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58 APRIL 2016 | EMSWORLD.com THE MIDLIFE MEDIC By Tracey Loscar, NRP, FP-C Perhaps that older par tner is not really bored, they are simply calm. D o Yo u L i ke Yo u r J o b? What you love about EMS may change over time R ecently, one of the younger medics I was doing my orientation with asked me, "Do you still like running calls?" We were washing the ambulance when he asked me that, cleaning off the accumu- lated grime from spending a night driving on Alaska's sand-covered winter roads. I am an anomaly in my agency. This is a young work- force, most of the full-time staff come in with under five years of paramedic experience. There are a few at or just above the 10-year mark, and I am the only one with over 20 years as a paramedic. I can admit with some pride and a fair bit of horror that I have been wearing a patch for longer than many of them have been alive. I have had to add a new dialect to my EMS lexicon. They do not "go on jobs" or "take an assignment" here, they "run calls." They do not work for an agency, they "run with." It feels informal, intimating more of an affiliation than a job description. It's like being part of a gang or club, versus being employed by an organization. The question sounded so odd to me. I reflexively said, "Of course." He kept washing the truck, not meeting my eyes as he went on to say how he's met many older medics who just didn't like going on calls anymore. They seemed angry, bored or frustrated. I've met many of the same. There are plenty among my peers, I've seen the arc from enthusiasm to apathy dozens of times over. Am I the anomaly again because I still like my job? Like my advancing grey hair, is that degradation of compas- sion or work ethic inevitable? No, it isn't. Apathy is a choice. I love my work and where I work. What I love about it, though, has changed over time. My perspective is dif- ferent today than it was when I was barely legal. Driving the ambulance with lights and sirens does not have the same appeal once you've been entrapped in one. Don't get me wrong, I have done my time driving that 8-ton box like a stock car, but today my primary goal is to get there safely—not only for the benefit of your loved ones, but for mine. The calls that excite me are different now. I have been on thousands of GSWs in my career; after a while you realize that a hole is a hole. Early recognition of respira- tory failure, on the other hand, may place the outcome entirely within my decision-making and clinical skills. This job is never boring, but with experience the large majority of calls become a more easily managed expe- rience. Urgency promotes a sense of fear, and that is contagious. Managing your response will go a long way in managing the reactions (or overreactions) of those around you. Perhaps that older partner is not really bored, they are simply calm because they have very likely seen a case similar to this one before and are bet- ter prepared. Kyle's question made me evaluate what it is about my job that I enjoy at this phase in my life. I love being relevant, learning new things and applying them to the same calls. I make an effort, when I can, to genuinely smile at a patient. I love it when you can see them relax just a little and smile back. That at this point, I can exude enough confidence that says, "It's OK, help is here now, we've got this." Differentials, I love differentials. Interview techniques, looking for clues and sorting through history. Giving report—I love to have made enough order out of the chaos to run off a smooth report that transitions care without a hitch or an eyeroll from hospital staff. To be mature enough to have the strength to advocate for those patients who cannot do it for themselves. Most of all I like the laughter. In recent years we have heard about and seen so much tragedy that comes from our line of work. Somber pictures that describe a field of professionals forever haunted by the ghosts of those they could not save. It is important to remember that we are not all broken, lost in a morass of grief and self-loathing over perceived failures and exposure to the worst moments that human life has to offer. Many of us—most of us even—still find joy in our daily work. We have all kinds of laughter here. There is the laughter between partners at a private joke. The chuckling that comes from gallows humor as those around you automatically convert horror to humor and understand why it's funny. The semi-delirious joking around at 2 a.m. in the ED, when you are all overtired but the calls keep coming in anyway. Laughter is contagious too. It helps, it heals. Yes, Kyle, I still like running calls. I hope you will too. A B O U T T H E A U T H O R Tracey Loscar, NRP, FP-C, is a battalion chief for Matanuska- Susitna (Mat-Su) Borough EMS in Wasilla, Alaska. Her adventures started on the East Coast, where she spent the last 27 years serving as a paramedic, educator and supervisor in Newark, NJ. She is also a member of the EMS World editorial advisory board. Contact her at taloscar@gmail.com or www.taloscar.com.