Man, it’s been a long time since I got on here and posted.
I could give you a list of excuses, but ultimately it boils down to me just not taking the time to sit here and write something. You would think that there should always be something to write about. Honestly, I always think there’s something going on that I need to get out.
But it rarely does.
We first responders have a tendency to repress our most basic instincts and emotional responses. Is it because we think we need to be strong at all times? Is it that we just do such a great job of compartmentalizing everything until it explodes and we’re left standing there, shattered reality around us?
This omerta, this code of silence, it follows us everywhere. There are things I see and do at work that I need to get out, need to tell someone.
But who to tell? My wife? My kids? I’m reminded far too often that my gory tales are far too much for respectable dinner conversation.
Instead of turning here, though, I sit, and I wonder about all those things I should have said, but didn’t.
And it’s a silence that is deafening.
I am, first and foremost, a firefighter. That is the career I have chosen.
But I am also an EMT with advanced training, working on finishing my EMT-Paramedic.
My department required me to have a Basic certification to be eligible for hire. But that is all.
No one forced me to advance my medical certifications. I have done that of my own accord and mostly at my own expense.
That being said, I could care less whether fire runs EMS or EMS is a third agency. That’s above my paygrade and beyond my scope. The people I work with in EMS are fine, dedicated people. I am proud to work alongside them, regardless of whose name is painted on the outside of the ambulance.
But what irritates me is when people say that Fire-EMS is just the Fire Department trying to justify their existence by trying to do someone else’s job.
That’s like saying that the 343 firefighters who sacrificed everything on 9-11 were only justified because FDNY also runs medicals.
I know it’s more complicated than that (I think FDNY took over EMS in 2005, but that’s not the point), but yet it is also that simple.
“I can think of no more stirring symbol of man’s humanity to man than a fire engine.”
Kurt Vonnegut was a firefighter. He is also a fire survivor rescued by firemen. At a tribute for our fallen brothers and sisters, he recited the names of all of the firefighters who were killed from the station he was saved by.
Firefighters are not heroes by default, and fire calls are down. I will give you that.
But go home. Look around. Look at the things and the people you love.
Now imagine that all burning to the ground.
I have worked in a burn center. I have seen what flame can do and I have felt its heat kiss my flesh.
George Orwell is attributed (perhaps incorrectly) with saying “People sleep peaceably in their beds at night only because rough men stand ready to do violence on their behalf.”
Maybe we can sleep peacefully because someone stands ready to rush into harms way, regardless of their career (Fire, EMS, law enforcement, military, etc) and who needs their help.
They hear the call, and they answer.
That, to me, is justification.
When she put the poster in her office (which had, until the day before, been a small closet), I couldn’t help but stare. For National Poetry Month in 2009, the American Academy of Poets put out a beautiful image of these two lines written into the condensation of a piece of glass.
“Do I dare /Disturb the universe?”
T.S. Eliot’s The Love Song of J. Alfred Prufrock is a complicated poem, one whose analysis is way beyond my scope. But I love it.
“Do I dare /Disturb the universe?”
I love that thought. It haunts me.
Mainly, it’s because I find myself asking myself that question all the time. Oftentimes, first responders (regardless of what field – EMS, Fire, Law Enforcement, etc) find themselves in futile situations. Anyone who has ever worked a cardiac arrest at a nursing home will understand what I mean.
“Do I dare /Disturb the universe? / In a minute there is time / For decisions and revisions which a minute will reverse.”
If only it were that simple. But still, I wonder.
Do I dare?
“Something wrong bud?”
In EMS, they teach us to look for pertinent negatives. If they’re not having chest pain, not nauseated, not short on breath, then they’re probably not having a heart attack, and it’s probably something else.
My stepson has the pertinent negatives. He’s not happy, not stuffing his face, and not talking. Especially not to his mom or I. And he’s definitely not crying (he says).
Sounds like girl problems. Or at the very least a bad case of the teenage angst.
Sigh. He and his sisters have been with grandma all week, and this is what we get when he gets home.
One day at work, we ran a drug overdose call. It was my rookie’s second or third shift, and he was definitely new to the wonderful world of EMS.
We walk in to the house and find a young woman in her mid 20’s laying on the kitchen floor, barely breathing. Her boyfriend is there next to her. His parents are standing in the living room holding a baby. They’re nicely dressed, respectable people, obviously unhappy with where they are and what’s going on in front of them.
