Editor’s note: “Built for this: A paramedic’s reckoning,” is a candid memoir drawn from more than 25 years in emergency medicine, following Jeff Abbott’s career from ground EMS to critical care flight medicine. Through the calls, dark humor, camaraderie, high-acuity medicine, loss and moments that follow responders home, Abbott examines the culture behind the uniform and the cumulative weight of a career spent responding when other people’s lives have gone wrong. At its core, “Built for this” asks what happens when being able to do the job is mistaken for being unaffected by it.
“The room”
On Wednesday, April 27, 2022, I woke up to a totally different world — one where the question of how a helicopter fell out of the sky was the only thing that mattered.
How do we comprehend the loss of Jim? What the f---- do we actually do now? Like seriously! What do we do?
The FAA grounded our aircraft. There was no real work to be done. No missions to fly. No tones. No checklist to run. Just stillness.
“A critical incident stress debrief team will be in; we’ll keep you posted,” was the only real instruction we received. There was really no news to disseminate.
When you’re used to movement, stillness is dangerous.
Brian called me that morning and ended my last sobbing fit. We began to speculate what the next steps were to come and just broach the cause of yesterday. He brought up the debrief and asked if I was going.
“F--- that. I don’t need a debrief.” I got my tears out last night and this morning. I will be fine. I was built for this. That’s what I told him, but Brian gut-checked me immediately.
“Come on, bro. We are leaders. We need to be there for our people.” And that hit landed exactly where it needed to. Not because I wanted to go, but because he was right.
“You know what? Roger that. You’re one hundred percent correct. I’ll be there for them.”
Notice the wording. For them. Not for me. I never would partake in those things as long as I have been a medic. I am a professional and this is what I signed up for.
With no schedule or idea of when the ECHO FAST team would arrive, we were in a holding pattern — physically and emotionally. The aircraft sat silent. The base was quiet. The normal coffee-talk around the table at crew change would be no more and no meals to plan for the upcoming shifts. Just absence.
Wednesdays were fifty-cent wing night at Halligan’s Tavern, so I decided to go there early. Prep wings. Clean the barroom. Stock coolers. Inventory again if I had to. Anything to stay busy.
I created a missing man table at the bar and posted it on our Halligan’s Tavern business page and then had to repeatedly dodge phone calls from the press after my social media post was seen.
Movement feels like control so of course I kept busy and, naturally, started drinking.
Drinking has never been a stranger to me. I’ve been doing it since I was a teenager. It’s prevalent in this field. We celebrate with it. We decompress with it. We mourn with it.
I stayed true to my roots and began the numbing process with Titos and soda again. It wasn’t dramatic or reckless. It was just familiar and that’s what makes it dangerous. You know what you know and I got blackout hammered.
We were finally told to report the following day, Thursday, April 28, to our main base for the stress debrief and of course I showed up as promised. Physically. Inside, I was circling a drain.
We sat in a circle in our training room and I listened to everyone’s accounts of the last forty-eight hours.
I slouched in my chair, arms crossed, trying to make sense of it all. I heard their voices but it wasn’t my voice. And at that point, only mine mattered and I wanted it to shut the f--- up too. I did not want to hear what anyone else had to say. They didn’t deserve to hurt or be affected.
That’s the part nobody likes to admit about grief — it can make you selfish.
I am a tatted-up, stocky, bearded dude. Your typical biker-looking guy. So, I maintained that persona as best I could. Silent. Stoic. Unmoved. Armor on because I am a swinging d--- in this business and that is what I thought I had to be.
It must have been obvious to the trained eye because one of the debrief guys, Roman Barker, who looks very similar to me, grabbed his chair, placed it to my right, and just sat there.
He didn’t interrogate me. He didn’t push. He just watched. He could see I was Mount Vesuvius waiting for pressure to crack the surface.
Eventually, that quiet attention wore me down and I began to speak. I explained what I saw. The six and a half miles. The radio silence. The landline request. The RTB call. Joy’s face.
I explained how it made me feel. But I did not purge and remained controlled. Measured. Strong.
Or at least I thought I was. It was my first Lieutenant Dan moment, as I call it.
It was the first time I said out loud that Jim was cheated. He died with a stranger. With someone sitting in my seat. He should have had us with him. A stranger did not deserve that honor.
My logical brain knew that was irrational. But grief isn’t logical and it wants intention, explanation. What it really wants someone to blame.
The majority of what I felt was anger. Anger at the unknown. Anger that I had flown thousands of hours and helicopters just don’t fall out of the sky.
Anger that Jim was just too damn good of an aviator for this to happen. Anger that other people were hurting, and I didn’t think they had earned the right to hurt outwardly the way I was hurting internally.
How arrogant is that? We lost a brother, and I thought I owned the grief. This is the consummate team environment, and I had the balls to think grief and shock should be rationed.
Roman stayed next to me the entire time.
After the group session ended, we had a one-on-one conversation that created a bond that still exists today. He saw through the armor. He didn’t try to dismantle it. He just acknowledged it. He is a major part of the reason I am where I am today and why I share this story.
The debrief ended, and we all dispersed to go and pick up our individual pieces and press on. Every one of us carrying that load differently.
Excerpted with permission from “Built for this: A paramedic’s reckoning,” by Jeff Abbott.
| MORE: EMS and grief — Understanding your emotions
ABOUT THE AUTHOR
Jeff Abbott is a critical care flight paramedic, author and speaker with more than 25 years of experience in emergency medicine. His career has included ground EMS, high-acuity transport, flight medicine and tactical medicine. In “Built for this: A paramedic’s reckoning,” Abbott writes candidly about the calls, people, humor, losses and cumulative experiences that shape a career in emergency services — and what can happen when the work can no longer be cleanly separated from the person doing it.
