It never fails….I’m sitting at a table, socializing with people I just met. Eventually somebody is going to drop the “what do you do” question. I used to be quick on the draw when it came to waving the “life saver” flag – be it in a feeble and unsuccessful attempt to pick up on women, or to simply impress somebody – but that quickly changed. After I got over myself, I actually started dreading that question because I know where the conversation is going to go. People want to know what I have seen and how I deal with the “horrible” things that they think we come across every day. Of course, their definition of horrible is much different than mine.

Movies and TV have given society the impression that we see a bunch of really nasty, mangled and bloody patients, then just drive them to the hospital.  What they don’t see on TV is a paramedic talking to a grieving father after his 8-month-old child choked on a water balloon and is showing no signs of life. They don’t glamorize the mother of a little girl that was found beat up and left for dead in a trash pile, only to find out that her own husband was the one that tried to kill their daughter. When someone inquires about the “worst” thing I have ever seen, they usually aren’t expecting one of those answers. For the sake of not ruining casual conversation, I typically just tell some humorous story and keep those painful memories to myself.

When I started in EMS, death didn’t bother me like I thought it would. My first full-arrest was a rush. I was applying newly learned skills and doing something exciting. Most of my friends from high school were still smoking pot, partying, and enjoying life under the shade of the parental umbrella. Not me. I was pumping on chests, driving fast, and looking freaking awesome while I did it. I didn’t quite grasp the seriousness of the work I was doing. While I’m glad I started out when I did, I often wonder if I was mature enough to handle the job I signed up for. Fortunately for me, it wasn’t until sometime later that I truly experienced my first case where I got hit with the ole’ reality sledgehammer.

I’ll never forget the day I transported an elderly lady in full-arrest from a nursing home who was pronounced dead shortly after arrival at the ER. For me, this just another old person that died. I couldn’t even begin to count the amount of calls like this that I had run during my career. It was business as usual until I walked into the room of the now deceased patient to find a little girl crying by her side saying “I’ll miss you, Grandma”. It wasn’t the emotion from the family that bothered me, it was the guilt of not feeling anything. I wondered how I could have watched so many people die and never lost a night of sleep? Was I even human anymore? What was wrong with me?

I took a big look back on my career and couldn’t help but think about the all the times I ran a critical call, and went about my day like nothing happened. Hell, I even joked about some of these calls. The deeper I dug, the worse I felt. This was the start of many years of feeling guilt and questioning myself as a person.

For the longest time, I have felt that EMS has changed me as a person. I often question my morals, and at one point, I even questioned my faith. The things that bother me aren’t death or crippling injuries….it’s misuse of ambulance services, the entitlement mentality that many of our patients have, and the on-going joke called Medicaid reimbursement.

I often wonder if I’m so calloused as a person that something like the death of somebody’s loved one just doesn’t touch me. It’s not that I don’t care, I just don’t have any emotion invested in it. I know that as an EMS provider, I can’t be emotionally tied up in all my patients or their tragedies. If I was, I would be mess. We all would.

Now having said all that, I must clarify that I’m far from bullet-proof. I can go about my business of providing on-the-spot taxi services for those who refuse to care for themselves, pumping on grandma’s chest and doing my part to combat natural selection. That is, until I run into one of “those” calls that jump right out of nowhere and hit you right in the face. Like a young man in his early 20′s that was tragically killed in an unfortunate accident at work. Life is fine and dandy until I have to notify his father and inform him that his only son just died during a freak accident at a low-risk job.

So how do I handle that? I finish my PCR, help my partner finish cleaning the ambulance, and try to go about my day as I always do. I’ll eventually reach a quiet moment where the emotion from the event hits home. I think to myself that it could have easily been me or any one of my friends or family members. I put myself in the shoes of the grieving father and imagine how I would feel if I received that phone call. Then I take a look at myself and maybe even crack a little smile, because all the emotion I’m experiencing means that I’m still human. I remind myself of the reasons I do this job, then head out to start the cycle all over again.