How to handle the change EMS forces on you

After accepting that personal change is inevitable, here is how you can begin to handle that change for you and your family

"You’ve changed."

Very few words cause more worry than those two.

My first reaction when confronted by this accusation is denial.

"No I haven’t."

Then accusation.

"I haven’t changed, you have!"

Then anger.

"The world has changed, and not for the better!"


"I can’t believe she thinks I've changed, woe is me, I’m doomed."

Next is bargaining.

"Maybe I’ve changed, but maybe it’s you and everybody else who are making me change. And maybe if you all stopped making me crazy I might be able to unchange!"

And finally, acceptance.

"I've changed. So be it."

Bad news and good news about change

The bad news is EMS will change you. There is no way that you will finish your time in EMS the same as you started. Every shift changes you. Every call will change you.

The good news? Change is good.

I knew that at the start of every shift walls went up. I also knew that by the end of the shift, most of those walls came down.

I also knew that over time those small walls grew and without my being aware a giant, impenetrable wall grew around me. While in the fight, I didn’t notice the small changes.

I was too busy taking care of my family to see how I changed. But, make no mistake, the family I was taking care of knew something was changing, but they could not define those changes until I let my guard down.

People with normal jobs don’t experience flashbacks, don’t have that gnawing feeling in their gut when they drive and are not burdened with the weight of thousands of tragedies. Knights used to wear chain mail under their suits of armor, and we are not much different.

Our chain mail is invisible and grows heavier as the years progress. We wear it under our turnout gear and uniforms, and now body armor, and it is supposed to keep us safe from the things that keep us up at night. But instead of keeping the wolves at bay, our protective suit doesn’t protect us, it weighs us down.

I had no idea how high-strung I was until I retired and got rid of the outer layer covering my hidden chain mail. Even then, it took a long time for me to breathe normally, to be able to focus on a conversation or watch a TV show without breaking out in a cold sweat whenever some actor did a good job of portraying a dead body.

To thrive in the difficult environment that I called my home away from home, I needed to have some thick skin. I wouldn’t have admitted to PTSD in a million years, or at least until I retired and began to see the world as a nice place.

Putting up a wall for my family made their lives more difficult than it needed to be. I didn’t have to keep my growing anxiety to myself. I didn’t have to suffer in silence. There was a better way to get through my career than what I knew, what most of us knew.

We are the kings and queens of the white knuckle brigade. Admitting that things got to us was OK, kind of, but only for a little while. It was and is much more desirable to white knuckle it, and deal with whatever is troubling us by ourselves. The problems go away, we figure, and we’ll be back to our old selves real soon.

Unfortunately, our old selves are taken away every day and replaced with a more somber, cynical and tired version.

Welcoming change

Trends have begun to shift; people are not as tight lipped about their struggles with depression and addiction as they once were. PTSD is a hot topic on most firefighting and EMS forums.

People are coming out and telling their stories. All of this feel good, love yourself, embrace the madness and get better stuff is helping lots of people.

Unfortunately, there are lots of us who have no idea that we are operating at stress levels that we simply cannot maintain. We secretly look at those of us who have the courage to admit their fallibility with thinly disguised disdain. Too bad for them, we think as we read about the latest paramedic or firefighter who crashed.

We just cannot see the cracks forming in our own lives. Our walls are formidable, and without allowing ourselves a little humility, those cracks will only continue to grow.

Handling change

You owe it to your family to do it right. One good way is to stay as emotionally healthy as possible. If you can’t do it for yourself, and most of us can’t or won’t, do it for them. Change for your family.

Simply being conscious of your own well being is a good start. An honest and thorough self-evaluation every year or two can help keep your life in perspective.

Doing such a thing in your own head is nearly impossible. Good, qualified and caring assistance is available. You don’t have to be nuts to make an appointment with a therapist. Paying someone to listen to you is remarkably liberating. Most of us politely listen to whoever it is we are talking with, while formulating a response in our own mind, thus never truly hearing what the other person is saying. A good therapist listens to everything you say and, believe it or not, there is more up there than you ever imagined.

So when somebody tells you that you have changed, believe them. Denying change is a fool’s game, accusing the person who only cares about you of being the one who has changed just delays the inevitable. Getting angry does not change anything, being depressed over the changes you have endured blocks your ability to focus on the positive. You can’t bargain your way out of something when you are the only one on your side, so you may as well accept the fact that you have changed, and realize that the person that you have become as a result of all you have seen and done has the potential to be a better, more compassionate person on and off the job.

Recommended for you

Join the discussion

Get Paramedic Chief in your inbox

Thanks! You've been successfully signed up for the Paramedic Chief Newsletter

Copyright © 2020 All rights reserved.