The t-shirts and the bumper stickers don’t get it right. The bravado inherent in the station stories misses the mark. The loudest talkers in the bunch have no idea. The quiet, weathered eyes of the senior medics are too kind to correct them.

The life of a working medic isn’t about lights, sirens, diesel therapy, saving lives, screaming down the road. It has elements of those things, but that’s like saying having a child is just about Play Doh and no more tears baby shampoo.

The job is the most demanding taskmaster you have ever met, the most strident girl friend, the most caring grandparent and the twinkle of stars on nighttime water. The job pushes you when you simply think you can’t give any more. It asks more, and you give it. When you’re reeling from something witnessed that is harder than usual to file away, it gives you a small child who, being carried into the ER, nestles their head in the hollow of your neck. It’s balm to your soul when you wheel the gurney into the home warm with lights on a winter’s night, family lining the rooms as the hospice patient comes home for the last time, grips your hand and says “thank you.”

It’s my heart pounding in my ears as I feel for a pulse, mentally pushing away the crying children and shrieking girlfriend of the gentleman unfortunate enough to have been walking underneath a large tree limb as it fell. It’s mapping at three am when I blink and struggle to focus on the name of an unfamiliar road in a township I’ve been to maybe once. It’s a phone buzzing silently in my pocket as I search for vocal cords on a cancer patient whose spouse can’t remember if there’s a DNR order and all I can think is, my elderly mom’s ill and is she ok?

It’s the hot dark city streets in the summer when the bistros close and the hipsters are home in bed and the alter ego of the city comes alive. It’s streetlights at one am passing overhead as my partner and I slow and stop, seeing a man picking a female off the sidewalk, looking around furtively and heading off with her over his shoulder. It’s the wordless nod of hello from an ERT member still outside in full gear as we arrive on scene to deal with a respiratory distress in an elderly female whose family member was the object of the sudden, explosive entry. It’s a fire captain protectively pushing me behind him into a corner when a suddenly not-seizing-anymore male erupts from the floor of a residence in a sketchy neighborhood, roaring in fury, the needle and syringe falling to the floor as he advances. It’s the burly dog, growling low in her throat, standing guard over a seizing diabetic patient as I enter a duplex – and freeze.

It’s holding a newborn baby boy, slick and wet in my hands and being struck dumb with awe and wonder, ok, and panic. Searching back in my memory for how many inches apart the ties are supposed to be for the cord and wishing he’d cry and then….then his obsidian eyes blink open and look solemnly up at me, and I swear I’ve seen the face of God in this tiny human entering the world.

It’s jerking awake in panic as the tones go off for the sixth time in an endlessly long night, stuffing my feet into boots and staggering to a brightly lit garage, mindful of the time it takes to activate. It’s being so tired I crave sleep as if it were a tangible thing to hold and cherish. Drinking coffee that hasn’t been warm for hours and never was anything more than low class – but still holds magical properties. It’s stinking, knowing you stink, and dealing with it ok until you give report to some freshly showered RN who was probably born the year I learned to drive a stick shift – and she has perky, clean shoes. It’s arriving in my own garage and reaching for a radio microphone to tell someone where I am and what my miles are. It’s sitting in a parking lot in an ambulance, posting as the sun goes down on a family event evening where everyone is present – and my chair’s empty, again.

Putting on the uniform and walking into a building where we all look the same and we’re all so very different. Climbing up in the cab and signing on the mobile data terminal, putting our names and signatures into the tablet. Informing MedComm our crew is updated and “assignment please”? Pulling out of the garage and heading down the street one more time. Not knowing what the shift will hold – but knowing you and your partner across the cab will face whatever it is, together.

It will change me, and it will mold me. Differently than he, or she, not as much as some and infinitely more than others. It’s a career, it’s my chosen profession, it’s exhausting and uncompromising and it’s the real deal.

It doesn’t get any more stark, any more frontlines, any more adrenaline charged and yet unglamorous than this.

That’s what the t-shirts can’t tell you, and the bumper stickers are clueless to explain. When you live it, you know.

It’s boots on the street, sweat, blizzards and thunderstorms, vomit and beautifully crying children with intact airways, grandpas with no pulse palpable as the sound of weeping fills the room. Toothaches for a week at two am, migraines, stomach aches , avulsions , hands caught in snowblowers. Requesting mutual aid, firemen standing knee deep in icy creek water next to me, walking a patient’s dog before she’ll consent to transport and an 86 year old female earnestly asking my partner if he thinks the problem might be that she’s pregnant.

It’s professional emergency medicine – compassion combines with proficiency, and  autonomy whispers “we’re here.”

“Can you take what you need but take less than you give?
Could you close everyday without the glory and fame?
Could you hold your head high when no one knows your name?”

-Bryan Adams

“Never Let Go”