The Working Weekend Blues


You know, I am not feeling EMS today.  I think the discouragement is strongly related to the dread of the working weekend.  Either that, or I’m in a rut.  Or maybe both.  I know that I’ve done a lot of good, but I can’t seem to keep those memories in my head today.  The vast majority of the time, we never even find out if our efforts were sufficient enough to make a difference in the long run.  Is the job getting to me?  I know it happens to everyone, but the perky aren’t meant to be so dismal.


I can’t seem to shake the downers of the job.  People are awful to one another.  In just a few years on the job, I’ve seen more neglect and abuse than I ever thought I’d encounter in my life.  I started this job with rose colored glasses affixed firmly to my face, and I honestly believed people were inherently good almost all the time.  That is so clearly not the case.  You only have to hold the hand of a 7 year old that is now blind, wheelchair bound, unable to speak, mentally stunted, and has daily seizures as the result of being shaken as a baby once to know there is unspeakable evil in this world.  The moment you find yourself thinking that the son of a bitch responsible was even crueler for not killing the child is when you know you have seen enough versions of this child to make your own heart hard.  You pick up an elderly woman off of the floor with a hip injury who is covered in her own urine and feces, as she has been lying there for two days as her son literally stepped over her conscious body just one time, and you know neglect is not a passive form of abuse.  I know abuse and neglect so well, I bet I could pick out the night shift DSS guy’s voice out of an audio line-up.   I know it almost never does any good, but I still call.  I can never stop trying to end that kind of malevolence.


Then there’s the violence.  I do not understand why people are so horrible to one another.  I still give every abused woman the speech that she doesn’t have to live that way, and I mean it every time.  I tell them that when he says he will kill you, he probably will one day and there is no reason to give him that opportunity.  I give them the address and phone number for the women’s shelter.  I know it’s futile, but I still do it.  It’s far rarer, but I’ve given the same speech to an abused member of a same sex couple and an abused man in a heterosexual couple.  Nothing is sacred and no one is safe, it seems.  Just today, a friend told me that she had a pregnant patient with horrible oil burns on her head and upper body; apparently, a member of her family intentionally threw cooking oil on her.   I’ve seen similar scenarios, too.  Weapons come in all shapes and sizes, and so do victims and assailants.  There are stabbings, shootings, assaults, poisonings, and all forms of viciousness.  Regardless of what they said first, there is no excuse for intentionally hitting four people with your car in a parking lot.  I used to find it infuriating, but nowadays I think it’s fucking depressing.


I also find the apparent constant threat and fear of litigation abhorrent, but it permeates my career.  My coworkers seem to constantly speak of the CYA method of emergency treatment, and paramedics can’t initiate refusals because of it.  Yesterday, an airline kept a child from boarding an aircraft to go home because she vomited.  She is a scared child, in a strange country where they speak a strange language and have greasy food she can’t digest easily.  She doesn’t feel well and did vomit, so there is obviously a risk in travelling under such circumstances.  That stated, shouldn’t it be her mother who makes that decision?   A disembodied voice on a telephone decides their destination fate based solely on the possibility of a lawsuit, however remote.  No vital signs, no therapy, no evaluation, no context, no compassion, and no humanity, all for no lawsuit.


If I park my ambulance at a scene of a motor vehicle accident, and I see minor damage and people screaming obscenities at one another, my heart will sink.  When I actually watch you scream at someone and hear you threaten to sue them, I have a difficult time believe your neck and back pain hurts nearly as much as your wallet does.  My medical opinion is that you are a gold-digging asshole.  I always try to calm people down and tell them we can replace cars, but not people.  I tell them accidents happen every day, and one should be grateful cars take the majority of the force so our bodies do not.  In shocking news, that doesn’t do any good.


