When I was eleven years old, my father came home with a paperback book he had found titled EMT: Beyond the Lights and Sirens by Pat Ivey. At the time I had a police scanner that I listened to religiously, and would hop on my bicycle to meet the Town of Tonawanda Paramedics on calls in my neighborhood. Ivey’s book gave me the first taste of being an EMT was really like, and I read it several times. At some point I lost it, and recently bought a copy on Amazon. Now after 13 years in EMS, I was curious to see how different it would be rereading a book I first read so many years before my EMS career started.
Ivey was a volunteer EMT and cardiac technician with a rural rescue squad in Virginia. Her book takes place in the 1980’s, and she joined the squad after it was called to find her sons who were lost in woods. She paints a picture of volunteer EMS Americana, with neighbors who respond from home and work to help people they often know. She and the squad members she writes about volunteered for the right reasons – a desire to help, which inspired me to volunteer for much of my career in EMS.
Working as a paramedic was a childhood dream, and Ivey’s book became part of it. I imagined myself getting toned out with a pager and crawling into wrecked cars like she did. I the excitement getting assigned a jump suit at the volunteer service I joined while in EMT class, just like the members a her squad. In a way I came full circle a few years later. I ended up volunteering as an EMT and paramedic for a few years in a county near her’s, and transported patients to the same hospital she that she did.
Reading her book a few weeks ago, I was first struck by the emotions her stories invoked. The book opens with a call where a three-year-old boy suffered a head injury. He and his sister had been in a crash while their mother drove them to the store for milk, and he later died in the hospital. After one call on Christmas day, she returned to the scene of an accident to retrieve the Cabbage Patch dolls that a young patient had left in her vehicle. Her mother had died in the crash, and she did not yet know. Ivey discovered that they were the same dolls that she had given her own daughter as a gift that morning. She writes about other parents and children who were killed in crashes, pediatric arrests, and standing by helplessly at a structure fire with children trapped inside. I felt sad after reading those stories as an eleven-year-old, but could not relate to them. Now I am a husband and parent, and have responded to similar incidents as a paramedic. I could not imagine what the parents in those situations went through after losing their children, or as a husband losing his wife. I also thought about those calls I went on, where I stopped at my house after leaving the hospital to hug my wife and children.
One important lesson I learned from Ivey’s book was about how EMT’s handle death. She writes that it feels much different when you encounter someone in cardiac arrest than it does when someone dies in your care. The first patient I did CPR on was elderly and had lung cancer. I thought I should have felt sad that she died, but I didn’t. A few nights later I went on difficulty breathing call for a middle-aged man. He was in pulmonary edema, was combative, and begged us to help him breathe. Then his sentences got shorter and his head started to drop. Then we had to ask him to keep his eyes open, and he stopped breathing when we got him to the ambulance. It bothered me after he was pronounced at the hospital, and I thought about that paragraph in her book after.
Another early lesson I learned was about burnout. She described a conversation with one squad member who resigned, who said he just didn’t give a shit after the tones went off. This was after he would frequently stop whatever was going on with his family and be gone for hours on calls. With overtime and volunteering, it is easy for EMS to become your life instead of part of it. Knowing this going in, I was able to maintain balance.
Ivey’s book was one of three memoirs that I read before becoming an EMT. Paul Shapiro’s Paramedic and Peter Canning’s Paramedic: On the Front Lines of Medicine were others. All three were a tremendous help, I plan to reread and review the others as well. Reading stories about what paramedics did for patients with certain complaints or how they handled complicated situations made it easier for me to understand it described in textbooks later.
EMT: Beyond the Lights and Sirens gave me my first look at what life in EMS really was. It became part of a childhood dream, which I continue to live out.