As I write this reflection, my new book has been available for about a week. I am still in a sort of post writing shock. It is a memoir and cut close to my soul.
I have been asked how I remembered so much in the way of specific detail; for example, the color of a blanket covering a patient or the smell of birdseed in a room or the way in which a victim was dressed. It can be the nature of depression or PTSD. Remembering is the easy part, forgetting it all, is rough. The good news is that remembering detail helped me put down the words I needed to write.
What the book is not
Far too many books on “ambulances,” “lights and sirens,” street medicine have been over-hyped and sensationalized. The human tragedy, the gut-level stuff, has often been relegated to the margins in order, I don’t know, to attract Hollywood producers and Reality TV programmers. The job is not like that. Of course, I saw hundreds, if not thousands of trauma calls that had nothing to do with the AIDS crisis. Strangely, those types of street jobs were relatively easy to work.
The hard part of the paramedic’s working life was the human tragedy. It is true, that in the midst of the job, call-to-call, especially in a place like New York City, there isn’t the time to grieve or reflect or ponder the Universe. It hits different providers in different ways. It hit me too soon. It forced me off of a job I loved.
I knew paramedics, who years after retirement, were forced to seek therapy. It didn’t make any of them weak, but it did make the healthcare companies or municipalities they worked for, ineffective and uncaring. My book is not a lights and sirens book.
I don’t know how many books have been written detailing the AIDS crisis from a street level emergency medical perspective or how many paramedics exposed their depression and mental illness to scrutiny. I suspect the answer to both those questions is “a handful at best.”
Inconvenient truths
The AIDS crisis was deeply and painfully ugly. It mostly killed without mercy. We saw patients, rich and poor, who faced the same outcome. Readers don’t like easy; most present-day readers prefer stories about children adopted by dragons or romantic, formulaic comedies. I would submit the real humanity displayed in the midst of the AIDS crisis soared above the formula writing and the true stories every paramedic of my era observed were compelling and taught lessons that are being learned to the present day.
Of paramedics, I can only say that for far too long, my brothers and sisters in uniform have been relegated to disposable robot status. This has often surprised me. Medical professionals, administrators, whole healthcare systems have turned their backs on EMTs and paramedics.
It is, in my opinion, elitist bias. In truth, many paramedics are highly educated. I worked with paramedics who, in their former lives, were lawyers, scientists, teachers, architects, musicians and playwrights. Yet, they were viewed as fools — or worse. I understand the dynamic; in any hierarchy there must always be some who are pushed to the bottom. You would not believe how often we heard, “You would not believe some of the paramedics we have to deal with.” My response these years later, “You would not believe some of the incompetent hospital healthcare providers we covered for on a daily basis.”
Minimizing the rhetoric
In my book I strive for balance. I try to avoid much of the usual name calling, “fake scenery” and sensationalism. I focus on the tragedy, on the toll it took on patients and providers alike, and to elevate the profession that I loved much more than I can explain. The themes I am beginning to open with this post will be expanded in future posts.
Part of my rationale for wanting to write The Sea of Peroxide was to add to the ongoing (and hopefully growing) dialog to encourage healthcare systems to openly and freely open mental health support for paramedics. The job is unique in the first responder world. The rates of PTSD for EMTs and paramedics are reputedly twice those for police or firefighters. If you come across this blog by chance, or intention or pure luck, and you wish to “talk” about your struggles please feel free. I am not a psychologist or social worker, just someone who has been there, and cares.