I took a lady off a city bus once because she felt she was injured when the bus stopped…not was involved in an accident, but stopped.  She said the bus stopped so abruptly, that the force thrust her forward and underneath the seat in front of her.  One look at the space to which she was referring compared to her girth ruled that event as unlikely.  The only possibility was that she would have had to have the supernatural ability to turn into another state of matter to extract herself, or we would have been spending that moment using pneumatic tools.  Apparently, her entire body was injured.  I suppose the pain in her entire body was from the cellular trauma of turning from a liquid back to a solid before I got there.  I suspected she might have been attempting insurance fraud when she said, “I’m gonna get what’s mine from the city!  Oooh, I can’t wait to go shopping!”  Don’t worry, I reported all of it, even though I know it’s for nothing.


The generalized 911 abuse is enough to bring one’s spirit down on its own.  On the way to a 911 call at the front of the hospital from which I had just left, I was informed by dispatch that a man was having extreme difficulty breathing.  When I got there, he was sitting on a bench smoking a cigarette.  I distinctly remembered seeing him get kicked out of that hospital 10 minutes before because he screamed obscenities at all the staff in the middle of the hallway because he was displeased with the lack of strong pain medications they gave him.  I asked him if he thought it was appropriate to call 911 from a bus stop and telling the call taker he couldn’t breathe while he was smoking.  He said, “I lied to them to get you here faster because I don’t want to wait for the bus.”  I told him we would be happy to take care of him today, but we wouldn’t be leaving until we made a police report citing 911 abuse.  I made the report, but we all know that won’t do any good either.


When the people who know they don’t need emergency services aren’t pissing me off, other medical facilities “turfing” their patients are.  You are medical professionals, right?  Right?  RIGHT?  You can’t be that dumb or that mean.  You can’t think that the police are going to file a report against a man with dementia that shoved you when you told him he was stuck there for as long as you say he is.  He has dementia and you are a horrible person.  You can’t tell me that you “don’t feel like dealing with him today,” and expect me to take him to a hospital without contacting your supervisor.  You should probably switch your career to a field without people or animals in it.


The one thing that has ground me down completely is the personal attacks.  I have been called a bitch, a slut, a cunt, a whore, a dumbass, an idiot, a fine piece of ass, and my personal favorite, a hussy.  I have been punched, kicked, kneed, head butted, nearly bitten, spat on, vomited on, shat on, and bled on.  Look, man, you called me.  Don’t call me names.  Don’t assault or batter me.  Don’t accuse me of trying to murder you.  You snorted both heroin and cocaine today, and now you appear to be an extra on The Walking Dead.  This is not my fault, nor is it the fault of my partner or the fire crew, all of whom you are trying to bite and kick and punch for no reason.


I will never instigate a fight with a patient, but some people are so full of hate and anger that I have to restrain them for their own safety.  I spent 10 minutes trying to calm down a woman whose family called 911 after she got into a fight with her mother and was anxious.  She was screaming obscenities, fighting, spitting, and name calling.  Her whole family was an anthropological adventure, but she took the cake.


I told her my name and that I’m here to help, but I need her to work with me to try to calm down.  She said, “Bitch, don’t be coming up in my house like you’re somebody.”  I told her I am somebody here to help, but she was going to have to calm down so I could understand what happened that I can fix.  Apparently, I said something completely wrong, because she became much, much more volatile and violent, and her mother called me a murderer.


I ended up giving her Versed to calm her down, which may be my absolute favorite medication to use.  As we loaded her into the ambulance, I remember thinking that she was so much prettier when she was asleep, which is an odd thing to think.  She was pretty much out the whole way to the hospital, but her respiratory rate started to drop a bit, so I gave her a light sternal rub.  I knew then that she had far more hate inside of her than any one person should ever have to be exposed to; her first statement out of unconsciousness was, “Fuuuuuuck you.”


