Whether it’s suddenly losing a coworker or feeling the weight of stressful situations during this prolonged event, dealing with painful emotions is an inherent part of being a provider here at Boston EMS. Our academy aims to prepare us for difficult calls, MCIs; but this is one like nothing we could’ve prepared for. In this line of work; unfortunately, death becomes familiar. EMTs and Paramedics are exposed to death so often in the field that it truly becomes ordinary; until the pandemic began.

Then the call comes in for a fellow public safety member, gravely ill after a possible exposure; you are the one dispatched to take care of one of our own. We as EMTs and Paramedics are facing an identity crisis: the “E” in EMS has effectively been removed. What I mean by that is every decision, every action, and every treatment we perform (or don’t) needs to be carefully thought through to minimize risk and keep us in the fight.  The emergency begins with a delay in accessing the patient because you need to protect yourself and your partner. Time seems to drag on, you can’t tie the knot on your gown, the boot cover rips… you know there’s someone who actually needs our help inside. You finally make patient contact and realize the patient fits COVID19 criteria; low sats, tachypneic, anxious, and febrile. The reality sets in, this person was dressed like me just days ago, responding alongside me to the same calls, doing the same things.

The reality that we are not invincible to this disease sets in, our uniform which has been a shield from some trauma suddenly weakens, but you’ve got a job to do. You do your best to take care of your patient, discussing the inevitable with your partner. Do I tell them they’ll end up on a ventilator? Possibly never come off? They’re one of our brothers, I’d want to know… So, the discussion ensues: listen… your breathing isn’t getting any better you’re going to have a breathing tube put in and be placed on a ventilator. The discussion hits home, you begin to understand your morality in all this. Is everything of mine in order? What if I end up like this?

Days later you find out the inevitable: your patient, your fellow first responder passed away. No matter how close we were to the deceased, the simple concept of losing a brother or sister in public safety still has a deep impact on all of us. Grieving is difficult for everyone and should be done at one’s own pace. Everyone develops their own way of coping with loss, we need to honor our feelings during this process, both good and bad. Grieving is completely healthy, but if not handled properly, can lead to other problems such as depression or social isolation. More than ever, during this time we need to remember that social distancing is not social isolation and often just talking to someone is therapeutic. For the foreseeable future we’ll remain in a state of hyper-arousal during which the grieving process can manifest itself in different ways: fear, anger, irritability, or sleeplessness. Moving forward, working to maintain normalcy by setting schedules, sticking to routines, and ensuring you have time to yourself where you are disconnected from the current events including social media to decompress is beneficial in the healing process.

I pray this is the first and last time this topic arises; but in reality, we are all vulnerable, so I pose this question as closing: Are you prepared to have the difficult conversations? Have you taken the time to organize your personal matters? Have you thought about what has allowed you to be resilient in the past during traumatic events and how will those practices work given our current situations?