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The 8 things I’d tell my 21-year-old EMS self

Nobody is born with the ability to respond to 911 calls, but these perspectives can help anyone in EMS provide better care and appreciate the ride


If only I knew then what I think I know now, I might have enjoyed the ride of a lifetime even more than I did.

Photo/Village of Mundelein

I struggled through far too much of an overall satisfying career in EMS. Looking back, it is easy to see where I went wrong. I wasted much of my youth being young and idealistic. I still have those ideals; somehow they remained intact, but experience changed my expectations. The job has remained the same, I’m a little different. When you change the way you look at things, the things you look at change. It took me nearly 25 years of continuous change to figure things out … so far.

Here are eight thoughts that I think would have helped me figure it out sooner:

8. Continually study anatomy

Understanding where organ systems are, what they do and how they affect the rest of the body will make the rest of EMS make sense. I never bothered to refresh the things I learned in EMT school and my patient care suffered because of it.

Learning something because there is a test on Wednesday is far different from knowing something because somebody’s life or wellbeing depends on it. Seeing a gunshot wound as the entire traumatic event to the body that it is and not simply a hole in the skin without wasting valuable mental energy to remember what is under there allows the thought process to move quickly, and mistakes are avoided.

Understanding the function of kidneys, the pancreas, appendix, glands and the liver creates a better understanding of a patient’s description of their problem, and will make you a better provider. Never stop learning.

7. Everybody hurts, it just hurts differently

The people in the world you now are responsible for will expect you to understand that their pain, suffering and fear are more important than anything that you are experiencing.

It is not their fault that they could no longer bear their suffering at three in the morning, or if their needs just happen to present a half hour after you were unable to revive a girl your age who overdosed on heroin. Each and every person who calls for help deserves to be the only person in the world when you arrive and secure the scene.

6. Hate takes too much energy

It is far too easy to allow contempt for the public to ruin a great opportunity for a rewarding career. You will see things that will haunt you for the rest of your days. You will be in the presence of evil, and be numbed by the experience. Terrible things happen every day, and you have chosen to be one of the people called upon to put things back in order.

It is not for you to judge or punish the child abuser, or treat the criminal in your care differently because of what they have become. Some things you will never understand – know that and allow yourself the freedom of letting go of the anger that will eat you alive if you let it.

5. You did not cause the tragedy, you responded

The only way to keep yourself from falling into depression after a few years of people dying on your watch is to know – to truly know and understand that your presence in other people’s worst moments has nothing to do with you personally. You were simply the person that fate sent when things went wrong.

Your mind and body are tools that need to be finely crafted and functioning at peak capacity, but put away when they are no longer needed. It can be done; it takes practice and vigilance, and not a small amount of expressing your feelings to a person willing to listen. Sometimes you have to pay that person – therapy works wonders when the going gets difficult.

4. Look sharp

The clothes make the person, it’s said, and while that is not exactly true, appearance does say a lot about how people perceive you. You know that you are awesome, but nobody will believe it if you look like you just dragged yourself out of bed (even if you did).

Staying on top of your uniform even when you are exhausted, grooming before your shift, tucking in your shirt, tying your shoes, keeping them clean – all simple tasks that make a seemingly small difference in how you feel about yourself as the long hours and years add up but which will profoundly impact your effectiveness and satisfaction.

3. Enjoy the mundane EMS interactions

Every patient contact has the potential to be one of the memories that you will cherish long after you hang up your neatly pressed uniform for the last time. People are the only reason you are here. Never lose sight of that simple fact. Every time you respond to a call, a person is the reason.

They are the threads that create the tapestry of your career, each one having a place in the intricate weave that you will not completely see until it all comes together. Believe that it is coming together, thread by thread, creating something breathtaking. You will see it when it is time, and the experience will be well worth the patience needed to keep it all together.

2. Treat yourself

Leave work at work. The reason that you work is so that you can enjoy your life. Your work is not that life, even though the temptation to incorporate the two is nearly overwhelming. Do not allow the job to define you.

Keep practicing those chords and scales, use the money you earned working overtime to buy a Gibson Les Paul and a Marshall stack, plug it in and let her rip, forgetting everything but the song in your soul.

Your experience at work is a part of what defines you, but there is far more to life than responding to other people’s emergencies. Nurture every part of who you are.

1. It’s not personal

Allowing yourself the luxury of self-pity is a fool’s game. Yes, EMS is underpaid, understaffed, underappreciated and soul crushing. But it is also what you decided to do. Make the best of it, work tirelessly to improve your own experience outside of the things about the industry that seem to conspire to destroy you. Nobody is out to get you.

The things that attracted you to EMS will always exist, in spite of the weight of it all. If it gets to be too much, have an exit strategy. Don’t double down – the older you get, the harder it is to start over. Being trapped is no way to live. Finding peace in your present situation while having a plan will make what seems unbearable far less so.

Enjoy the EMS ride

Being over the hill of time certainly makes the going easier. Every day seems shorter than the one before it now that I am past middle age. Gone forever are those endless days where hours last an eternity. In their place are moments spent in fast-forward. Weeks fly by, months and even years go by in a blink.

Perhaps knowing that I no longer have time to do anything I can imagine has something to do with that. Long-term planning is absurd when time is ticking, and the energy needed to accomplish great things has been spent surviving a lifetime of mediocrity.

Fortunately for me, the boring routine of living was interrupted quite often with moments of bliss, madness, chaos and satisfaction. Looking back, I vividly recall those moments while conveniently forgetting everything it took to survive them.

I had a lot to learn before I was able to be in the thick of things without losing my mind. Nobody is born with the ability to respond to 911 calls. Now that I no longer respond, I think I have it figured out. If only I knew then what I think I know now, I might have enjoyed the ride of a lifetime even more than I did.

Captain Michael Morse (ret.),, is the bestselling author of Rescuing Providence, Rescue 1 Responding, City Life and Mr. Wilson Makes it Home. Michael has been active in EMS since 1991 and offers his views on a variety of EMS and firefighting topics, focusing mainly on the interaction between patient and provider as a well respected columnist and speaker. Captain Morse is a Johnson/Macoll fellow in literature from the Rhode Island Foundation.