05/20/2026
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I always find myself rolling my eyes quite a bit during EMS week. My Facebook feed is taken over by posts about how heroic and selfless everyone with a star of life on their sleve are and quotes about all of the patients that are ripped back from the brink of death because we are there. And you know what? That's true every now and then. Maybe every once in a blue moon we will do something that actually saves someone's life. Sometimes that medication is just what they needed. Sometimes that shock will restart their heart. It does happen, and when it does we are happy. It reminds us of why we considered this career to start with as we watched an ambulance speed through an intersection, lights and sirens blaring, long before we came to the realization that every patient inside the box of an ambulance isn't being pulled back from the brink of death by a superhero, like working some kind of magic with their highly effective skills and training. What is the bulk of what we actually do? We move people who can't (or won't) move on their own. We transport patients to life sustaining treatment every week twice a week for years, sometimes when they've given up on life inside already. We enter into chaotic situations and restore order. We're not heroes. We're people. We're humans. We are people who work a job where every single day we show up and have no idea what our day will consist of. And that's the way we like it, or we wouldn't be here. A meaningless desk job is our nightmare. We are people who got into this field having no actual understanding of our day to day job description. We are a field full of bright eyed, well intentioned, self-labeled "cardiologists" "adrenaline junkies" and "trauma lovers", who will eventually learn that scraping a family returning from a happy summer vacation off of the highway and trying to piece them back together isn't all it's cut out to be. We stay at work for days sliding around on icy roads and dodging tornadoes, sleeping in the back of a parked truck until we're needed again to respond to another emergency... or the patient having back pain for three days who suddenly decides they need a routine checkup at the ER in the middle of a snowstorm. Every now and then we get attached to a regular patient that we see more often than we see our own grandparents, then one day we show up to work to find out they're gone. And we go about our day. We are people who have the honor of being one of the the last voices a patient hears as they travel home to die under hospice. We always hear about the "life saving", but so much of our job is helping transition people into death. We are people who do CPR on a baby by the light of a Christmas tree with a young set of parents watching, all the while knowing deep down that their child is dead and their lives will never be the same. And because we are there they still have hope in their eyes. They don't know what is ahead of them, but we do. After we work in a county long enough, there aren't many roadways we can travel down that don't have a house or a curve or a roadside cross that we could tell a story about. Sometimes we think about it when we pass and sometimes we don't. We complain about the habits of our 650 lb dialysis patient while we eat dinner from a gas station. We see what the doctors and nurses often don't: the home a patient comes from. Usually that involves a lot of cigarette smoke and animals and shaky front steps with holes in them. We are trusted and we are lied to by the patients who call us to help them. We are cursed at, kicked, and called unrepeatable names by patients and family members. We see and hear things that give us an irrefutable understanding of the horrible things humans are capable of doing to one another; things normal people will never encounter or comprehend. Which is the way it should be, because this is not the world that most people choose to work in. We are people that go home after a 12 or 24 hour shift and creep into our kids' bedrooms and watch them sleep to reassure ourselves. We witness new life come into the world in the bedroom of a trailer, surrounded by people whose language we don't understand. And we have a clear picture of what the end of life really looks like, be it in the form of a terminally ill young mother going for treatment at the local cancer institute or in the elderly man we transport for the various ailments that come with age. We are well aware of the frailty of life, but we act like we aren't. We joke about everything. We welcome new employees in a fraternity like fashion. Sometimes our job is being called to cure loneliness or anxiety or mediate a dispute. Most of the time we are the only ones on scene aware that there's really no need for us to be there at all. We do the best we can with what we have, and most of the time we feel like it isn't good enough. Sometimes we find ourselves feeling like we could conquer the world when a call successfully flows with an unmistakable rhythm from the scene to the ER or cath lab door. At the end of some shifts we sit on the bumper of our ambulance as the sun is rising on a new day with our shoulders sunk low and feel defeated and swear we aren't coming back... And some don't. We work in a field where most of us will be gone within five years. We, as a field, have one of the highest rates of divorce there is, yet we still gravitate to those who work the same job we do. We are a family, and we trust each other with our lives every single day. Often we share a connection with our work partner that most people will never know with their best friends or family. We spend holidays together and we speak to each other in a way that would make the HR department of any company cringe. We run on coffee and energy drinks and have superstitions and habits that probably could get us admitted to a psych ward if they could find enough beds available. It's an odd world but it's our world. It is my world and I would not change a thing.
Happy EMS week.
Written by Tim Middleton