Along those lines, something I absolutely cannot stand is the accusation of ineptitude by people who have no idea what I do.   If you don’t know what I do, please do not tell me how to do my job.  I am not your local drug store; it is not ridiculous that I don’t have basic over the counter drugs.  Some lady’s “recommendation” that I carry Neosporin does not matter to me at all.  Personally, I recommend that you reserve your ambulance use for emergencies, but that clearly doesn’t matter to you, either.  A bystander recently gave me a completely unsolicited “recommendation” that a person involved in a minor accident go to the hospital because her husband recently “almost died from a-fib.” Do what?  What the hell are you talking about, lady?  Strangely, I get asked from time to time by adults with full mental facilities, “are you a real paramedic?”  Nah, man.  I just wear this outfit because it encompasses my gang colors.  And that is how I pimp my ride.


It is hard not to get particularly frustrated with all this while I know I’m missing out on things I’d rather not.  My high school reunion came and went while I was on shift.  That’s not a terribly big deal, but I kind of wanted to see who got fat.  Plus, I was kind of a late bloomer and I would have liked to flaunt that the last decade has been kind to me.  It’s silly, but true.  It’s always a bummer when I miss out on social events.  Tonight, friends of mine from college are getting together, but I’m at work.  I want to do things like take night classes, but my schedule is not exactly conducive to functioning within the non-EMS world.  I can live with missed social opportunities and hobbies, but the worst is missing family gatherings: holidays, graduations, birthday parties, high school sports, welcome home parties, and reunions.  I don’t see how people with kids deal with this. I am very close to my family and lucky that they understand my work demands.  This year, they had a mini-Christmas for me two days beforehand, and my mom and aunt chased my ambulance around the city to bring my partner and me Christmas dinner.  I know how lucky I am, but it still sucks not to be there.


It’s not that I was born with a silver spoon and expect the world to cater to me.  I never had a sheltered upbringing or was coddled.  My dad is a drug addict with the kind of mind that shows genius and insanity are closely related.  My mom is a single mom who held at least two jobs for as long as I can remember so that we could have luxuries like food.  I was awkward, odd, and socially stunted.  I kept myself surrounded by books constantly; they were such excellent vacations from reality.  I had a weird childhood that turned me into who I am. I believed I could move mountains, make changes, and save the world.  I am a girl who read comic books growing up and idolized superheroes, and now I have a job in which I literally save lives.


I guess I didn’t expect the toll it would take on me.  I never expected I would constantly see under-education, malevolence, cruelty, ignorance, and rudeness.  That was never in my plan.


You know what?  I need a save.  I’m way overdue.



  • Matt Stone says:

    I know the feeling all too well.  I work in a busy system about 1-1 1/2 hrs north of you.  The abuse runs rampant.  Physical, mental, and system abuse, I’ve seen it all.  All I can hope for is the one patient that looks up at me and says “Thank you”.  That helps make the day better.  Don’t give up.  Hang in there.  We will all make it though the day.  Oh, one more thing.  Thank you.  

  • Cullytrade says:

    Ah there you are in the realm of reality.  Sorry your glasses got smudged but I feel sure that one day soon you will have them cleaned up…and with this new sense of sight you will infuse into the world around you that wonderful thing called love and laughter.  You are a gem and I so  hope to find you do not become so jaded that we have to kick your booty.   Love you lady… slip that sweet smile back on. 

    • parapup says:

      I'll bounce back in no time, I'm sure.  Apparently, it is totally normal in EMS to go through ruts in which the job drags you down.  How lame is that?  I love my job, but it is full of ups and downs.  :/
      Love you!!!

  • Cindy says:

    Love you.  You’re great, and you do outstanding work.  Keep your chin up, Tiff – it sounds paternalistic, but I sincerely mean it.  – Cindy xox  p.s. I dislike most people and your post reinforced that.  Geez, there are some awful people out there…

    • parapup says:

       Thanks, Cindy.  There are really some awful people out there, and it gets harder and harder to ignore.  On the other hand, there are some great people out there, too.  I just didn’t write about them. 🙂  Thanks for reading, dollface.

