Servitude over Saviorism
Like many undertakings in life, we create expectations based on the stories and images we see and hear. Depending on how vivid and unregulated our imaginations are, those stories and images sometimes take on a life of their own. While this aspect of the human condition often leads to disappointment, these thoughts can, at least in the short term, drive us into action. The stories of Army Special Forces are legend, as are some of its members. I wanted desperately to be one of the bearded, tattooed demons of the night doing violence on behalf of their countries to protect an often "taken for granted" way of life. My reality consisted of immeasurable hours of range time, endless miles under a heavy ruck sack, practicing for what "might" happen…and yes, there was violence. I left Army Special Forces when my vision of the future was no longer something I felt genuinely excited about. Suddenly my future looked like courses for field grade officers with a clean uniform and no beard combined with the administrative undertakings of a Major in the United States Army. As hard as it was for me to do, I left a decade to start over again as a cadet, only this time I was Paramedic.
Just like in the days following September 11th, I dreamed and created an expectation of what being a paramedic would be like. At the time the world, not just America, was engaged in another war. This war wasn't fought on some distant battlefield but was taking place all around us, so naturally, the "front lines" was where I wanted to be. However, just like my mental projection of Army Special Forces was influenced by outside images and stories, so was my vision of being a paramedic during a global pandemic. In general, I thought paramedicine was about back to back high acuity calls; requiring expert levels of surgical cricothyrotomies to save the COVID positive infant in cardiac arrest from dying due to a chunk of a hot dog getting lodged in their trachea. My first 100 calls shed light on my expectation and as it turns out, I was glad to be wrong. For a second time.
For the average American, when symptoms of illness arise you make an appointment with your doctor. 911 for the average American is truly when you feel entirely out of options. Realistically speaking, most of us never actually run out of options. Unless we were already out of options, to begin with. My first 100 calls as a paramedic shed light upon the reality of most Americans and what the majority of paramedicine is about. Paramedics are essentially medieval street physicians. The vast majority of calls we run are for people who don't go to doctor's offices or any health professional for that matter. My very first call was to help an old lady in a single-wide trailer back into her recliner and to check her blood sugar because she had since run out of test strips for her home glucometer. My second was for a heroin overdose who was conscious and alert by the time we arrived (due to the police administration of Narcan) and was more interested in our public Narcan distribution than going to the hospital… you know, in case it happens again. He refused our treatment and transport. My first 100 calls generally followed the same trends of "soft emergencies" but yes, to satisfy my itch for adventure and excitement the EMS gods sprinkled in a few life or death emergencies.
When I reflect on both careers, along with their associated expectations, I am glad to have "overshot" with my imagination. Safe to say, most of the time our dreams and visions "overshoot" reality and for many, this causes us a very high degree of disappointment and anxiety. Initially, this was the case for me, until I started to weigh my expectations against the real world. From this, I arrived at one very simple and elegant conclusion as to why I was so thankful to be proven wrong. My expectations were never sustainable. For people pursuing their dreams, the real expectation is to be able to do it forever. If every call pushes you to your absolute limit, your life will become very quickly overloaded; your light would burn out as quickly as it hit its maximum brightness. I believe at my core that every man, woman, or child has a mark to make on this world and for me, my mark is made through paramedicine. For my brothers and sisters in emergency medicine, the reality that keeps us going is elegant in its simplicity. While we may forget the faces of most of our patients as we run "emergencies" day in and day out, they won't forget us and the difference we made.
