There was rain in my boots.  Thick mud had sloshed up as far as my knees and was slowly hardening, every movement accompanied by the uncomfortable squish of wet socks.  It was my first respiratory arrest and my movements were formed from months of practice; make a seal, squeeze the bag, count, squeeze the bag, check for chest rise, squeeze the bag.  We didn’t know her name or how long she had been sitting in the wrecked vehicle in the dark.  She appeared young and frail, the metallic scent of blood was in the air, several injuries were visible and my supervisor was doing everything he could to keep her with us.  The siren was screaming as we sped down the dirt road, and I was ashamed to be distracted by such a mundane thought; there was rain in my boots, and a girl was dying.  Training can teach you to squeeze a bag, but nothing can prepare you for the emotional aspect of an emergency.  Later in my career adrenaline wouldn’t have a hold on me; my thoughts would be the next move, the next intervention, the next step in the algorithm, but there would be moments when I would remember that girl in the dark.

More calls came and went, some more critical than others. My favourites were the quiet moments where a patient needed empathy and kindness rather than a major intervention.  I became a field training officer and then a working supervisor. Life was going well and I started to think about the future.  I had been working alongside doctors, nurses and physician assistants for years, and I had taken prerequisites in college because I knew I would not want to be a paramedic forever.  I had been considering becoming a PA for a long time, and I decided that soon it would be time to move on from EMS; I wanted to foster a deeper understanding of medicine, and I was drawn to the lateral mobility and the ability to balance life and work that I had observed in my PA colleagues. The largest draw was the ability to focus on my favorite aspect of medicine, which is patient care. I resolved to apply and my supervisors gave me their unwavering support.  Yes, life was going well.  It was a beautiful sunny day when I performed a routine lift and felt the twinge in my back that would change the course of my life and put me in physical therapy for over a year.

Physical therapy was a long and difficult journey.  I had gone from being a strong and competent supervisor that routinely lifted people two to three times my weight to a person that struggled getting out of bed in the morning.  Instead of going to work where I could help people I had to go to PT for six hours a day and learn to help myself.  I reassured myself that it was only temporary and remained optimistic.  I joked with the staff, became friends with the other patients and waited to get back to work.   As the months went on I started to worry.  My back pain was improving but lifting hundreds of pounds seemed to be out of reach.  My physical therapist remained upbeat, but I could tell she was becoming less optimistic.  She was kind when she told me, using a tone I had used so many times in my life; a tone designed to deliver a painful message softly.  Learning that I couldn’t return to being a paramedic due to my injury was one of the hardest blows of my life.  I felt derailed and set adrift.  Who was I without my job and my strength?

I decided to travel and visited five different countries and various national parks.  I did my PT exercises every day; I did PT at the top of mountains and next to rivers.  I hiked, I biked, I swam, and I reclaimed my physical capabilities.  I taught jiu-jitsu to kids and adults for over a year.  I loved it all, but something was missing; I still missed taking care of patients.  I started to look at PA schools again, and I investigated opportunities to shadow and volunteer.  One day I walked into a local supermarket and stopped dead in my tracks.  There she was, working the register.  It had been years but I recognized her face and the pattern of her scars instantly.  She looked confident and happy.  I glanced at her name tag, smiled, and walked away.  I knew the name of the girl in the dark, and I was going to apply to PA school.

My path toward PA school has been longer and more complicated than I originally planned, but I always try to keep in mind the lessons I have learned along the way.  More than anything else, I want to be a PA to help people like the girl I found on that lonely road, or the thousands of less critical patients that needed only basic interventions and a kind word to get them through.  Over seven years of EMS I have seen patients in so many places and conditions that I couldn’t describe them all if I tried. I’ve been complimented, thanked, cursed and yelled at, but I carry the lessons of my experience with me.  I always try to have empathy for how people might react strangely in stressful situations, because after all, they might have rain in their boots.

Leave a Reply