  • Medic-to-PA says:

    Been there, done that, even got the tee-shirt.  Feel for you, know this all too well.  Me? I’m getting out, maybe not that far out, but out of EMS.  Great job, horrible career.

    • parapup says:

      I don’t know if I want out, but I don’t know if I can do this forever either.  It’s hard on the body.  Right now, I’m 28 and really healthy.  My back isn’t going to be this young forever, and fat people aren’t going to learn to levitate any time soon.  Then again, I have no idea what I would want to do instead. 

  • ERNURSE says:

    You are such a good writer. I empathize with you and have the same feelings frequently. Honestly, I am glad I am not the only one.

  • Mkopowsk says:

    I wish I would have read this a year ago when I was working in the Boston area. Growing up in northeast Ohio, I, much like you, believed that all people were inherently good. Then came Boston. Sometimes it feels impossible to put on our boots and go to work knowin what you are going to see. Always remember that One patient who reminds you of your grandma and is truly thankful makes it all worth it; and that homeless guy you know by name that you’ve seen for the 4th time that day will just disappear.I also feel you on missing family events, I’m an only child and have missed the last three christmases in Ohio. As I’m sure you know, it gets better, and know that you’re not alone.

    • parapup says:

      I guess everyone has to have their reality check, but it seems to be a little more abrupt in the EMS world, doesn’t it.  You hear about all these bad things, but seeing them is a different beast altogether.  This job changes you.  I’ve gotten to meet a guy I brought back from the dead, but I also had to tell neglectful parents that their toddler is dead.  It’s a bizarre gig, isn’t it? 

  • Hilinda says:

    Great post, on such an awful topic.
    I hope the venting at least helped a little.
    There are a lot of things in the world that don’t make sense, and most of them seem to end up with EMS involved, one way or another.
    Remember the good stuff. Let that carry you through all the crap.
    As depressing as all this is, I couldn’t stop reading because of how well you write.

    • parapup says:

      Thanks for reading, Hilind.  The venting did help a little, actually.  Writing is cathartic for me.  It helps me get the demons out.  And I appreciate the compliment.  That kind of commentary makes me a little more motivated to keep writing, which isn’t always easy.

  • Ldonaldson86 says:

    I completely understand what ur going through. there are times where I ask myself why the hell am I doing this. dealing with stupid people who treat us like crap. missing time with my family and friends. then there are those times where I wanna scream I freaking love my job. ems is definitely a bipolar career.

    • parapup says:

      It really is bipolar, isn’t it?  Most days I love my job.  I’m so proud of what I do most of the time, and I don’t know if there is any better high than saving someone’s life.  But then there’s the other side…

      Thanks for reading.

  • dbum says:

    After 13 years of seeing trauma, I am also aware of that feeling. Might I introduce you to a solution to the stress and trauma? And if you even have questions about stress or trauma, call one of those on our list. Please visit There is also a short informal survey, which is anonymous. Any other questions about our solution, you may leave us an e-mail from the site.

    I wish you well!

    • parapup says:

      That’s a great site.  Thanks for reading and for providing such an excellent service!

      • dbum says:

         If you find yourself in our neighborhood, I give you permission to use the Net. It’s quite young, and we are still gearing up to make our presentations to the various organizations here on the Island. After that, a neighborhood like yours….

  • CJ says:

    Yup. You ARE a superhero. It’s just that the comic books and novels rarely show the isolation and frustration superheroes feel.
    We do this as individuals and agencies because of the saves that we do make. The rest of it is what we have to sift through, like finding a needle in a haystack.
    BTW, no one out in the real world works 9-5 anymore either. Everyone I know is doing shiftwork, and we all miss out on the special events that you write about.
    It sucks, but having an understanding family makes it all better for me.

