The Chair

The Chair

On Location

My first real job out of college wasn’t in medicine, or anywhere near an ambulance. It was in lighting — the kind that makes concerts glow, trade shows sparkle, and corporate galas look like the Grammys. The company was called On Location Lighting Systems, or OLLS, based out of northern Kentucky just south of Cincinnati.

That place was equal parts magic and madness. The shop always smelled like sawdust, gaff tape, and dust from road cases that had been halfway around the country. I was mostly broke — just out of school, living mostly on PB&Js, takeout food, and overtime — but for the first time, I felt like I was part of something creative. I was the shop manager, which meant I handled all the rental gear going out and coming back in, did minor repairs, kept the chaos somewhat organized, and still found myself out on shows and short tours whenever they needed an extra pair of hands.

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A Mental Health Odyssey – Still Here

A Mental Health Odyssey – Still Here

Gratitude and Light in the Dark

When I wrote A Mental Health Odyssey, I honestly didn’t know what would happen. Hitting “publish” felt a little like standing naked in the middle of traffic — raw, exposed, and bracing for impact. I wasn’t sure if anyone would read it. I wasn’t sure if anyone would care. And if they did care, I half-expected whispers, judgment, or polite distance.

What I got instead was the opposite. Messages from colleagues in EMS who admitted they’d been in the same hole. Supervisors who could have looked the other way, but didn’t. Members of Marina’s congregation who reached out with warmth I didn’t see coming. Even people I barely knew told me they saw themselves in my words. It felt like people started handing me candles in the dark, one by one, until the room didn’t look so terrifying anymore.

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A Mental Health Odyssey

A Mental Health Odyssey

I’ve written before about my struggles with mental health. I’m diagnosed with major depressive disorder, generalized anxiety disorder, and social phobia. Many are surprised to learn this about me in contrast with my chosen profession of EMS, where I am routinely confronted with high-stress situations and interfacing with the public and unknown groups of people on a regular basis. At baseline, I’m a pretty easy-going guy. Through a combination of a lifetime of therapy and the right medications, I am able to live a happy life, and function well at work, providing professional, courteous care to my patients, and working well with my peers and supervisors. Over the past year and a half or so, I lived and worked through some very difficult changes in my mental health. They affected me, my family, my work life, my home life, everything around me changed as a result. I am writing this (very long) blog post to share my journey into, through, and out of one of the worst times of my life.

Please be forewarned that I share very personal information and thought processes, some medical information, and thoughts pertaining to suicidality/self-harm in this post.

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McClain, Paramedics, Qualified Immunity, Other Thoughts

Many of you may have already read the verdicts rendered for Jeremy Cooper and Peter Cichuniec, two Aurora-area Firefighter/Paramedics who were involved in the care and transport of Elijah McClain in 2019 in Aurora, Colorado. The encounter between Mr. Mcclain, Aurora PD, and Aurora FD ultimately resulted in his untimely death. For those unfamiliar with the case, the brief summary is thus:

A suspicious person call resulted in a PD stop of Elijah, who was walking home from a convenience store with the merchandise he purchased. Several Aurora PD officers on-scene attempted to restrain Elijah, ultimately utilizing a carotid choke hold to subdue him to the ground. During this time, EMS was also summoned as he was suspected to be suffering from “excited delirium” – a diagnosis made by PD, not by EMS, as they had not yet arrived on-scene. When AFD arrived on-scene, according to body-cam footage, the FF/Medics were directed by PD to restrain Elijah with Ketamine because of his apparent excited state (it was later determined he was likely hypoxic from the carotid hold, and not because of an underlying drug- or psychosis-related delirium state) and the paramedics, without performing their own physical exam, checking any vital signs, or determining the appropriate course of action, seemed to follow directions from APD, who do not have medical control authority over AFD. The paramedics administered 500mg of Ketamine (likely an inappropriate dose and inappropriate medication to give in the first place), and then placed Elijah in a prone position on the stretcher for transport. No vital signs were assessed and he remained handcuffed and prone for enough of a period of time to cause apnea (stopped breathing) and went into respiratory arrest, ultimately going into cardiac arrest and dying while under EMS care and in APD custody.

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Out with the old…

Out with the old, and in with the new, they say, right? It’s a small thing, but the red penlight on the right has been with me for the better part of 15 years. I think it maybe was a gift when I graduated from paramedic school. It’s been in my sleeve pocket or shirt pocket on literallyevery single EMS call I’ve gone on since then, and has assisted me with assessing thousands of patients. It recently started malfunctioning, and despite having survived several trips through the wash, untold rolls under the stretcher wheels, drops down stairs, and being forgotten in ambulance footwells, patient homes, and on sidewalks, somehow it always managed to find its way back to me. Tonight it finally gave up the ghost, and I replaced it with a new blue one of the same model, a Streamlight Stylus Pro. (why in the world would I look for a new model after such good service from the original?)

I know many of my colleagues trust the disposable penlights handed out by the service they work for, but there’s something meaningful and tangible to me of having my own diagnostic tools available and at the ready. I think my wife rolled her eyes a little when I expressed some sadness at the idea of moving on from ol trusty rusty here, and I get it. It is, after all, just a thing, an inanimate object that I have assigned meaning to over the years. It has no feelings or thoughts and won’t know that I have replaced it with a cleaner, shinier, better-working version of itself. And yet…. there’s a tiny part of me that will miss ol’ red, it won’t be the same penlight I’ve had for all these years in my pocket. There’s something to be said for consistency, and I find great comfort in it. Anyway, can’t help patients with a broken penlight, so I must move forward and start another 15 year adventure with blue here, and see what kind of trouble we can get ourselves into!

