Tonight at midnight my paramedic ratings expire.
I will no longer be legally able to practice as a medic, though I will probably continue to stop at accidents, tend to sick and injured where I find them. Do what I can until the "rated" folks show up.
I'm not really sure how to feel about all of this, although I've had a good year to consider it.
Sometimes, when I see an ambulance go by with lights and (sometimes) sirens, I get a little nostalgic and remember some of the good times I had as an EMT, from my Basic days, up until I resigned as a NREMT-P from Winneshiek Medical Center in Decorah, Ia.
I remember when I started training as a Basic EMT. The thoughts of getting rated for all sorts of things. Wilderness medicine, CCP, water rescue...
I remember getting hired on with Zumbrota Area Ambulance as a basic, learning more from the other EMT's and medics I rode with than it seemed like I did in school. Amazingly friendly and amazing caregivers. I experienced things both terrifyingly awful and somewhat hilarious. Mostly I learned the most important lesson of EMS. Your patient is ALWAYS having a worse day than you are. Unfortunately, the "boss" was a special kind of stupid, and did a great job of destroying the moral of the staff. I was technically a "paid volunteer" which meant that I signed up for 24 hour shifts and got $1.00 an hour. That went up to $9 an hour when we were paged out. It wasn't a terribly well paying gig. But I got lots of experience, and loved the people I worked with, if not the one I worked for.
I remember the decision to go to medic school. Upgrading my rating from NREMT-B to NREMT-P and learning more advanced skills. The teacher of the course had that title in name only, and we did more self study than anything else. I'm not entirely sure, but I don't think I was the only one in the course that felt like I had been "self taught" at the end of it. Fortunately, the group of us that went through it studied together a lot, and I felt pretty confident going into the testing that I could probably pass.
I remember much of my ride time with Tri-State Ambulance in Lacrosse, WI, learning from them how to be a paramedic. It was during those days that I did my first CPR on a real human - a three month old child that did not survive. While many calls during that time were heartbreaking, many others were not, and I learned tons on about every shift.
I remember sitting in front of the computer for weeks, checking for a note on the NREMT website that listed me now as a P instead of a B. (This was before the days of computerized testing with instant results) It was nerve wracking, but oh did we celebrate when I got that P rating!
I remember applying to Winneshiek Medical Center in Decorah, Ia. I interviewed just fine for that job. It turned out to be a good fit for me, as they were hospital based, so I would get to help in the ED as well and learn things from the doctors and nurses I would work with.
I remember the day of my orientation very, very well. Not for the subject material, but because my Aunt Bobbi, who had been like a second mom to me, had come around from a drug induced stupor to say her goodbyes. She had been diagnosed with very advanced uterine cancer a little over three weeks earlier, and after surgery and many, many hard days, she had been released to my folks house for hospice care. I left orientation in the middle and headed back to Cedar Rapids to be with my family. Bobbi died the next day, on her birthday.
I remember my second attempt at orientation, my first few rides. The early days and months were quite fun and educational. I was amazed at how well everyone worked together when serious cases came in, and pretty soon I was part of that chaotic dance where everyone knew what to do and when to do it to give great care to the patients that came in.
I enjoyed almost all of my time at WMC. The people I worked with, almost every doctor, nurse, medic, tech, whatever, were excellent at their jobs and fun to work with. Unfortunately a couple of things happened that would cut short my time with WMC, and ultimately as a paramedic.
I had a few run-ins with my supervisor. Nothing big at first. Asking why we did things certain ways when as NREMT paramedics we could be doing more. Asking why we did other things, like breathing treatments or having to be security without any training or safety measures provided. I don't think he liked those questions, as the answers were always "Because that's how we do it here." Which of course, isn't an answer at all.
We had other meetings where he would criticize my run reports for using words that were too big, or in one case I was accused of over dramatizing the scene when I said there were many intoxicated people there that were interfering with our ability to treat the patient. I disagreed with his assessments of my writings, especially when his reports contained multiple spelling and grammatical errors, including the now famous rodeo report where a horsewoman "fell off her house, landed on her butt ox." I wish I could say I was making that up.
As mainly a night shift worker my yearly performance ratings were, like all of the night shifters, mediocre at best. Every year when I asked about it, I was told that since he didn't work much with us, he could not really rate our performance. So average was what we lived with. I wondered why we didn't do peer reviews, especially for us night shifters. Why do the same old things that didn't work? You guessed it. "Because that's how we do it here."