    • parapup says:

      Thanks for reading and for the kind words.  You’re right…we certainly don’t do this for the glory or the money.  We do it to put some good in the world.  To save people.  My boyfriend works a “regular” job, so I am very lucky that he tolerates my schedule.  Then again, if he didn’t, he probably wouldn’t be the kind of guy I would want to date.  The family is very understanding.  I just can’t help but feel like I’m missing out on so much life.  I think I’m just feeling a little sulky.  🙂

  • Squeak571 says:

    I’ve been on the street for 24 years. Through those years I’ve had some serious ups and downs. What I see here is all the negative moments in your career…what about all the people whose lives you have improved through your efforts?  I know that we don’t often see the after-effects of our patient care anymore due to privacy policies but I do know that there are folks out there who are genuinely glad to see us arrive.  I’ve even had a precious few come by to thank me and my crew for what we’ve done.  Most say that they couldn’t possibly do my job.  I cling to those moments with both hands when I come across the really “bad” calls.  My friend, it sounds like you are heading for a definite case of burn out. Check out the info at the sites below, try to remember why you got into this field in the first place, change something up in your career, (get out of the city if that’s where you are), but most of all believe that what you do is important.  Remember that some people still consider us hero’s for the things that we do….and that’s the type of life that I still strive for after all of these years.

    • parapup says:

      24 years…holy crap.  I’ve only been alive for 28 years.  I know I’ve done a lot of good.  I know that there are people alive today that wouldn’t be without me and my actions.  I know I’m one of the good ones.  I don’t know why it’s so hard to see it sometimes.  Other days I’m on top of the world and nothing could bring me down.  This job is weird like that.  Thanks for the insight and for reading.

  • Geoffrey Horning says:

    Ah pup, c’mom!  It ain’t that bad!…(Truth is, its probably worse.)  Intelligence and ability to think beyond today are probably two things that kill you in particular in this job.  Reading and writing are probably two things that save you.  Abuse to my patients and abuse from my patients are probably the two things that really bug me personally in the job, but BS from Co-workers and our Hospital colleagues probably does the most damage. We like to eat our young and recycle our dead and dying in this wonderful thing called EMS.  Great writing as usual, I could tell by the length that you had something to say.  The good thing is, you can always branch out.  Don’t let one type of EMS poison you to the whole thing, especially while you’re young.  I know for some guys and girls, (a lot of my friends).  Life was never more complicated than “gotta become a medic, gotta get a couple years experience, gotta get a helicopter job!”  For some you can replace the flight medic thing with “XYZ city Firefighter/Paramedic”.  Those folks are happy as clams.  They’ve got their job, their pension, and probably a family along the way.  There is nothing wrong with that, I love those guys! BUT there’s nothing wrong with wanting something different either.  Lots of stuff out there especially when you’re young with a few years experience. county, city, rural, rescue, fire, flight, wilderness, tactical, industrial, oil company/rig, resort, cruise ships, hospital etc…Enjoy the hard job you do while you can, jump ship before it kills you.  As for me, I haven’t decided what to be when I grow up, don’t know if I’ll be a medic again when I come home, don’t know if I’ll ever come home!  Its a big world though, and taking a look at everything from a different but similar perspective can sometimes make you either realize what you want, or appreciate what you already have.  Great writing, I enjoy the heck out of the blog!

    • parapup says:

       Thanks for reading!  I don’t know what I want to be when I grow up, either.  I’m not sure how much my body can take of this job.  Right now, I’m 28 and in tip top shape.  That won’t last forever, and the morbidly obese aren’t even pretending to learn how to levitate.  That stated, I love the good parts of this job so very, very much that it might just be worth it. Hmmm…

      Where are you now?

      • Geoffrey Horning says:

        I’m currently teaching EMS in Saudi Arabia, It’s a lot tougher for a woman, and I haven’t seen any Western women instructors…yet.  But the times are changing.  Plenty of Jobs in Qatar and Kuwait, Dubai and Abu Dabi.  S. Africa’s always looking too, but those dudes are seriously intense.  I blog about it and whatever else crosses my mind here:

        Great blog, really, really good writing and style.

