“10-4 Control We’re 10-8”
“One single word – like EMERGENCY, or love – can
revise a whole night. A whole life.”
— Alena Graedon
Several months ago I wrote a blog titled No Thanks Needed. This was one call that I worked while in the Emergency Medical Service (EMS) field. Let’s face it, no one calls for an ambulance or seeks out any helping professional because things are going great in their lives. Likewise, I didn’t seek out counseling because functionality was my No. 1 attribute. I began seeking counseling because I was being tormented though it was not voiced at the time.
The title of this post “10-4 Control We’re 10-8” I have said hundreds of times while working on the ambulance. It simply means, “Yes we are enroute.” I’m sure this varies from service to service depending on the differences in 10 codes and signal numbers nationwide but you get the general idea. There is no possible way to do justice through words what working in this type of job carries physically, mentally, spiritually and just about any other area of a human being’s existence.
As a teenager, I had my heart set on being a police officer. Then I determined that since I loved doing drugs that being a police officer was probably not the best option. However, I had the need and want to be in some type of helping profession. At a young 20 years of age the thought of going to school 6 years for a counseling degree was nowhere near the table. Finding out that I could go to EMT school for 6 months, however, was. I was beyond excited and totally immersed myself in my studies and training. My husband wasn’t real excited because the pay was extremely low in that career. But for me there was a higher calling, the want and need to help people.
I studied myself silly those 6 months and learned everything I possibly could about this exciting field that I saw myself loving naturally. We were told about different types of scenes that would be a high likelihood that we would encounter. However, nothing could ever prepare me for the things that I would actually see and experience. In my personal life, though, the grasp of the evil hands of abuse seemed to become tighter and tighter. He pretended to support my career decision but that’s all that it was….PRETEND.
In February 1997, fresh out of EMT school and newly married I got my first truck assignment making a meager $4.95/hr with the local ambulance service. I worked for an ALS (Advanced Life Support Service) which required that a paramedic to also be on the truck. This meant that the drugs given and additional skills that would be required were higher than my scope of practice. Some of these skills would include intubation, cardiac monitoring, starting IV’s, giving narcotics and various other skills that I as an EMT-Basic could not legally do.
Performing as an athlete required split second decisions but now it was not about winning ballgames it was about someone’s life. Mistakes now had a much higher price tag. The one thing I always tried to be as an EMT was humble. There were those that had a very narcissistic view of their position and thought of themselves as a god. This was not a stance of mere confidence but a stance that nauseated me to my core. Most of the time I would see this in paramedics which we would then refer to them as “Paragods.” Working alongside confidence rather than blatant narcissism was where you could really learn and working with confident paramedics I did learn.
We were taught in school about the importance of “self-care” while in this career that would be crucial to making it past the national burnout rate which, at that time, was only 5 years. Included in the self-care education was the importance of EAP counseling after a bad call or mass casualty. The daily stress of the job and the ongoing abuse at home ensured that I would never come close to that 5 year mark. There are laws now that regulate the amount of hours that a crew can work without downtime but then apparently there weren’t. It was nothing to have to work 24, 36 or a 48 hour shift with very minimal sleep and/or food. We were commonly called “Trauma Junkies” because it seemed the more horrific the scene the better as bad as that might sound.
There were several “bad calls” that I experienced but only a couple where afterwards I went to a supervisor to request EAP services just like what was suggested. What I was met with was the attitude of “if you can’t handle your job then you might need to consider another career.” Not only that but then you have to face being ostracized by not only management but also the other medics in the company and seen as “less than” or “weak.” So, really the only option was to “suck it up” and somehow separate mentally from the daily harsh reality of life.
Anyone who has ever worked in some form of EMS services understands that as a means of survival the job requires that emotions be put to the side and you function purely on logic. But suppressing these emotions does not mean that emotions were not affected. In this kind of career there is a lot of maladaptive behaviors that take to the forefront namely drug/alcohol addiction and a high rate of suicide. Not surprising but nevertheless a reality. I saw things and was involved in situations that the human brain has difficulty processing and accepting.
My husband’s opinion and others that I’ve spoken with at times posed the statement, “Well you chose the career” or “You have the easiest job on the planet. All you do is sit on your ass in an air conditioned truck.” Easiest job on the planet couldn’t have been farther from the truth. It was one of the most dangerous and taxing jobs that one could possibly encounter. The downtime that we would have sitting in the truck “posting” at a location was only due to other trucks being on calls and us covering their area.
I have always replied, “Well then who else was going to do the job? You?” That was always met with silence.
My husband, at the time, was a newspaper editor and well he didn’t and still doesn’t have a clue what that type of job entails. I told him more than once, “If you can work on someone’s mother, father, grandmother, child or grandchild for them to still die even after your best efforts and then go home and lay your head on the pillow and sleep soundly doing this day in and day out then you’re not human. You’re a machine.” The ability to function like this day in and day out requires a certain degree of callousness. But make no mistake that those calls bothered me then and now.
For the last 21 years, I have run some of those same calls all day and all night like my career never ended. The putrid smells of rotting flesh from week old dead bodies that had to be taken to the morgue I can again smell at random times throughout the day. The smells of blood, fuel and mud/dirt from car wrecks. The screams of mothers who I had to tell that their child was dead or wouldn’t survive due to the severity of their injuries. The horrible images of abuse and/or neglect of children, adults and the elderly. The smell and site of exposed brain matter from head injuries, suicides and or murders. The individuals that died simply because you couldn’t get them out of the vehicle because the jaws of life were being used elsewhere and subsequently the vehicle caught fire and were burned alive. The children that would look at you and ask, “Are you going to help my momma or daddy?” While knowing full well that their parent was already dead. The decapitations that looked and felt like you were in a real live horror film. And the leftover pieces of meat that don’t even resemble a human body after being hit by a train consume my thoughts and emotions when most people lay down for a night’s rest. It’s at these times, once again, that my shift starts on the once beloved career working on an ambulance. I didn’t work several years. I only worked one year on the ambulance until the abuse at home combined with the daily trauma that I was exposed in this career caused me to buckle. I saw enough in that one year to still have me waking up in the mornings with my face and shirt wet with sweat.
Without fail whenever I see or hear those lights and sirens, I instantly want to run and jump on the truck and ask, “Ok. What kind of call are we going to?” Sometimes I’ll still listen to a local scanner to find out what’s going on throughout the city especially on a weekend. I will also hear those very same words, “10-4 control we’re 10-8” and then the crew is given the next location for an additional call. It’s in those moments that I realize that EMS and the need and want to help people will always be a part of me. And at night I realize that EMS is still a part of me.
One of the most powerful lessons that was taught to me through experience of working in EMS is to tell those that you care about that you love them even strangers because you might be the only one that speaks those words. The last words you say might very well be the last words that are said.
“The most basic job of an EMT is to notice things and then wonder about them.”