The flickering flame of a paramedic

Lately, I’ve been feeling myself becoming more and more burned (or burnt, whatever) out. And I don’t like it. I love this job. I love taking care of people.

But sometimes I feel as if I have an unrequited love.

When I first started in EMS, everything was new and fresh and exciting. It was easy to get excited about the calls that didn’t need excitation, and very easy to get too excited at times.

Now, after seeing hundreds of people who are simply seeking drugs, I’m cynical. I don’t want to be cynical, and I want to take care of my patients appropriately, but something is happening to me that I don’t understand.

Yesterday, I picked up this middle-aged lady, who I have picked up several times before. Her complaint? Chest pain. Every time. She says she has 14 stents, and has had 7 or 8 heart attacks. “I stopped counting after five,” she says. She then tells you that she has to go to the University Hospital, 30 minutes away, not one of the 7 (seriously, seven) other hospitals that are just as capable as the University one.

It gets better.

She’s allergic to nitroglycerin. And aspirin. And literally almost everything else you can think of. The list is incredibly ridiculous. Then she says she can’t have a heart cath done, because her doctor says if she gets put to sleep, she might die. Never mind that they don’t actually put people to sleep for heart caths, she says she can’t have one. “So what does the hospital do for you, if they can’t really do anything for you?” is the next question that probably every other paramedic would ask. And it is a legitimate question.

“They give me painkillers.”

Well, there you have it. She wants painkillers. The cynical medic in my says “fine, you want me to drive 30 minutes, past 7 hospitals, just so you can get some meds? Then I’m going to sit behind you and not do a damned thing. But I don’t want to be that medic.

Is she really a drug seeker who is simply wasting everyone’s time? Maybe. Is she having a legitimate event, and in actual need of narcotic analgesia? Maybe. If she was really a drug seeker, wouldn’t she want to go to the closer hospital so she can get her drug? Maybe. Does anyone benefit from a cynical, burned-out medic with a bad attitude?

Certainly not.

I started typing this about an hour ago, then took a break to take a walk.

And I don’t take walks.

I don’t know what I’m trying to say here, and how to say it. I don’t know what the problem is, or what went wrong, or when it went wrong, for that matter.

But something is wrong, and I don’t like it.

I miss the old medic I used to be.


  1. So, I know worth a moniker such as mine it may not have the gravity it may deserve. So let me invoke the infinitely smarter Rogue Medic. Sometimes the best treatment is benign neglect. And I’m sure you know with your experience that sometimes the best thing to do for the patient is sit in that captains chair.

    I don’t think being cynical with regards to the abuse of the system that goes on is a bad thing. I think being either naive or willfully ignorant of it is worse, with the worst being those in power to change it being aware of it and knowingly doing nothing to better it.

    I hope these words are a salve of some sort for your soul, but if not kindly disregard them.

  2. Man, I’ve been there. You LOVE what we do and patients like this won’t be going away anytime soon. What we can do is try to refocus on our mission. Every time we take her in she’ll be discharged, right? Perhaps calling her the next day to follow up, stopping by unannounced while still in service to offer a BP check and talking to her about her health could decrease the need for transports in the future. Nothing I mentioned is against HIPAA (Someone will mention it, so there) and may actually lead to a reduction in her calling. You could also have a supervisor or medical director follow up with her primary care or cardiologist to make these concerns known. Might work, might not, but the burn out you’re feeling is real. Don’t shy away from it, it’s about to teach you a lot about why you do what you do and why the most important part of your post is “I don’t want to be THAT medic.”
    Simply by knowing the difference, you never will be.
    Stay strong and shoot me a line if you want to talk further

  3. EMTWinona says:

    At 30 I’m hoping to start medic classes next fall. I read this and I am fully aware of those I work with in the same position. I’m choosing not to do EMS full time right away to avoid this outcome. I’m hoping my older age starting a new career in EMS will help me see this coming and avoid it. I wish you the best.

  4. Midwest Medic says:

    For what it’s worth, this post could very well have been written by me as I have been feeling exactly the same recently. So, knowing that spitting a bunch of cliches and slogans and sayings aren’t what you need, I will simply offer up my support in spirit and let you know that your post made me feel a little better. In part because I know I’m not the only one feeling “the burn.” Your posts about the ridiculousness of the system and lack of regard from the policy makers are seemingly a universal truth, and it helps knowing that it isn’t just my system, my employer, or my region (we’re not exactly the torch holders of progressive EMS in my neck of the woods). Thanks, and I hope it gets better for you.

  5. I know it doesn’t help but I feel you brother. If I had an answer other than thinly veiled rage and sarcasm I’d offer it.

  6. I may have written a post about burned vs. burnt a long time ago.

  7. Anne Tracey says:

    Posts such as this always these always take me back to my friend’s video. After posting this, he left EMS for a while, then returned then left for good. He is now getting his Masters degree in Health Care Admin, as he told me “The patients in the end got me. I am now trying to help people and help from another angle.” He was one of the best EMTs I ever had the pleasure to meet and happy to call a friend still. Take care of yourself CCC and if you need to talk there are great resources here!

  8. Having burned out of a job that I really enjoyed and had loved. I wish I had seen the little flickering flame before it engulfed me. I might not have left that field had I seen the signs that you have seen. All I can say is do what you need to put out the little flame. Talk to someone, write, scream, find an outlet where you can recharge (mine is multi-day tramps). You know who you don’t want to become, and that is a great step in the right direction.

  9. Just saw this post and sorry I haven’t jumped in sooner. Email address is right there if you need or want someone to talk to.

Speak Your Mind