      • Geoffrey Horning says:

         Also…yeah 28 and tip top shape won’t last forever. In fact, it’ll last a couple of years until its “30 and not exactly out of shape”, then 35 “OK I’ll exercise a little more”.  It just goes down hill from there.  I do know people that have stayed in great shape despite age and family and such, but they’re addicted to the endorphins.  No seriously, exercise to them is like religion, politics and a good book all in one.  Great folks, but I get uninterested after they 15 min conversations about juicers, and “eating like they’re ancestors”.  Glad I fall into the 35 and not entirely unhealthy just yet category. And you’re right, The Hostess company isn’t going out of business anytime soon.  Even in the Zombie Apocalypse there will be sno-balls. 

      • You should see what happened to us, altho I wasn’t working when it did. They were transporting a morbidly obese patient and dropped the stretcher, injuring one of the medics really bad and the other not as serious. But the worst part of it was that after it occurred, the man got up and WALKED of his own accord to the ambulance.
        He could walk all the time and didn’t tell them.
        I couldn’t believe that when I first heard it.

  • Rez Medic says:

    Wow, you’re my urban twin; my husband actually asked me when I wrote that piece.  Yes, we all need saves, but like fixes to an addict, we’ll just need more and more and more until it’s not enough to drag our ass’s out of bed and go to work. Every time someone asks me what I do, I tell them I have the best job in the world, and I mean it.  But it all comes at a price.  Personally I need a long vacation to put things back into perspective.  Keep on, sister.  Make time for yourself and those you love, learn to knit or garden or play with kittens at the humane society. Anything to recharge

    • parapup says:

       Ah, the emotional roller coaster that is EMS.  It certainly comes at a cost, doesn’t it?  Well, I’m glad to know I have kindred spirits out there. 

      I do try to keep up hobbies.  I just started taking a sewing class with my mom, but do you know how freaking hard it is to find someone willing to take in a student who will only be able to come every other Thursday?  Or I can come every other Thursday and every other Tuesday of the opposite week.  I tried kickboxing, too, but got frustrated for the same reason.  I really liked kickboxing, actually.  I can’t take a photography class because of my schedule, and online tutorials only get me so far.  If it’s not one thing, it’s something else…but damn, isn’t it just the most amazing thing in the world when you save someone’s life. 

  • Medic9five says:

    GREAT post ” PUP” Your best post so far. Love reading em ….keep them coming

  • john says:

    Thanks for the honesty.  It’s strangely encouraging somehow.  

  • I don’t TRY to handle CERTain types of violence anymore. Not that I say anything about it, I don’t, but neither do I feel as sorry for the abuser as the society at large appears to feel for them while experiencing NO emotion for the victims.
    My sister had a Trauma 1 emergency that I saw happening in front of my eyes.
    The paramedics who saved her life, and the EMTs who talked to us while paramedics were working my sister saved mine.
    I honestly believe I would have gone crazy if they hadn’t talked to me and acted like they understand; so convincingly that at 13 I really believe it. It’s why I decided to be a medic. I remember telling them that, and they laughed b/c in 1980, nobody with only 2 legs worked in EMS.
    I didn’t care though. I felt it like religious people must feel when they say they were called by God to do something. I felt an intense need to give back to families and patients what EMTs and paramedics gave me that night.
    They gave a lot more than you’d know. My two wonderful nephews, Aaron and Gabriel, and a life with my sister I never would have had without their intervention.
    You can never adequately thank a person for giving you back your relative.

  • Oldmedic says:

    good on you pup. I am on the street almost 30 years and “got the tat” and a bunch of damaged body parts to go with the career. You will cope well  with the bullshit I think because you recognize it and the burnout that is inevitable. Its the decision point for many medics. Can I find some grace and good in this job or do I move on to something else to stay clean and whole. No right answers. We all go to Hell our own way.

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