Thanks for reading my ramblings. If you got this far… are there any tools or gadgets you hold on to despite their obvious replace-ability?

My New “Worst Call Ever” Has Arrived

Ask any EMS or other public safety professional what stereotypical trope in conversation they hate the most, and they’ll probably tell you not to ask “What’s the worst thing you’ve ever seen on a call?” – and for good reason. We don’t like revisiting those calls. We don’t need to trudge them back up into memory for your own personal entertainment. We have our own ways of dealing with the feelings and memories surrounding those calls, and a lot of them are private, sensitive topics and are not for public discussion. Certainly not around the dinner table, or standing at the grill in the backyard over a couple of beers. Not only that, but you, as an outside observer, likely have no idea the amount of trauma you’re about to be subjected to by engaging in experiencing such a traumatic experience in whatever vivid detail we decide to come up with in response to your imposition. Asking a public safety professional to rehash their “worst call ever” is like asking a loved one “what’s your most painful memory and would you mind sharing that with me just for giggles?”

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Revisiting Mental Health…. Again…. and Again…

I wrote about the Code Green Campaign back in 2016 in my post about calling a code on our mental health. I was talking about how some of my “ghosts” haunt me, revisit me, remind me of some of the worst calls I’ve ever been on. It happens to me frequently. At night. During the day. When my mind wanders. When I run into an old partner. When I run the same type of call. When I’m training a new hire and they ask a question that reminds me of a patient with the same type of symptoms. I guess since I’ve been “doing this” for 15+ years, I’ve run enough calls that I’ve got more than a few bad memories stacked up inside my head, and some of them bubble up to the surface occasionally. Sometimes I can just shake it off. Sometimes they stick around, and I sit with it for a while and think about how the call went. How it made me feel then, and how it makes me feel now. Sometimes I think about what lessons I still carry with me as a result of the call, because I try to never let a “bad” call be in vain. A very dear mentor friend of mine told me that every death in the field should be a gift in some way to a field provider, that we should still be able to learn from it, and grow stronger as providers and be able to better care for patients and their family members as a result of having gone on that call, even if we weren’t able to have a positive outcome for that particular patient. I also write things down in journals, so I can look back and reflect on them. I talk to friends and coworkers. I talk to my family, sometimes more than they would like, I think. Probably most importantly, I talk to a therapist. Not as often as I should, but I have built a trusting relationship with a clinically trained therapist who specializes in working with public safety employees, and I know that I can reach out to her when needed, and that’s a valuable tool in my mental health toolbox. So why am I revisiting this topic again, today?

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Lifesaver? Hardly.

This lifesaver pin was presented to me to celebrate my first CPR “Save” – when, early in my EMS career, I worked as part of a team of EMS professionals to apply CPR (Cardiopulmonary Resuscitation) to a Sudden Cardiac Arrest victim, and this resulted in the patient having their pulse restored long enough to be transported via ambulance to an ER for definitive care for their blocked coronary artery. The patient lived, was able to walk out of the hospital, and to the best of my knowledge, lived a long and happy life for a good number of years after that. I wear this pin with pride, celebrating this moment in my career when I worked as part of a team of professionals to truly save a life, to help literally bring somebody back from the dead, to give them a second chance at life. To make the biggest, greatest, possible difference in a human being’s world one could ever possibly hope to make.

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The People Who Make Up My Life

My wife joined my life journey unexpectedly, and has remained a steadfast and constant source of compassion and comfort.

I’ve been thinking a lot lately about how people move in and out of my life. Quickly. Slowly. Suddenly and abruptly. Gradually or almost without noticing. The amount of time they spend in my life, in my physical presence seems completely unrelated to the amount of time they remain in my conscious and subconscious mind for days, weeks, and years after we part ways. Did they become a part of my life because I was born into a family they were already a key part of, as with my Gramma, and so I never knew a world without her as I grew up, forming every early memory and becoming the person I am today with so many of her fingerprints all over my way of thinking, of being, how I interact with people, how I think about the world around me? Or were they a coworker who became like a family member to me, a brother or sister, who I could trust with my life in a heartbeat, and who would trust me with theirs just the same? Were they a patient? Brought into my life by maybe the worst part of theirs, expecting me to solve their most dire problem at a moment’s notice, together for perhaps only minutes or an hour, and gone again just as fast.

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EMS Week 2020!

EMS_Week_2020_Final_CMYK-scaledIt’s EMS WEEK 2020! It sure doesn’t feel like it, though. Usually as we are approaching this week, we’re talking about crew breakfasts, the EMS week banquet, service recognition events, team-building, and other fun events. Instead, our discussions are focused on things like PPE utilization, COVID alert rates, disease spread, and community fatality rates. Much of the work that ACEP and NAEMT have done in preparing for EMS Week this year has basically been to support all of us in EMS in continuing to do the job that we love so much in the face of such a strange and challenging pandemic, rather than their traditional roles of cheer-leading and boosting morale during this week. Continue reading “EMS Week 2020!” →