Getting knocked down isn't the badge of honor, getting up is

To be resilient to the stress of an EMS career, stop being proud of your pain or your lack of it; instead, be proud of overcoming it


Children collect scrapes and bruises. Well, at least they did in my generation.

Nowadays, maybe they develop carpal tunnel syndrome and gamekeeper’s thumb from their Xbox controllers, but there once was a time when the marks of childhood were the scrapes and bruises you got from falling off your bike or playing tackle football at the park, or perhaps the cast on your arm you got when your older brother convinced you that you could tie a towel around your neck like a cape and fly off the top bunk like Superman.

And when I was a child, and I’d fiddle with those scabs and scrapes, my mother would admonish me, "That’s never going to heal if you keep picking at it."

There is a difference between acknowledging your scars and bragging about them. (Courtesy photo)
There is a difference between acknowledging your scars and bragging about them. (Courtesy photo)

The same advice is true of the psychic scars we pick up in EMS.

That’s one reason the practice of mandatory critical incident stress debriefings has been questioned by mental health professionals and researchers. Most of us heal better if we don’t pick at the wound.

I’ve been open about discussing my depression. I don’t like talking about it, but it’s something I’m willing to do anyway, frankly and matter-of-factly, because on January 28, 2014, a co-worker took his life behind his ambulance station. I didn’t know him personally, but his profile picture on our intranet was of a smiling, happy 25-year-old kid. He didn’t look suicidal.

I don’t look like I suffer from clinical depression, either.

Yet, I do, and I’ve been blessed with a forum that allows me to speak to a large number of EMS people. And I thought that day in January, "I wonder how many of Adam’s friends and co-workers knew he was depressed? I wonder if his supervisors and managers are torturing themselves right now, wondering what they could have done to prevent this?"

And so I wrote "Suicide and salvation in EMS: How to save a medic's life" and I contacted the next conference that had booked me to speak, and asked if I could change the topic of my keynote address. They said yes, which led to me standing in front of a few hundred people and declaring, "Hi, I’m Kelly, and I’m clinically depressed."

It scared the hell out of me then. It even scares me now.

But if someone who hears my story can see that other normal people (OK, "normal" may be pushing it, for me.) suffer from mental illness, or feels empowered to admit their problem and seek help, then it’s worth it to me.

Since that day, many other people have joined in the discussion. There are thousands of us out there, providing peer support and trying to erase the stigma of mental illness in public safety. It’s working so well, that thousands of people are coming forward, and provider mental health is the hot topic in EMS these days.

But there is a difference between acknowledging your scars, and bragging about them.

On social media, I see dozens of self-aggrandizing T-shirts talking about the psychological toll that EMS takes upon the people who provide it. Today’s emo word cloud T-shirt about nightmares and PTSD is yesterday’s "Drive safe or I get to see you naked."

Both are unseemly.

My friends in EMS run the extreme from the parasaurus, an EMS dinosaur sub-species, who subscribes to the "Harden up, cupcake," mentality, and the emo navel-gazer who owns an entire wardrobe of T-shirts sporting a variation of "See how damaged I am? Love and honor me!"

I’ve even heard it said in some forums that if you don’t have nightmares and PTSD from the things you’ve seen in your career, then you’re either a sociopath or someone who hasn’t run many calls.

Neither of those extremes has a place in EMS.

Believe it or not, there are many of our colleagues who are compassionate, empathetic and professional providers, and yet aren’t overly affected by the bad things they’ve seen. They’ve learned how to leave work at work, and how to develop emotional resilience.

And there are also people out there who haven’t developed those coping mechanisms, or overestimated their own emotional resilience. But those people still have a place in EMS. In fact, we need more of them. EMS would be immeasurably better if we stop trying to recruit adrenaline junkies and teach them how to be hand-holders, and start recruiting hand-holders and teach them emotional resilience.

And the key to that is to stop making fun of each other, and start learning from each other.

EMS dinosaurs, that kid who is bothered by the pediatric code isn’t some pampered millennial who has no place in EMS, and our profession isn’t helped by telling him to get off our metaphorical lawn. Teach her your work ethic and your coping skills, and she might just help you reconnect with your long-lost idealism, and maybe even show you how to work the ePCR while she's at it.

Millennials, that crusty old medic isn’t always some burnout or sociopath who lacks compassion. You don’t stay in this profession as long as he has without genuinely liking people, and you don’t survive it without being able to bounce back mentally and emotionally from the bad calls. Pick his brain, and figure out what it is that he does that allows him to work for 30 years and still be a loving father and husband on his days off.

But whatever you do, stop being proud of your pain, or your lack of it. Instead, be proud of overcoming it.

"My scars tell a story. They are a reminder of when life tried to break me, but failed. They are markings of where the structure of my character was welded."
-
Steve Maraboli

About the author

Kelly Grayson, NRP, CCEMT-P, is a critical care paramedic in Louisiana. He has spent the past 24 years as a field paramedic, critical care transport paramedic, field supervisor and educator. He is president of the Louisiana Society of EMS Educators and a board member of the LA Association of Nationally Registered EMTs.

He is a frequent EMS conference speaker and contributor to various EMS training texts, and is the author of the popular blog A Day In the Life of an Ambulance Driver. Kelly's books are available on his author page at Amazon.com. You can follow him on Twitter (@AmboDriver) or Facebook, or email him at kelly.grayson@ems1.com. Kelly is a member of the EMS1 Editorial Advisory Board.

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