. D. dissertation on death humor–dark humor–amongst first responders as a coping mechanism, but also to show camaraderie and commiseration, it is a very interesting topic which has been widely untouched by the academic world. We, as a community, tend to rally around ourselves creating a strong support network, but we each handle our emotions in individual, different ways. In thirteen years of full-time service, I have seen many bad things, but know, at the end of the day, I have done good.
I believe we live in two worlds in the way as I note; the disbelief of the public and their lack or understanding in our job–remember this is prose, not everything is literal, but can be an analogy, writing allows the ability to use words to convey ideas without outright stating it. There is reality and then perceived reality. Although we live in reality, I cannot alter the perception of John Q Public who does not understand or believe what I do, but instead believes what Rescue Me, Chicago Fire, or 3rd Watch, has taught them about firefighting and EMS. This is a common problem with many jobs that become tropes in television and stories.
A pen can be a form of therapy, exorcising demons. We all deal with things differently. And it isn’t the idea behind the thought that is the cliche, but a cliche is a phrase that is overused and unoriginal. I am illustrating that sometimes there are few words that can fill the air as minds race, so instead we use overused phrases to fill that void.
Again, thank you for your support. I appreciate it.
Very deep post; thank you for putting it out there. “People never believe the stories I tell them, and then I think they really didn’t want to know once they’ve heard it.” I believe, and am here to read what you say.