It came to a messy head after some serious and false accusations were slung around. But I pretty much had a target on my back from then on.
Adding to the stress of having to watch my back when it came to my supervisor and a few of my co-workers, I started having dreams. Not so good dreams about patients that had died. It was effecting my sleep patterns, which pretty much sucked anyway having to switch from nights to days and back again, and started effecting how I acted around my family.
I was grumpy and withdrawn. Short tempered and angry. And always, always tired. If I wasn't working I was sleeping, and even when I had extra days off I would nap. It was easy to diagnose myself with depression, and so I cut back to PRN to relieve some of the stress.
That worked pretty well, right up until my supervisor asked me to give him my personal schedule so he could know what I was doing all of the time. Apparently he needed to know exactly when I was available in case someone called in sick. Essentially, he wanted me to be on call from home and have that all scheduled out for his convenience. It was a surreal conversation with him, and after describing it to my wife she uttered the words that would take me to the next adventure in my life.
"Why don't you just quit?"
We talked long and hard about that. If I quit, I would be giving up retirement benefits as an Iowa public employee. I would not have a regular source of income. I knew from talking to other Tri-State medics that their service had gone through some not so great administrative changes, and I didn't want to work there. I've never been enamored with the organization of our local Gold Cross service. So where would I work? And I liked being a medic. I was good at the job.
Then we started thinking about the positives such a change could bring. No more commuting an hour to Decorah and an hour back for shifts, saving not only gas money, but stress on the Wife when I was driving home after a long shift in crappy weather. Regular sleeping schedule, meaning hopefully less grumpy days, less napping days. No more interactions with a boss that I had completely lost respect for. No more dead people, broken people, awful situations. No longer having the stress of having someone's life occasionally literally depend on me being at the top of my game.
Though as we talked, I knew those all might come up again when I started working for another service.
It was decided that at the very least I would stop working at WMC. It was as if a weight was lifted from my shoulders when I handed in my resignation. I was a little disappointed not to be able to tell someone higher up the real reasons I was leaving. But I did have an excellent exit interview later where I was able to voice my frustrations, and tell them that if anyone else had been in charge, I would probably not be leaving. I got to tell the HR people that when I became an EMT, I wanted to advance with my ratings, with my career. Unfortunately at WMC the career ladder has two rungs, and my supervisor made it clear that any advancement we wanted to do would be at our own expense on our own time. I walked away from the hospital a final time knowing I would miss lots of the people I worked with, but also knowing I had made the right decision.
Then the Wife and I talked about what would happen if I stopped being a paramedic all together. That was really hard to wrap my head around. I spent my twenties defining myself as a Marine. My thirties defining myself as a paramedic. Now heading into my forties, what would I become? We talked about what it might be like to try and do Bluefeather Workshop as my full time job. My profession would be that of an artist.
Eventually, obviously, we landed on that path. I am becoming a full time artist. Slowly. Learning as I go how to market the things I create. Learning what I really enjoy creating and focusing more on those things.
On my worst day, I fret about whether or not to spend money on a new piece of equipment, or if I should add green or blue to that piece before I put it in the kiln. Nobody dies. I don't get spattered in anyone else's blood. Nobody pukes then spits in my face and mouth. I am not caught up in the worst moments of other peoples lives. It may not be as dramatic or intense a lifestyle as I had as a medic, I haven't saved a life in well over a year. But I haven't had to clean up human road kill either. So there's that!
So, tonight at midnight my ratings expire. I go from NREMPT-P to ARTIST. Self employed, which is great, because I obviously can't tolerate incompetent leadership (thanks Marine Corps for raising that bar too high for most civilian employers I've crossed paths with). No safety nets, no fall back plans. With the support of a wonderful woman who for whatever crazy reason loves me and believes in me, I will wake up tomorrow using only the term "Artist" to describe what I do for a living. I'm not sure what to think about that day also being April Fools day. But my parents met on that day, and they've been pretty successful thus far!
I'll miss being a medic from time to time I'm sure. Much like I miss being a Marine from time to time. But in my heart, I will always be both of those things. I've earned those titles and they cannot be taken from me.
Now I'll work to earn the title of "Artist". Hoping that this is my terminal career. Because I really do love what I'm doing now. Life has become a much happier place, and that has affected those close to me as well. I spent twenty years learning to kill and defend my country, learning to pick up the broken pieces of others and try to help fix them. Now I get to spend my days creating. Useful things, beautiful things, abstract things. Imagining. Dreaming. Making. Creating.
And I love it.