“What’d she take?”
“Fentanyl. It’s her drug of choice. She drew up a hit for me and a hit for herself, and when I came back to do mine she was like this.”
Long story short, a little Narcan later and she was awake, talking, and pissed to have come off a killer high.
When we got back to the station, my rookie walked over to me and asked me if it’s always like that.
“That dude just talked about shooting up like she’d just poured a couple shots of whiskey or something. And he had no problem telling you about it.”
You know, it’s funny. We’re not cops. When people have to call us after snorting, smoking, shooting up, etc, they usually don’t have a care in the world about telling us. It’s almost like they’re inviting you into their world as if you were an old friend.
Most people end up talking. Women talk about periods, drug users about their habits, gangsters about their babies cough that has them scared shitless.
And yet I can’t get my own kid to tell me what’s going on in his world.
Sometimes, this parenting shit sucks.
It may be just a legend. No one is really sure.
Picture this: The streets are full today. Plebeians and senators, soldiers and scholars; all are there. The delineations between classes are not as apparent today as they usually are.
Over the roar of the crowd, you catch the slightest echo of something. You strain harder to hear it, and there it is again, only louder. Horns. The deep, throaty rumble of horns. The clap of iron sandals on stone. The harsh crack of drums. As the noise grows, the shouts and yells of the crowd slowly meld together into a colossal cheer.
Then you see him.
He rides in a chariot pulled by white horses. His armor is draped with the skins of leopards and the deep purple of royal robes. On his brow sits a laurel crown, the gold leaf glinting in the sun. Behold, the victorious general, returned to Rome and honored for the glory he has brought it.
But it is not the general who catches your eye. It is the lowly slave behind him, the one who almost seems to disappear in the general’s splendor. You can see him whisper into the victor’s ear, but you can not hear over the cheer of the crowd.
“Respice post te! Hominem te esse memento! Memento mori!”
“Look behind you! Remember that you are but a man! Remember that you shall die!”
Maybe it’s true. Who knows. The Romans didn’t always keep the most accurate histories. It’s been argued that the story of the servant is more a moral reminder than a literal history. Perhaps it was meant to serve as a warning to the rivals of Caesar – remember that while you are the victor today, you may fall tomorrow, especially if Caesar wills it.
Remember, thou art mortal.
I’m rambling again. It’s what I do. But this is the story that came to mind this morning as I sat at work. While I was roved out to another station, my regular engine crew ran a cardiac arrest today. I honestly don’t know the specifics, but it wouldn’t matter if I did. They rarely differ. This one did slightly, as resuscitation was ceased on scene. We often ride in, still performing compressions. Not today. No need.
In a recent med refresher course in which they stressed the importance of quality compressions and minimized interruptions (because we didn’t know that already, apparently), they pointed out an interesting fact. I don’t recall the doctor’s name, or what his title was, but I do recall that he was a major player in resuscitation research. One of his key points is that the success of a cardiac arrest resuscitation is almost always determined on scene. If they don’t regain pulses before we put them in the ambulance, they probably won’t get them back at all.
When I first got into EMS, I had to take my CPR class just like everyone else. I was lucky. I had a burned out, retired medic as my instructor, and there were only two of us in the class.
She didn’t sugarcoat it. She told us the things they don’t typically tell you about CPR.
She told us that we would save less than 8% of our cardiac arrest patients. She told us that we would break ribs. She told us we would stare into open, empty eyes while families screamed at us, and that we would begin to feel remorse for working most. I’m glad she prepared me for that.
That’s not to say that I’ve lost my compassion. Far from it. If anything, the calls that haunt me the most aren’t the bloody traumas or massive AMI’s. No, for me, it’s the wife hugging her son in the corner, crying into his shoulder as we pump on the cracking chest of her husband of 50 years. It’s the tears in the crystal blue eyes of a 50 year old man as we tell him not to be scared while we hand squeeze saline bags to try and force fluid into him and to force his pressure above 70. It’s his quiet whisper of “I’m not scared,” while the monitor shows a massive heart attack that has pushed him into cardiogenic shock, and that will ultimately take his life in the next two hours.
What we do is important. CPR is important, and it saves lives. But the ones we don’t save slip in line behind us as make our triumphal entry through the sliding ambulance bay doors with the patient we just snatched from the jaws of death, whispering in our ears:
“Respice post te! Hominem te esse memento! Memento mori!”