Fitness in EMS

Every once in a while, a trend starts regarding the fitness for duty of EMS providers, including a recent story of a fire department mandating fitness while on duty for their firefighters and paramedics. While I'm not on board with departments mandating fitness while on duty, I am on board with EMS providers needing to be held to a higher standard of physical fitness.

Those of you who know me personally are well aware I'm not a well-chiseled physical specimen. For years I've comprised my diet from the likes of McDonald's, Wendy's, and Burger King, with a few other specialties sprinkled in for bad measure. As a result, I've "suffered" the consequences of high blood pressure, high cholesterol, pre-diabetes, and an expansive waist line. The costs have also included being unable to keep up with my seven year old son or go kayaking with my wife...and much, much more.

In the past, I've been openly asked if I made EMS my career because "you're too fat for the fire service." As much as that statement hurt, part of it is true: I'd never qualify with a fire department. There's no "weigh" I'd make it through the rigors of fire training in full turnout, mask confidence, or maze courses. In fact, I will openly criticize any fire service that accepts morbidly obese members and permits them to participate in active firefighting activities, including pump operators and "exterior only" operations. It's not safe for anyone, least of all the people who are unhealthy.

Being overweight has caused me to question at times whether I can still do this job. All the aches and pains I experience on a daily basis are quite possibly related to 17 years of lifting and moving people...or are they? The continuous exhaustion is ridiculous. The desire to eat nothing but junk is damn near impossible to overcome some days.

Where am I going with this? I can't take the negativity, self-imposed or otherwise, anymore. I can't continue to be hypocritical when talking with patients about their life choices when I obviously haven't made the best decisions. I shouldn't have patients asking me if I'm okay after moving them down the stairs. And I certainly can't keep this up anymore. I'm sick and tired of feeling sick and tired.

Hi, my name's Jon, and I'm a morbidly obese EMT. I'm also a father, a husband, a son, a brother, and a human being that's just trying to live my life as long as I can. I'm making a change, starting today, to be healthier. If you're in a similar situation, better or worse, I encourage you to do the same. This is a big step for me, admitting I have a problem and openly sharing the details. I'll keep you up to date, and see how this all works out...I hope you'll follow me on this journey.

Response Policies, or, Responding Red at 11 pm

Only part of the conversation...

I recently participated in a social media conversation started by a former colleague of mine who openly questioned the response to a working house fire. At issue wasn't the emergent response but the manner of the response. I don't normally engage in these types of conversations, because there is rarely any real resolution achieved. However, seeing as I was an unwilling audience to the cacophony orchestrated that evening, I joined in.

Some background: I live in a "planned community" east of Rochester, NY. Not much happens there at night; traffic is generally non-existent after 10:00 pm except for residents coming home or going to work. I've lived there for nearly 9 years, and it's not a bad place to catch some shuteye without the drone of vehicles all night. 

So imagine my surprise when, at 11:00 pm, I hear what can only be described as a "mayday alert" traveling through the neighborhood. Multiple pieces of apparatus were rolling through to the aforementioned house fire using every audible warning device available on the vehicle: siren, Federal Q, airhorn. Simultaneously, and without relief.

Now, I have absolutely no concern with using sirens at night. In fact, state law requires it when lights are activated. However, situational awareness (and a little common sense) might dictate that the usage of all warning devices is overkill considering the hour, historical traffic pattern, and no reports of persons trapped. Needless to say, my statements to these conditions did nothing to appease the supporters of the local departments. One poster continuously pointed to "thanking" volunteer firefighters, another pointed to V&T law (which I had already agreed with), then provided the "kill:" you weren't there so you don't know if vehicles were failing to yield; maybe they did it on purpose; etc.

Therein lies the rub: as a public safety professional, you are held to a higher standard. If vehicles aren't yielding, back off, don't drive more aggressively. If you're raising the dead on purpose, someone needs to be held accountable. These are not the actions of a professional. If it's attention you're desiring, it's attention you will get, though I doubt it will be positive.

I'm going to add my own theory, something I'll call adrenaline. Adrenaline is a funny thing: it makes us go into Sonic mode ("gotta go fast..."). Unfortunately, those in the business of responding to emergencies need to harness that adrenaline and slow down. Making all the noise in the world and driving like a man possessed isn't going to get you there any faster (or safer).

Department leaders need to start stepping up and reviewing their response policies. This is already happening with the agencies I work with: all BLS responses and many ALS responses are now "green." There's just no data to support the usage of lights and sirens to be a time-saver in all but the most extreme cases of medical severity (think choking, cardiac arrest, or stroke) or distance. Before I get heckled for my lack of knowledge of fire behavior, I get it: fire doubles in size in seconds. But again, unless it's the most extreme cases (such as people trapped), there is zero need to make yourself look foolish to those you ask to support you.

Has it really been five years?

Five years ago today, I experienced what to that point had been the most frightening situation I’d ever encountered. It actually still ranks up there in the top two or three in my mind. At 30 years old, with young family and the bulk of my professional career with the company, I lost my job. No explanation, no “thank you,” just an abrupt “your services are no longer needed,” and out the door. It was a cataclysmic fall from a meteoric rise…and probably the best thing that ever happened to me.

I can’t blame the company. I mean, I could, and I did, for quite a while after my “meeting” that morning. I’d never been dismissed from a company before, and to have it happen without as much as a reason why shook me to my core. After all, I’d done everything that had been asked of me. I took every position asked of me, dealt with the “slimming down” of the management team, took on tasks once handled by three supervisors. To an extent I saw it coming, especially since I was asked to come in on a day I wasn’t scheduled. But regardless of how much I prepared, the result was still shocking.

I spent many hours (okay, years) brooding over this, feeling as if I’d never accomplish anything ever again. Being the personality type that I am, that many of us in EMS are, I needed a reason why. Why, after so many years of success, was I suddenly un employable by the company I’d been at the longest? Why, after doing everything I was asked to do (and more, in my opinion), was I put to the curb? Where did I go wrong? I still don’t have an answer, and I probably never will.

In the end, it was a rude awakening that nothing in life can be taken for granted and that I was way too comfortable in my position. Looking back, I see now that I was ignoring warning signs that probably started almost a year earlier. I was getting subtle messages that things needed to be changed, yet I did nothing to heed those warnings. I’m much more attuned to those little messages now, though sometimes I need to hear them a couple of times before reacting.

I also learned that feeling sorry for yourself for any great length of time isn’t going to change things. It isn’t going to get your job back, and it isn’t going to help you move forward. It’s only going to make you more miserable and restrict you to seeing that which you have achieved, not what you can still accomplish. It took me way too long to learn that lesson, and I probably lost more than one job opportunity due to my state of mind. Since then, I’ve doubled down on my chosen career field, made decisions to pursue certain opportunities while letting others wait. I’ve opened myself to more opportunities, especially ones that are outside my comfort zone. And while I haven’t achieved the rapid successes that I had in the past, the victories are considerably sweeter because I’ve opened myself up to something new.