Progressive Paramedicine: 3 reasons to never stop learning

Progressive Paramedicine: 3 reasons to never stop learning

How I found a way out and back to what I love as a paramedic

The problem wasn't being a paramedic, but how I was handling the job and the stress that came with it


By Michael C. Julian

When did I stop making a difference as a paramedic? When did I begin to dread the tones when I used to embrace them?

Walking down the stairs to the unit I noticed I am leaning on the rail a little more each year. As I round the corner, I wonder how many times I have made this trip. How many times does a hand have to grasp a hand rail before it becomes polished like a stone washed up on the shore? As my eye moves to my feet, I notice my boots are worn and dull. When was the last time I polished them?

Paramedic Julian with his greyhound, Eric. (Courtesy photo)
Paramedic Julian with his greyhound, Eric. (Courtesy photo)

Protocol requires us to be en route to a call within one minute of notification, but the pain in my knee put me well behind my partner. I barely noticed the annoyed look in his eye as I keyed the microphone.

On the way to the call, I wondered when it happened. Surely I am more knowledgeable than I was years ago. My equipment and protocols have advanced at least at the same rate as my skills, but it seems like I am walking in quicksand, every step taking more effort than the last.

So, when did I stop making a difference? Was it when, after counseling dozens of domestic violence victims on the dangers of going back to their abusers, I found the once beautiful young wife dead in her garage? Her last act was cowering in the corner, hands in front of her face as her husband emptied 16 9 mm rounds into her frail body.

Maybe it was the last time I tried to revive a trauma code. God knows, I almost never get one back.

Maybe it was the diabetic that we had transported at least a dozen times. I used to feel like a magician, watching his eyes for that glint of recognition as I pushed the viscous dextrose though his IV. It seemed like a waste of time the day his 10-year-old son found his dad cold and dead. I remember sitting on the porch reassuring the kid that his father loved him, all the while disguising my anger at the man, knowing in my heart that, had he really loved him, he would have made at least a passing attempt at managing his disease.

Could my former employer have had anything to do with it? Did I stop making a difference when they refused to cover the surgery to my shoulder that was injured on the job? "Workman’s comp? We’re the Government. We don’t have to follow those rules!"

Walked away from EMS without feeling

Maybe I felt like it was hard to care for the public when the public didn’t care for me. Whatever the trigger, at 45 years old I felt like I was done with EMS. I walked away, bitter, angry and physically exhausted.

Oddly enough, as bitter and angry as I was, what I felt wasn’t the worst part of it all. The worst part was what I didn’t feel. The spiritless-ness and indifference that was a part of my being began long before I picked up a radio and a stethoscope, but it grew and festered in the darkness of what I experienced and grasped on to every fiber of my being.

Sometimes I wondered if this detached listlessness was the only thing that made me good at my job.

"You are so calm during a crisis," people used to say.

Just once, I wanted to look them in the eye and say, "Being calm during tragedy is easy when you are utterly paralyzed by apathy."

Shutting people out

Many years ago, I used alcohol to numb myself, but, when that became a problem, I put away the chemicals and learned to shut myself down from the inside.

It’s really the only thing I had ever been good at doing, shutting people out. But it’s exhausting to do. I knew I would eventually find my way back to the chemicals, which are the solvents that dissolve not only my feelings, but my family, friends and possessions.

What was useful in the field was disastrous to my personal life and my marriage. Building a wall to veil the bad from my conciseness protected me in a way, but the wall I had built was indifferent. It couldn’t tell the bad from the good, and, in separating me from the painful, I found that I also lost the things that made me feel good, and all I felt was empty. I became a void that could never be filled, no matter how hard I tried.

In blocking the hate, I forgot how to love, and shielding myself from loss, I found myself incapable of making any connection; not to a parent, a lover or a friend. I reached a level of loneliness that was all encompassing, like a prisoner in 24-hour seclusion, but worse, because I could see my life going by through one-way glass. I found comfort in the dead, because, in their empty eyes, I could see my soul.

In giving to others, I had erased everything that was me until there was nothing. I was nothing. It would be so easy to just let go.

I found a way out

I wish I could say that I opened my eyes one morning, had a religious experience, and everything was well again, but unfortunately climbing out of the hole I had dug for myself involved a good bit of work and a great deal of support from friends and family. As despondent as I had become, in a way, being numb to the world was comfortable, and that comfort prevented me from growing as a person and provider. It also encouraged me to remain in a place that sustained my unhappiness for more than 10 years.

It was only when the job I had lined up when leaving EMS didn't work out that I was forced to make changes and take an objective look at what I had been doing to myself. This involved, among other things, a long commute to a county EMS service with a very high-call volume and little tolerance for internal change, and a home in an area where I had little invested in the community. While I was juggling two part-time jobs trying to make ends meet, I realized that it wasn’t the job that was causing the problem.

The problem was how I was going about working the job and handling the stress. It was then that I came to an understanding. Instead of trying to fit into an EMS system that was hiring, I would seek out a system that fit my needs as a paramedic and a community that fit our needs as a family. It seems like an obvious solution, looking at the problem in hindsight, but the reality was that I was completely blind to it at the time.

I also was forced to become more honest with my wife about my failings as a man and become more aggressive at treating my addiction issues and changing the way I dealt with stress. I learned that just taking the alcohol away didn’t fix the problem. I became more involved in my 12-step program and found a psychiatrist that could treat my anxiety and depression who also specialized in addiction medicine.

During this time, I took the time to seek a place where I wanted to work and grow as a paramedic. I pestered them until they agreed to hire me. We sold our house and moved 20 miles to a community that made us both happy to live in and where I could also serve as a paramedic.

Working on me continues

I would love to tell you that everything was perfect during this time, but life continued to happen and I lost both my parents within the span of a year. This, among other things, forced me to further explore my inability to properly process grief. The employee assistance program at my new workplace provided counseling to both me and my wife. This article is the product of an assignment given to me by my EAP counselor.

Today, I continue to work on my personal issues and make an effort to change my situation when things begin to feel too comfortable. It is only in discomfort when I am able to grow as a person and a provider. It is only when I am willing to grow that I can be an asset to my community and family.

If you are experiencing any of the feelings expressed in this article, please speak to a professional. There is help out there. In 2010, I walked away from EMS. Today, I am back in EMS and love going to work and making a difference in people’s lives every day.

About the author
Michael C. Julian is a paramedic with Williamson Medical Center EMS in Franklin, Tenn. He helps educate paramedics about behavioral emergencies and addiction. He lives with his wife of 13 years, Gina, and his retired racing greyhound, Eric. In his off time, he is an instructor for a motorcycle track day company and is active in promoting adoption and placement of greyhounds when they retire from the racetrack.

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