By Crystal Wallin, NREMT-P, CCEMT-P

I wonder if they know, patients and families, how we carry them with us?

Oh, we like to think we don’t, or at least pretend we don’t. We are professionals who do this for a living and so we all have a wall of sorts. Behind that wall are all the ugly things, the things we don’t want to admit we saw/were impacted by/were changed by. The wall may be temporary and one we clamber over occasionally as we work through the things placed back there, in a safe time and space, dealing with in a healthy way. The wall may be tall and bitter and the things we throw up high over the edge may lurk there, rotting and undealt with until one day they demand our attention. We employ all sorts of things with which we choose to manage the effects of the job. I will tell you that the loudest scoffers and the dramatic eye rollers are among those who have sobbed in quiet quarters, describing the call that nearly broke them. Why the determination to act as if we are all untouched? Culture, I guess. Bravado. Grappling with the way to couple our human response to repeated front row seats to the tragedy of others – combined with the backbone and ego necessary to get on the truck and handle anything the tones throw in our lap, long hours at a stretch.

Maybe once the mask slips, it’s harder to put back in place? I hope we get to a place as a profession where the mask is unnecessary at all. Where we do the job and we take the time to get to a healthy space and we allow our personnel to do this before throwing them back, immediately, into the churning call volume. Human minds don’t speak response times when they’ve been exposed to trauma. Human minds need a minute. I think we will get there.

But aside from all of that very real conversation, there’s another way we carry the calls. Let me explain.

Any given time I drive down streets or roads in our response area, there they are. The calls, the patients. The other night we were going out for a family birthday in the city where I was a full time paramedic and as we entered the city limits, I looked over reflexively at the stately farmhouse. As I always do, I remembered a particularly vulnerable family who opened their doors to myself and my long-term nighttime partner one evening. The family patriarch was dying, and the house was carefully readied. Family was present, the energy was calm and loving. He was in the restroom and they were unsure of how to get him from where he was on the toilet, using the lift provided for them. They were gracious and apologetic for calling and in need of guidance. They got a couple of young, new paramedics who hadn’t used a lift before but together we all worked it out. You know, I remember that farmhouse every time I drive by for one reason. The father/grandfather of that family, despite being wrecked by cancer and frail, in pain, slightly embarrassed at the assembly in the large bathroom on his behalf- kept up a steady stream of encouragement, calm patience and then dignified appreciation for everyone’s cooperation and teamwork. I look at that farmhouse every time I drive into the city because I remember the way he led the group, even in his vulnerability. What a family to be shaped from a soul such as his. That stately farmhouse will always evoke that memory to me.

We drive down a bluffside street to our eldest son’s house and I remember the older German man who fell frequently, who that same partner and I knew well by first name. We’d pick him up and discuss the need for evaluation and he would set that stern German jaw and with his accent unchanged by time, firmly avow his need for lifts but not for any doctors or hospitals. I wonder what happened to him, in the end. Did family talk him into acquiescing? Did he go to an assisted living? Or did he finally fall asleep for good in that study full of beautiful old books, where we often assisted him off the floor? I remember the winter night my partner shoveled his walk. I remember his name yet.

Or the duplex where we transported a young mother of two small children in for evaluation, the way we had to move small bicycles, one pink and with streamers on the handlebars, one with training wheels, out of the way of our stretcher. The way a healthier and pink cheeked version of her grinned down on us from the living room walls, a sharp contrast to the sharp cheeked and medicated, in pain version of her on the couch. The way I shut the back doors of the ambulance and turned, unfortunately in time to see her husband close his eyes and lean his head against the door frame of the entrance from the laundry room to the garage, where we’d just exited. In that gesture, a lifetime’s worth of “if only’s” and “how will I….” all but screamed wordlessly, as those bikes sat just to the side. I wish I hadn’t seen that. I wonder when we pass that duplex, how he’s doing. How the kids are. If she had to say goodbye or if she rallied somehow.

And the playground at the corner where we turn to make our way to the ambulance garage. The playground with equipment that allows children in wheelchairs to play. The playground that was the idea of a soul I will probably never be able to talk about with dry eyes, but a soul that shaped my view of life forever.

It is an honor, and a privilege. I need the wall less and less, as I age. I realize its all part of the human experience, and the job, and time blurs the edges just enough that they are easier to release. Still…

I wonder if they know, patients and families, how we carry them with us?